Diabetes Disparities Courtesy of the VA

I have Type I. I have been in contact with another Type I (in Kansas City) who also uses the VA. I found out he has a CGMS provided to him free of cost - including all supplies - by the VA. I asked my VA endocrinologist in Durham, NC about getting one from them. “No dice” she said. The VA does not cover it. When I told her about the vet in KC, she seemed surprised. A week later, I talked to a senior staffer about this, and she shared a secret. Different VA networks cover diabetes supplies differently. In KC, you can get a CGMS if Type I or Type II. You can’t have one in Durham, NC regardless of type. But Durham gives out meters and strips to Type I and II. But if you are in Fayetteville, NC’s hospital, you get a meter and strips only if Type I, but not Type II.

Inquiring minds want to know one thing: WHY?

I think that’s terrible. Maybe you could throw a fit to your congressman, or something

Good question. Really why? Can you see an endo living somewhere else even without moving? Just to get the CGMS??

Sorry, what’s a VA?

government bureaucracy and lack of communication between which leads to incohesive policies?

More homework and letter writing for you and others , Tom .
Advocacy is never finished .

The “VA” is the Veterans Administration.

Here is how it works. If a veteran is eligible for medical care from the VA - and not all veterans are - they have to enroll. Based on where they live, they are assigned to a Community Based Outpatient Clinic. If they are lucky, there might be more than one Primary Care Physician in that clinic. If not - they get to see whoever happens to staff that clinic. Specialty care means going to a hospital that takes patients from a collection of nearby CBOCs. Keep in mind that for the veteran, they may go to see a specialist in a hospital that is not the nearest VA Hospital. If they need emergency care, or are just plain sick and need to see a doctor, then they are supposed to go to the nearest VA Hospital, which might be different from where they might go if their PCP or specialist wants them admitted.

Confusing - isn’t it! And in case you wonder - this is all a ‘take it or leave it’ proposition. I can’t tell you all how many veterans I’ve talked to at the diabetes clinic at the Durham VA Hospital who had to drive 3 hours or more to get to an appointment. As for choosing your doctor, or taking the best available treatment - it is like dealing with your local Post Office or DMV.

Some comments to this blog post have suggested letter writing to elected representatives, or otherwise “fighting” this. It is an idea I’ve considered, but it would most likely be like asking the Post office to deliver only when you are at home, or getting them to have additional clerks manning their customer service counters. Another suggested moving to take advantage of better access to CGMS - the central point of my blog post. I’ve moved 18 times in my life, and if I never move again it’ll be just fine with me. To go somewhere else just to get CGMS is not really a good enough reason for me to go through all the work of uprooting my family