Greetings Brian,
If you have been blessed with good health, it might be difficult for you to understand what TuDiabetes does for those of us who have not been so fortunate. What I get from my Dr. is the meat of what Diabetes has and is doing to my physical body. My Diabetes Educator fills in some of those blanks. Everything else I get here. The practical stuff, the emotional stuff, and yes, even the spritual stuff. Unless you have been blessed with Diabetes it may be difficult for you to understand this isn’t just a “social network.” These people are my family. What I get here is something you can’t get from the Dr. or a CDE. What I get here is support when I want to quit, an understanding that my Dr. will never have, because he is not Diabetic. What I get here is men, women, and yes children who have been where I’ve been. Many of them have climbed this mountain before me, and the encouragement they have to share with me isn’t something you can get from any Dr. When I’m on the mountaintop, I get to share with someone else who is in the valley. What I get here (at the expense of sounding corny), is the kind of love that can only come from those who understand my plight. You see, Brian, I have never met any of these good folks face to face, but what we give and get in return is something that can only come from family. My vision is a huge TuDiabetes Convention where we will one day extend the right hand of fellowship. When I meet Manny, and Melissa, and Kevin, and Saundra, Marie, George, and the list goes on and on, we will know each other because we have already been in the trenches together. What we get here in this place is priceless.
As far as insurance, I am one of the fortunate ones-so far. I wonder sometimes with my rising costs to treat this disease how long it will last, but I have no reason yet to believe they will drop me, but that is always subject to change within the wide world of Insurance Companies. There are some things though, my insurance doesn’t pay, so even though they paid for my pump, I have lab fees right now that I am behind on–so… I watched helplessly as this disease very effectively destroyed my mother’s life, and can’t help but wonder if her insurance had paid for better treatment if she would still be around. When I was first diagnosed with this disease I tried desparately to find a treatment center for Diabetes. I was told at every stop that the Insurance Companies are what prevents that from happening. Are you kidding me?! It only makes good sense to me if I can go to a treatment center for Diabetics where I get the best training, education, and technology to set me on a path to good health with diabetes, then I’m all for making that happen if I’m in the Insurance business. If you can help cut the cost for insuring people like us, and knock that right off the top, how do you possibly say no to something that is going to make you money. Now granted, not everyone that goes to treatment is going to respond favoribly, but for everyone that doesn’t there will be two who want to live.
Well that’s all. That’s my contribution to TuDiabetes today. I hope your one of the good guys, Brian. I hope this is about you making a difference and not about you making money.
Peace to you and your family,
Bobby
I have thought some more about this…if my insurance company had a site for fellow diabetics to chat, I might learn how others in the same system better use the coverage. Any opportunity for people to share and learn is worth considering.
That must be it exactly…the insurance companies assume we will be with another company when the complications strike. It seems obvious, though, that someone else with another company now will be with them when their potential complications present themselves. Short term bandaids vs longterm fixes.
Hear Hear! Well said Bobby!
I caught this show and thought it was important. We all to learn how health care is delivered around the world.
Maybe we could get a better system for America. Select the watch online button at the top of the page.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/
Hi Brian
I totally agree about the first question. TuDiabetes has been a life saver for me. I have shared with my doctors about my involvement on here and have gotten extremely positive feedback from most of them. One of them had no idea what i was tallking about. I feel that I am stronger and healthier for being with our family here. And i believe that we can handle anything when we have such a great community backing us
Unfortuately, my answer to the second question is ABSOLUTELY NOT. I don’t mind them knowing what we talk about, but I object to them having any say in anything or adding anything to our discussions , groups or fourms. I have received nothing but extremely inappropriate communications from my insurance company and have asked them to leave me out of any further advice they have. An example of cost cutting efforts on their part is this. I am taking the highest dose of Diovan because i desparately need it. The insurance compnay sent me a letter asking me to voluntarily cut my med in half and take only a half a tablet per day. Do you thnk they want me to do that because they care about what will happen to me if my blood pressure gets so high I have a stroke or lose what is left of my kidneys? So what happens if they get a chance to tell us what they think we should be doing because they have access to our thoughts and feelings on here. Do you honestly think any changes that come up will be to our benefit or will they continue to make cost cutting changes that are not to our good health?
I apologize if I seem hostile. I don’t mean to be rude with anyone. I am just definitely very opinionated about commercial people who can make changes to our open, trusting, loving and supportive family. We are close and treat each other as family. I don’t want to lose that.
But wouldn’t insurance companies want to stop this kind of interaction amongst their clients? I mean, if you find out they approved my medication or device and they didn’t approve yours, you’ve then got a leg to stand on in your appeal. They benefit by isolating us. They benefit by making the coverage process more difficult.
When my mom worked for an insurance company that shall remain nameless (1998-2006), she was rewarded for shorter call times and was told not to escalate people’s issues to a level where someone would do something about it. When people asked for a manager, they were handed off to another random rep in the cubicle who pretended to be management. This is the “customer service” that insurance companies offer. I would have to take any community organizing sponsored by my insurance company with a grain of salt. It’s like going to a specific-pump-company-sponsored pumpers support group. It’s essentially a sales rep or a nurse/doc with ties to the company telling you how you don’t need anything but their product.
To get coverage for my CGM, by some miracle, I found out the extension for the exact person denying my claim and was able to get an authorization number from her after pleading my case for a continuous glucose monitor. What was taking months and months of paperwork, painstakingly prepared by my doctors and me and sent into the blank void of “the insurance company” culminated instead in a less-than-ten-minute conversation where a woman asked me how often I went below 50 and I said “on average, 6 times per month” and she said, “approved.” But do you understand how impossible they make that person to get to? She’s not in the phone tree.
“If you wish to get help for coverage for the medically necessary prescriptions your doctor and you feel are imperative to control of your illness, press 1.”
And what happens to my coverage when the CGM keeps me from having those lows? How do I prove to this company that the product they pay for is what keeps me healthy? One of our members here is going through this as we speak.
A remarkable video segment. I encourage people to watch.
We just need to prove that all this typing burns glucose …
- Yes, because after working my way through all the posts, I tested my blood glucose. And made an insulin adjustment. And yes, because in my heart I know reading about and typing about diabetes makes me better understand what I can do to improve my control, empowers and encourages me.
What do researchers say? I know of one weight-loss study that included a social network component. Jean Harvey-Berino at University of Vermont and founder of Vtrim Weight Management Program (uvm.edu/vtrim) concluded for a story in the magazine I edit, Diabetic Living: “Internet programs can be as effective as in-person programs both for encouraging initial weight loss as well as long-term weight maintenance.”
Researchers are interested in using social networks to stem the tide of type 2 diagnosis: http://www.canada.com/montrealgazette/news/arts/story.html?id=8f1a621b-241e-4956-b1d5-aeea007e7ec9
- Yes, insurers should play a role in this conversation. Certainly, even those companies that already offer extra services to try and trim their costs associated with high-risk chronic-disease groups such as PWDs (newsletters that are too basic when you’ve had diabetes for years, calls from nurses who know less about day-to-day diabetes challenges than we do) might get a little smarter about what would really help.
The more awareness and discussion, the more people who may find help living with diabetes. Plus, I believe authentic social network sites such as tudiabetes.com will prevail.
I am curious what the “role” for insurance companies would be. I think if it means insurance companies LEARNING about the life of people with diabetes in general, that sounds potentially good. If it means insurance companies tracking their patients, that sounds potentially scary.
I truly value the social networking, particularly the community here at TuDiabetes. The only situation that I can imagine where people touched by diabetes would GAIN from insurance company reps joining the dialogue would be to understand what it is like to live with diabetes. But I have a hard time imagining insurance representatives being good at listening. (Sorry Brian.) It just is not in the current incentive systems.
Hi Brain, I’m loving your post. Thank you for ASKING about the proper role of an insurance company, and declaring your conflict-of-interest up front. Huge numbers of ‘social networking’ sites, and even OTHER kinds of sites (e.g., 'Linux" and ‘Free Software News’ sites) are now being Infiltrated and Hijacked big business. For example, on many of the sites I just mentioned, there’s recently a vast upsurge of “People” post all kinds of “My Windoze systems all work great”…
While being PAID for those posts (either by the Post, or as an actual hourly JOB) while doing so. And not disclosing this. These social networks, need to be, I feel, respected as networks for INDIVIDUAL PEOPLE to discuss their shared interests. Infiltration with large amounts of commercially-compromised posts, portrayed as “member” material, would not be a good thing.
So, basically, please stay out. There is, on this particular forum, a special kind of “Discussion” created from time to time-- where a highly qualified professional is invited to speak as a professional, that person’s affiliations clearly shown right at the top of the discussion.
As for encouragement by insurance companies, directly to THIS community, I must also say “no thanks”. Feel free to encourage them to visit an independent search engine, e.g., Google, to look for communities like this one-- tudiabetes is pretty easily found. But a direct recommendation of a particular site from an official insurance co. communications arm is starting on a very bad path.
Thanks for asking, YOU are obviously a great guy. If you continue to remain here and take part, ( and I think I’d actually like that), I’ll only ask that you PLEASE disclose the fact of your “insurance affiliation” right at the top of each post you make.
One social network I participate in is the newsgroup alt.support.diabetes. It has been more successful than most health providers at getting its type 2 diabetics to control their blood sugar levels. If you want to see a gathering of their advice about how to do this, see here:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm
I don’t see much role for insurance companies in this except that it would help if they would loosen their restrictions on paying for the extra test strips needed to use this plan, typically about 8 a day and often even more at first, in exchange for the cost savings in paying for diabetic complications this better control gives.
The insurance companies might find it useful to pay for studies into whether a low-carb diet works better for controlling type 2 than the low-fat diet normally recommended; the research reports I’ve seen so far indicate that it does, partly because after the first few days, the sugar craving usually disappears. People that doubt this should ask a number of food animal farmers what they feed their animals when they want them to gain weight. They should also be careful not to accept a definition of low-carb diet where more than half its calories are from carbohydrates, or assume that all the glucose the brain requires needs to come from carbohydrates in the diet instead of letting the liver produce it from protein. More research into which “complex carbohydrates” help matters by being slow to digest would also be useful; results so far indicate that many of them don’t.
Expect some parts of the food industry to be against some of the changes these ideas call for, since it is likely to reduce profits for the companies who make high-carb but low-fat products.
I haven’t been keeping a close track on how well the alt.support.diabetes newsgroup works for its type 1 members.
Note that it doesn’t help that newsgroups are becoming harder to access these days.
I am sure you know that it’s OBVIOUSLY not the same thing, but what if a health insurance company did what Progressive Auto Insurance does? i.e. they offer quotes from different companies (including theirs). Arguably their quotes will get them the kinds of drivers that they are seeking to insure, “passing along” drivers that do not fit this profile to other companies that do seek to insure them.
Now, THIS WORKS only because everyone can get car insurance (in the US): it’s just going to be more expensive for those with a driving record with spots on it… I don’t know if this would work in our case, but I guess I was thinking out loud. Anyone else?
Interesting…and that’s only 5 countries…does the US differ greatly from any of these?
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Yes, social networks help in many ways.
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There are trust issues with insurance companies, but the issue of insurance company involvement in social networks is not solely about trust. Insurance companies are not in business to help us live healthier, happier lives. They are in business for profit.
The health care system in the USA is an utter failure. We spend more on it than almost any other developed nation, yet rank way behind almost all other developed nations in things like infant mortality and life expectancy.
Sooner or later we have to see that health insurance is a bloated middle man that seldom benefits either the consumers or the producers of health services and products.
Health insurance companies just take our money and tell us why we can’t have it back when we need it. The business is based on a bet that we cannot get our money back once they have it in their hands.
If the question is, “Should health insurance companies be willing to foot part of the bill for maintaining social networks that benefit the health of members?” the answer is, “Yes, but with no strings attached.”
Good luck with that.
This “no strings attached” idea should be applied throughout the health insurance industry. Their dealings with doctors should be with no strings attached. Their deals with pharma companies should be just about patient health, and not kickbacks or discounts.
But that’s not the way it is.
I think that if we looked at it objectively, one of the reasons for our stats on infant mortality and life expectancy would turn out to be that we accept into our country undocumented workers (and their families) who do not qualify for health insurance, but who are not turned away from our emergency medical services. We are talking about people who are paid less than minimum wage, whose food options are likely to be less than healthy, and who do not have access to preventative or alternative healthcare.
Also, if we looked at it objectively, we would find that our understanding of “preventative medicine” has shifted from “healthy diet and lifestyle” to multiple pharmaceuticals, which hike both the immediate and long-term costs of care due to increased tolerance of the therapeutic effects and sensitivity to the side effects of these pharmaceuticals.
Two good topics.
#1: Yes, social networks encourage positive behavioral change. There’s lots of research to support this statement.
#2: Thanks for stating that you work for a health insurance company. My comments are not directed at you personally. I don’t know you.
That being said, insurance companies are not in business to improve your health or cover your care, they exist to make money.
They make money by getting premiums and not making payments. They want healthy customers who will not file claims. It’s called “cherrypicking”.
Comments about how insurance companies would save money by covering CGMs or other items are off the mark. They don’t want sick people (diabetics) in the first place. If you are a healthy customer and you get sick they want to get rid of you. Do some research about insurers retroactively denying coverage; I believe the term is “recission”.
Insurers don’t care about saving money long-term on sick customers because in America’s fragmented health insurance system it’s likely that the person will lose coverage and become some one else’s problem (now with a pre-existing condition).
I have had Type 1 diabetes since 1991. I have lived in the US, Canada, Thailand, and Japan during that time. I’ve had no insurance, employer-provided insurance, and national insurance at various times so I can speak from personal experience. In the US, the private health insurance industry is THE problem with health care.
Yes to number one and a maybe to the second. We live in Canada and are very fortunate that my husband’s insurance through work covers all of our son’s test strips and syringes for nothing. But not everyone is that lucky. I have never trusted insurance companies and have seen them cut vital medical needs off (to other people) due to silly reasons. I think it is fine that they read so they really know what people are dealing with but I personally don’t have much interest in their reasoning. Money and medical treatments just don’t mix. Money just clouds the thinking of insurance companies. So many people are denied the care they need. It is so sad to hear when a person is limited as to how much medication they can take because some insurance agent sitting behind a desk says so. My first husband broke his neck and became a quadrapalegic. AISH (Assured Income for the Severely Handicapped) actually had the nerve to refuse him coverage because he “was not disabled enough”. Now, how sick is that! The guy just breaks his neck and some clod sitting behind a desk tells him that he gets nada because he is not disabled enough.
So, as you can see I don’t trust insurance companies enough to really have them around.
Behavior change can come about via social networks but it is not easy to measure. As far as Insurance Companies, it is not what the pharmecutical companies want. To be specific - behavior change that decreases the need for meds also decreases profit for the pharmacea. I would think that this is an emerging field as I see Blue Cross is aggressivley trying to contact me with phone support by an R.N. and a “Your Diabetes Workbook” sent to my home. I finally connected last night and the nurse was great. We need to remember the masses with lower education and motivation. It is nice to see this new educational trend. I hope it takes hold. I hope you can visit an article I wrote a while back on the importance of education and motivation at this site - just copy and paste in your browser:
http://www.helium.com/items/404491-living-with-type-1-diabetes
Thanks for asking two great questions that I hope our national leaders consider.
The ADA which keeps pushing the idea that low-fat diets are the best way to control diabetes, with a definite shortage of scientific evidence to back up that idea, and the similar groups in other countries that keep pushing the same idea with the same lack of scientific evidence? The scientific reports I’ve seen on that subject seems indicate that low-carb diets are more likely to work, at least for those with type 2.
http://www.nutritionandmetabolism.com/content/5/1/9
http://diabeteshealth.com/read/2008/06/26/5802.html
They also keep pushing the idea of defining a low-carb diet so that all the glucose the brain requires must come from carbohydrates in the diet, instead of letting the liver slowly make it from proteins and thereby keep the peak blood glucose level low.
And the idea that no one will follow a low-carb diet well anyway, in spite of the fact that most of the people who have tried one that is low enough find that after a few days, the craving for carbohydrates tends to go away and leave you less hungry than a low-fat diet with the same total number of calories.
And the idea that cholesterol in the diet must be eliminated, in spite of the fact that for most people, the liver makes more cholesterol from carbohydrates than is found in the diet. Most diabetics on low-carb diets have found that their cholesterol levels eventually go down, even if they keep eggs in their diet.
There are, however, some medical problems for which neither a low-fat diet nor a low-carb diet is likely to control both the weight and blood glucose level well without correcting these other medical problems first:
http://cushings.invisionzone.com/index.php?showforum=199
And also a variety for which just one test is unlikely to find or rule out the problem: