Healthcare reform in US and Diabetics...What do you know?

I have been watching C-SPAN the last few mornings to see what the “Elected Officials” are telling the people. From what I am learning, everyone will be MANDATED to get insurance and the companies can not deny coverage for pre-existing conditions, but what they aren’t telling you is that the insurance can be a much higher rate for us because of diabetes. The Blues are beginning to limit the amount of test strips they will pay for to 3 per day. They say that is because that is all Medicare pays for so that is what will be happening for all diabetics. Fair or not, we, as diabetics in America, need to get some letter writing and phone calling going out to these Congress people. A lot of them get BIG $$$ from the insurance companies and are shareholders in them. Who will be getting rich and who will be going in the hole?

Thanks for posting this thread Catherine…and you are spot on! I went to one of those town hall meetings Tues evening here in Missouri w/ Senator McCaskill. I was called by an old friend and urged to attend to balance the feedback she was getting from the community…I guess there has been a lot of organizing by groups wanting to stop healthcare reform. It is well know insurance concerns organized groups to bring down reform the last time it was considered (called astroturfing)…these companies were lobbying firms funded by the major interests. Well…the meeting here in Missouri this week was a circus…people were chanting that pharmaceutical and insurance companies should make all that money! When McCaskill began talking about the extreme costs of diabetes care in the US…they geered and she then began talking about “accountability” and reducing costs. I talked w/ McCaskill before her run for Gov. and she assured me she understood the issues around diabetes and costs…and stem cell for that matter. I am not certain if she was pandering a bit…saying key words (accountability, responsibility, reducing costs) that they automatically agree with.

I put out an email to all the people here on Tu in the St. Louis area that I think we should try to form a coalition of persons w/ diabetes and experts to meet w/ her to clarify some of these issues. I know she is powerful and can make a difference. I would urge anyone who is concerned about paying for healthcare and quality of healthcare…to contact their reps…and maybe do more than just write or call. Face to face is always better and anyway to document the interaction…the better…make THEM accountable! This bill may actually go through…and it should reflect the needs and concerns of diabetics.

Oh…just as a last point…I submitted a question at the town hall…on limiting costs of medications and durable equipment so that people can actually afford them! especially w/ all the talk about “accountability”…but, my question was never asked. You are right…these folks get a lot of money from Big Pharma, insurance companies, and providers to meet their needs…who lobbies for the people? The answer is nobody. It is a democracy that does not work…we need to put pressure on to reclaim some of the functioning of a democracy. Anyone in the St. Louis area…or Missouri…feel free to contact me and hopefully we can get a large, diverse group together to meet w/ our Sens and Reps. We are also wanting to put a spotlight on International Diabetes Day by lighting up the Arch in St. Louis…getting their support for such a measure would open some dialogue in the community about diabetes and better health for all.

Another thing I am questioning is with all this is what happens if you can’t afford coverage because of pre-existing conditions. The diabetes thing they are talking about is Type 2 diabetes, not Type 1. They don’t realize that Type 1 is a much more dangerous condition that is very sensitive to changes in management.

Right! We all may be guaranteed “access” to healthcare insurance coverage…but, will we be able to afford it (they can price us out of the market) and will our care be covered immediately? all questions that need to be answered and spelled out in any bill. I lived by the reimbursement guidelines written in the revised Medicare bill about a decade ago…they left out certain types of care…so, no body would pay for them! Meanwhile, things such as PT/OT/, etc…were all covered and companies sprung up across the country…interestingly, started by some of the very legislators that wrote the bill! If we are not written into the bill and very clearly covered…we have lost the chance to be so. At the town hall I attended, they brought up the reimbursement of docs for discussing options of care w/ patients…because they were worried docs would not get paid enough:) So, the AMA is looking out for it’s interests…we need to voice our concerns about coverage and access for all.

Yes…one of our goals in meeting w/ our Sens/Reps would be to educate them on the differences and needs of different members of our population. All types and levels of disease need to be considered and treated equally.

Town meetings are only for the people who aren’t paying attention to the legislators and are being fed a bunch of lies by friends. I am not able to run for office due to my job nor am I allowed to be a lobbyist because of it. Are there any Type 1’s here in NW PA where I live so that we can get together and meet with these people to make sure chronic conditions are covered and not excluded because of cost. What they forget is that if they would cover 8-10 test strips per day and education for people with diabetes by people with diabetes, instead of people just out to make a buck and not really knowing what they are talking about, teaching people about control and proper eating habits that they would save so much more money by not having people in the hospital and losing their sight, their legs, their kidney function, having heart attacks, etc.

if the Blues are saying Medicare only pays for 3 strips per day, they’re not telling the truth. (There seems to be a lot of that in the Health Care comments). With a prescription Medicare pays for my 10 strips a day.

My BSBC coverage only allows me 3 strips a day already. Believe me, I’ve argued with doctor and insuraunce company about this. I was able to test 5x a day on my last prescription but this time they tell me only 3. Very frustrating.

Hi Catherine! I have Medicare as my primary insurance. The only way you can get medicare to pay for more test strips is having your doctor write them a letter to say why you have to test more than 3x’s a day. I test 10x a day and at the first of the year, I have you send Medicare a three months of back log books showing you are testing that many times a day. You can do that with any insurance company… If you have a Doctor letter, they cannot give you a denial… I like your post though and very true… It’s not fair for what Congress is doing… I know alot of you do not have health insurance, I was there too until I got disable by Social Security and that took 2 1/2 years but I got it done. I’m with you Catherine, We need to fight but I’m not forsure how… Calling and mailing letters is a good idea but will they read the letter and recieve our phone calls? I wish I had the money and to go Wahington DC. I’ll handcuff myself to the fences around the White House until I was heard from every member of Congress! Sorry, I was getting alittle out of hand… :}:}:}:}

Hi all,

There is this social network from the Public Health Institute, Dialogue4Health Social Network, where I believe, we can find information of were to go, and who to write, and so on. Here is also their regular site: Dialogue4Health

I haven’t had a chance to research the site yet, but I believe it would be helpful.

I think a lot of this is specific to the plans negotiated locally and by employers. What I have noticed, is that in my state of Missouri…my insurance is a lot worse than when I lived in Boston. I worked at 2 top ten hospitals in both states…no reason for them not knowing what kind of care to provide. The absolute worst coverage (and by the way…most expensive) has been when I left a large, teaching institution. I think it is all about lack of regulation on insurers and power (or lack) to negotiate good plans for your employees. My point is that if it is better for us all and results in less disease and costs…why not just say this is the standard of care and all insurers have to cover these things…but, any business is bound to a goal of profits and providing care costs them money. I personally think the only way to do it is to not tie it to employment. By the way…how do you get insurance…what kind of employers have you had? I have only had 3 different employers in my 20 years in the work force. I suspect my next job will be at a university, teaching and I will probably stay there the rest of my career given how one works there way up to tenure…glad that they are progressive and would argue for the best possible coverage for employees under our current system…or maybe I will have more choices if we get reform.

Well said!

Thanks Andreina…I found some of the links to planning a visit to legislators, etc. helpful:) Printed them off for our local planning meeting here in Missouri.

Catch my blog posting on this subject at http://bit.ly/Wo5lU

I also have great health care with Cigna but it is still impossible for me to keep up with the monthly bills, 20% adds up. I’m more concern with how the cost of health care has grown. I get what I need but I (we) all still pay too much! Health care is not a profit business or should I say that it should NOT be a profit business.

Many have argued with me on this point but I have lived in Europe for many years and I had great health care. We need a single payer system and it’s very sad that the general public labels that socialism. Personally, I believe in social programs and socialism but I do realize that in this country that is a four letter word.

Hopefully, they will at least include a public option in the health care bill and I can only hope that will help to bring the costs down.

I’m tired of the quality of my life and the lives of others having a price tag on it.

I’ve been given all I need by Medicare.
I think one should go to Whitehouse.gov and get answers.
I’m sorry to see so many lies and screaming in town hall meetings. People don’t seem to have much civility in their debates. Our democracy is based on a knowledgeable populace being able to debate.
But the only way to know is to get it straight from the dot gov source.
It’s not just the impoverished who need universal health care and a one payer system option. Our whole country needs the preventive care health care reform brings. Just think if everyone were tested at regular intervals for diabetes and given treatment as prediabetics. Diabetes could be diagnosed early, rather than after complications exist. It would no longer be known for its complications. Disease statistics in the US certainly support our getting universal health care and a one payer option when compared with those in countries which have a government sponsored universal care system.

Right on Carol.
I could not agree with you more. It is time for a single payer program that takes the burden of cost for healthcare out of employers and individuals pockets. I laugh when i hear people say we will become like europe,I hope so. Take care

Dave, I’m in CA and in my experience it has a lot to do with who you work for – not necessarily the insurance carrier. For example, I had a pretty decent BCBS plan through my work up until about a year ago, when my employer downsized and we were all downgraded to a crappy high-deductible plan – less coverage, more expensive. It’s still through Blue Cross though.

As for test strips, under this plan I can have as many strips as I want – I just have to pay 100% of the cost myself. At a conservative estimate of 55 cents per strip (online at Amazon), that gives me 12 strips a day, all the way up until I meet my $2500 deductible. After that, they’re free. Whoo hoo!

If you want to know what the bill says, here it is in all it’s legaleeze. It’s a free download. Don’t rely on what “everyone” is saying find out for yourself. Information is our greatest tool.
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

May God have mercy on us!

True- The Blues must be talking about what they cover without having a Letter of Medical Neccessity from the MD. If a pt. with Medicare is treated with insulin or we are trying to decide what treatment changes need to be made, then we can squeeze more strip coverage out of their plans… (: Still pretty sad that we even have to go the extra mile for that- I know supplies are expensive…but what the heck? I get so frustrated with insurance co. and Medicare- if the people writing these policies/benefits had to go around not knowing what their BG was… ridiculous…

Watching NBC news this AM and lo and behold enough has been said about “End of Life” issues that those have been pulled from the new bill. Think it will make room for Chronic Conditions such as Type 1 diabetes? By the way, I live in NW PA about 1/2 way between Erie and Pittsburgh. I do work for the State as an Aide for MR adults, have a husband of 18 years and an almost 14 year old son. We have insurance through the State, but they are now making us pay a portion of the cost (2% of Gross Pay) each pay day. I am very concerned about single payer stuff as there would then be no competition. Would they be able to say to the patients, “If you don’t do what I tell you, then I will no longer see you as a patient!” There would be many unqualified doctors out there that graduated near the bottom of the class and how are we going to be able to find a true endo.