Horror Story

This page from the study tells me that they were focusing on diabetics under the age of 18 who are insulin dependent. Most of these children would be type 1. You can’t compare their experience to one of an adult type 2 who doesn’t take insulin.

http://www.hta.hca.wa.gov/documents/glucose_final_key_questions_062110.pdf

You’re right – children are very different from adults, even those who do take insulin. This paragraph bothered me:

Although organizations make recommendations and guidelines exist on use of blood glucose monitoring, the effectiveness and optimal frequency of self-monitoring of blood glucose in patients is controversial. Several lines of evidence suggest an association between glucose monitoring and increased discomfort, inconvenience and worsening of depression scores with regular self monitoring, along with a lack of clinically relevant improvement in diabetes-related outcomes in patients who self-test. On the other hand, children and adolescents can be especially at risk for some diabetes related complications (e.g. hypoglycemia, ketoacidosis). Information about the best management strategies for diabetics under 18, including evidence of efficacy and safety and cost; and correlation of frequency (including strip frequency and continuous monitoring) to improved outcomes is needed.

Of course, there is discomfort – same thing with shots, but no one’s trying to withhold shots from these children. Strips are more inconvenient than a CGM, and I sincerely doubt that any data on depression, which I think comes from the diabetes itself, and not from testing, is in any way relevant to children. And lack of clinically relevant improvement is probably because most of the subjects of the studies were Type 2’s, probably not on insulin, who didn’t test very much, and didn’t know what to do with the test results, anyway. And that’s a result of the general neglect of Type 2’s but don’t get me started on a whole new subject!

So the paper is shot through with holes. Doesn’t matter now, anyway, because they did vote to continue supplying strips to diabetic children, but the whole issue had me cringing because our lives and the lives our our precious children are in the hands of disinterested people who only read studies, without regard to how flawed they might be.

Inconvenience, worsening depression & discomfort. Insert head firmly in sand. Reminds me of a conversation with a CDE who agreed A1c & BG goals were too high, but kept info from patients because she didn’t want them to be discouraged. Less discouraging to have complications, I guess.

Relieved that limiting strips has been shelved, but this issue will come up again & again with other studies to back saving costs.

The problem with blaming the other side for a bill that in the end will end up costing us money ( I think we can SAVE money if done right) is that the left had a super majority. They could have crammed through whatever they wanted (just like they crammed through the POS we are currently talking about).

Jean as you lament those who are working full time for “Mr. Murdoch, the brothers Koch or someone else in the propaganda business”. you have to realize that by simply expressing that sentiment anyone who knows anythig about politics in general will propose (whether accurately or not) you are just repeating the Left’s line. This in turn makes everything you are arguing irrelevant in their eyes which does you no good in posting in the first place. Those who think like you will say “good” but those on the other side will simply disregard your arguments.

I am an independent. As far as I see it both sides of the isle are very similar. They promise a lot but deliver little (anyone remeber Obama promising the healthcare debate would be on CNN?) I think it is time for all Americans to step out of the right vs left and stand up for what they believe in. Stop perpetuating the right vs left sentiment. In the end they are both the same. Out to tell as many lies as possible to get votes and in the end do whatever ends up making them the most money/ protects their interests.

I simply do not accept the “this bill is better than nothing” mantra. This bill will end up making a bad situation even worse. We needed actual reform, not adding people to an already broken system.
Obama screwed himself. No one needs to blame him because it is quite clear he made a lot of promises that he broke (transperency, bipartisinship etc…). He dug his own grave…

They didn’t want to “… cram through whatever they wanted…”

Instead, they compromised, compromised, compromised in their (FAILED) effort to get the Republicans to cooperate.

Calling what was passed “ObamaCare” is ridiculous. It should be called “RepubliCare” if anything at all.

As far as I’m concerned, Obama’s biggest mistake as President was to bend over backwards to try to get totally obstructionist and refractory Republicans to cooperate so as to make a bipartisan deal. His plan wasn’t so bad until Republicans twisted and mangled it. Even the non-partisan Budget Office said it would have saved money if it had been enacted as planned.

The accuracy thing seems overblown to me. I was sort of like ‘eh’ but figured I’d get one anyway and have been very pleasantly suprised with how useful the data is, despite the potential for inaccuracy? The allergy thing is probably a dealbreaker though.

One thing that I think is that 6-8 isn’t quite enough data points? I love the hundreds of data points from the CGM but really got things in more in line w/ about 10-14 tests/ day as you can ‘cover’ your whole day, spot trends and steal a march on suprises sneaking up on you?

“Stop perpetuating the right vs left sentiment. In the end they are both the same.”

I’m sorry, but that’s like saying that Kaddafi and the U.N. are both the same because they are both using bombs right now.

Politics isn’t just about tactics; it’s about intent.

What is the intent of the Koch brothers? What is the intent of John Stewart? What is the intent of President Obama? What is the intent of Michelle Bachman?

It’s not enough to just throw your hands up and say, “Oh, all those people in politics are just the same.” We have to look closely at what they intend to accomplish, their end-game, their goals and objectives, who is funding them and why, as well as how successful they are at sticking to their principles, persuading others to do the right thing (even if it hurts their bottom line a little bit), making reasonable compromises (e.g. not capitulating before even discussing single-payer), etc.

My intention is to get excellent healthcare to every, single American at the most sensible, affordable cost possible without sacrificing quality.

Does this mean that everyone will be able to get botox, tummy tucks and a massage every morning? Um. Nope. Does this mean that we’ll have to have “death panels”, people waiting for five years to have necessary surgery and doctors working for minimum wage and food stamps. Ummmm…no. Absolutely not.

I agree. The CGM is a great tool even if just for trending, though when I have a good sensor it’s so much more than that. I actually shocked my endo (who doesn’t quite ‘get’ technology) when I told him that I haven’t reduced testing. He said something to the effect of, then what’s the point? I told him that it’s about testing smarter. I now usually wake up in-range because I don’t have to wait until I wake up to find out that I shot up or down unexpectedly, even if being woken from a nice dream is a high price to pay!

All I know is that it’s not as simple as either side makes it sound. If we’re going to have a system that doesn’t turn away sick people that don’t have insurance, then we have to have a way to pay for it. What I don’t hear from politicians or pundits is anything that resembles an honest acknowledgement that cutting costs is going to require tough decisions on what gets/doesn’t get covered and that as we move more and more toward biologics that the cost of care is only going to go up…

Medicare, Amtrak, USPS, Social Security, et al. Our government has proven itself over and over to be efficient and trustworthy. Liberal, conservative, independent, republican or democrat should all agree RUN MY HEALTH CARE PLEASE.

What is your positive proposal to solve the problem of 40 million Americans with no health coverage?

Do you like the idea of being permanently uninsurable in the state where you were born and where 85% of your family currently live, because the private insurance companies won’t cover your diabetes (pre-existing condition) and the corrupt state legislature and governor are fine with that?

Do you like the idea that your health insurance company will take your premiums for years, and then when you develop T1 they’ll cover it at first (while their rescission specialists get busy researching your history) but then they’ll turn around and drop you a few months after diagnosis because you failed to disclose treatment for an ingrown toenail fifteen years earlier, a minor condition you completely forgot to write on your pre-existing conditions form?

Do you like the idea of having “health coverage” that costs you hundreds of dollars every month, but won’t pay for more than two test strips, won’t cover CGMS, won’t cover a pump, won’t cover any new medications (their formulary is limited to generics, even if the generics are crap), won’t cover more than one A1C test per year, won’t cover trips to the ER unless you’re admitted, etc. etc. etc. because they’re in business to make money off of your premiums, not provide quality healthcare! How are their VP’s and CEO supposed to become hundred-millionaires if they use your premiums to pay for stuff you need?

If you love all that and more, you’ll love having the monsters of greed who run our private insurance companies in charge of whether you get to live a reasonably healthy life – or die too young and medically indigent.

Research the German system. They have it down.

Being a person who had no coverage for twenty (yes, 20) years in a state where for a good number of those years individual coverage was non existent, and having developed t1 about halfway through that time, I do believe strongly that reform is needed. The current plan, in my opinion gives us the worst of all worlds. I for one do not want to deal with a government agency for ANYTHING. The government does not need to take over in order to correct the issues that really need to be addressed. There is absolutely nothing in this law that will truly lower costs because a. it does not address tort reform or drug companies to name just two, and b. it is to be operated by the most run amuck, top heavy spending machine in the history of man. I love our country and what it was founded on. Unfortunately it has become nearly unrecognizable. Even so, it is still the best place on earth to be a citizen. I think if they could change course and actually run existing programs in an efficient, cost effective fashion I might feel differently about them taking over such an important and massive program. But you know what they say about leopards.

Unlike with a pump, you wouldn’t even need to use it all the time, but could wear to get more data points for certain foods/events or if you make a change to your lifestyle that might be affecting numbers. It would save on the cost too.

“What is your positive proposal to solve the problem of 40 million Americans with no health coverage”

They can go work on our new oil farm!!

Jean- Did you know that in 2010 of all health related contributions (including Big Pharm) the Democrats took in a cool 75 million dollars? Republicans took in about 100 million dollars. From what I can see as far as this debate goes they are BOTH on the take. This leads me to believe they are looking out for THEMSELVES and not me.

Problem is there are too many there who have been there for too long and are more than willing to show any newbie’s how to take full advantage of the system they have set up. To assume you can judge a politicians intent is stretching it a little thin. The one thing I can say for sure they are worried about- $$$$$. Where does that leave you and me? Republicans are everything you rail against I am with you there. But it would be in your best interest to take a good look at your side of the aisle as well. They may not be a squeaky clean as you might wish.

Massachusetts has already shown us this current healthcare system will not work and now we are going to attempt it on an even larger scale? You say Germany has it right. Why didn’t the Dems propose a system more like theirs? Could it be they were more concerned with what was politically expedient than what was right?

Positive change number one: Fewer uninsured Americans should lead to a lower-cost health care system.

Positive change number two: No more caps on coverage.

Positive change number three: Insurance companies can no longer refuse coverage based on preexisting medical conditions.

Positive change number four: Keeping kids on their parent’s policy longer.

Positive change number five: More employers will be offering coverage.

Positive change number six: Free preventative health care.

Positive change number seven: A better appeals process.

Positive change number eight: Help for seniors.

"My personal opinion on health care reform doesn’t really matter, but if you want it, here it is. First, understand that I’m not a democrat, a republican, a tea-partier or an independent. I’m a consumer reporter, which means that my job is often about helping “the little people” battle infinitely more powerful and less-principled corporations.

Now that you know where I’m coming from, here’s my opinion: It’s an absolute disgrace for the most powerful and prosperous nation on earth to allow it’s citizens to go bankrupt simply because they get sick. And we’re the only prosperous country in the world that watches it happen to hundreds of thousands of it’s citizens of every race and economic status each and every year. That’s wrong, period. The health insurance industry needs reform."

http://www.moneytalksnews.com/2010/03/22/health-care-reform-8-positive-changes/

Insert sound of head slap here: THWUNK.

Gotta love it. I tell you the hypocrisy of those in power never ceases to amaze me.