War (title too short)

Has the war on Medtronic and UHG come and gone?

Has it disappeared like the Cold War did - quietly into the night?

I’m just curious because a lot of time has passed and a lot of events have unfolded.
Perspective will be different now than it was 10 years ago. Perspective will be different now than it was 1 year ago.

War with pharma definitely confusing and on hold, due to covid.

I would like to know where other people are at because I don’t know where I’m at. I can’t see the landscape through the snow.

Here is recent announcement, although may be still policies not yet updated.

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I really think they need to offer at least 2 options.
Kaiser offers the same tandem or Medtronic.
However I wish they allowed eversense, however no pumps will allow eversense to control them. Still I would try it if it was covered

I swear that they have Omnipod currently on the policy.
Because remember when they tried to take it off the books and everyone went nuts?
I think that Tandem will be the 3rd, right?

I think Omnipod is not welcome at UHC. Omnipod is currently running a 30 day free trial and UHC is specifically excluded.

Right now Kaiser of southern cal only allows Medtronic and tandem. You can get a pharmacy script for the pods but they need to have a good reason. I’m not even sure they still do that. If you ask your Kaiser doc about a pump, they won’t even mention them unless you specifically ask for them

Ok, you guys might just need to clarify a bit. I might be confused by the details because there’s UHG, UHC, Optum, and a bunch of little puppet governments under that. Sometimes I have to ask someone who works there to explain the organizational structure to me. It’s confusing.

But, I recall that they removed Omnipod (See link below).

Then, the advocacy organization got infuriated. The internet chats were embittered. This really “set people off.” UHG withdrew the deal with MT to be the sole provider of insulin pumps. I recall it because it made me mad, too. I had a post taken down by admin that was an old Soviet propaganda poster of Mao and Stalin in this goofy embrace. They were hugging one another, which made it a strange visual image. I altered it so that Mao was wearing a t-shirt that said MT and Stalin was wearing a t-shirt the read UHG. That was a step too far and it got taken down,

UHG withdrew that agreement with MT and reinstated coverage for Omnipod (but, maybe that’s just for children, not adults). Or, maybe its just for people on Medicaid. Which means I misunderstood this stuff.

Source: UnitedHealthcare FAQ's | Omnipod® Insulin Management System

"UnitedHealthcare members have had access to the Omnipod® System but it was through a third-party supplier. Insulet has worked directly with UnitedHealthcare to reach agreement on a competitive in-network agreement that will give more people the opportunity to enjoy the benefits of the Omnipod® System."

What strikes me as odd about all this is - MT, UHG, and Abbott are all in Minneapolis. But, Abbott is based in Chicago. Why can’t Abbott get the deal done? MT and UHG both have headquarters in Minneapolis and they play ball together in a ‘different,’ somewhat unsettling way that can feel like market fixing. I always imagined this stemmed from geographic location.

I have United healthcare - UMR and got a tandem pump fully covered last year. I waited a few months to get the pump based on a rumor I heard from a Byram rep that United may expand pump coverage in June…the U.S. healthcare system is a complete disaster. Thank you to that Byram rep for saving me $1,800!

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Did you know that the BetaBionics iLet insulin-only automated system, may be out this year, is expected to work with Dexcom and Sensionics CGMs. From diaTribe:

What’s new? Beta Bionics is a Massachusetts-based startup developing an AID pump and algorithm called iLet. iLet will work with Dexcom and Senseonics’ (Eversense) CGMs (and possibly others in the future) and is designed to be especially user-friendly. diaTribe founder Kelly Close participated in an early Beta Bionics trial (2013!) and raved about the system and how easy the pump seems. At set up, users only need to enter body weight (no insulin-to-carb ratio, sensitivity factor, basal rates, etc.), and the system will learn more over time. To bolus, users will use icons to describe meals as containing more, less, or the same amount of carbs as usual (no carb counting). The insulin-only clinical trial for iLet began in the summer of 2020 and is expected to wrap up in the first half of 2021. Beta Bionics aims to launch iLet mid-to-late-2021, though this could be delayed as the FDA continues to prioritize COVID-19-related devices.

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The new thing that seems odd to me is that we see local pt communities in MN that hate Dexcom and Abbott. I think they are a gathering of less experienced and less technically sophisticated patients who’s only concern is cost. They appear to be organizing rebellion against our largest technical advocates like Dex & Tandem. Its suspicious that they are located in MN. Its such an unusual perspective that its notable. Its an offshoot of the free insulin people. It represents a substantial break from the perspectives that have developed over previous decades.

Since your a MT guy, @Terry4 , I feel like there might be value in our online forum community writing something that summarizes very directly the technical perspectives that organize people according to pumps and sensors. There has always been a split. But, if that becomes a ‘hot war’ divide in the pt community, we will be less effective in our advocacy. We could have users from each side write something that summarizes both perspectives of the technical perspective divide that has always existed between MT and ‘other’ pump/sensor users.

Everyone here has written so much about it over the years, I feel like this is something that we could all address very directly and succinctly in a way that is valuable for newer diabetics. We all understand this divide from talking to one another for years. Maybe it just needs to be addressed in a formal way. I feel like, as a group, we all work to help one another and we have all known each other a long time and one another’s perspectives and are able to work cooperatively. But, there’s a sense of ‘diabetic extremism’ here that I see. It doesn’t generate from the deep engagement with these issues that we have here. It makes me nervous. There’s something ‘off’ about it that isn’t centered in motives of patient advocacy. They are angrier and more damaged and feel disempowered by illness. Its possible that we could say something that is valuable to them if we really thought about it. They are different than us. I find theor advocacy kinda painful to watch. Maybe they remind me of myself 20 years ago…just scratching the surface of this stuff. flora cash - You're Somebody Else (Lyrics) - YouTube

UHG is the giant umbrella holding company that operates UHC (medical Insurance), Optum (a pharmacy and pharmacy benefits manager combined company) and the bunch of puppet companies

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They do commercial real estate, El_Ver. Commercial real estate. I’ve seen the job postings.

Given the large scope of operations, that makes sense that UHG is involved in commercial real estate. The more they are able keep processes in house, the lower the cost and the greater the control for UHG overall which long term equals greater profits for them.

Personally I’m not a fan of for-profit healthcare. I recently had to switch from not for profit to for profit and thus far it’s been an eye-opener. The focus is not so much on mitigation, management/education, and quality of life but rather the end cost to the insurer based on an actuarial table versus the medical insurance industry average covered patient churn rate. The for profit insurer is gambling that some other insurer will be paying for a patient’s poor health outcomes down the road because they don’t want to invest resources to change patient behaviour/outcomes since it affects their bottom line profits. Not for profit insurers gamble on the long term patient outcomes, while for profit insurers gamble on the short term outcomes and assume the long term outcomes will be someone else’s problem.

I think you would appreciate my art collection.
I have a piece about actuarial science that I bought.
People’s parents find it so disturbing that I have to take it off the wall when ‘adults’ come over. It’s one of my favorite pieces, :laughing:

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