Welcome to Diabetes Blog Week! Diabetes Blog Week is just like it sounds… diabetes bloggers all blogging on daily topics for an entire week. Or, in this year’s case, for five days. To find out all about Diabetes Blog Week and to sign up,
As always, thank you to Karen Graffeo, creator and curator of Diabetes Blog Week. She’s awesome.
It’s Thursday… today, we’re covering The Healthcare Experience.
Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What’s your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!
Today, I’m going with a suggestion from a Facebook friend whom I’ve never met, who would like me to talk about CGM coverage for Medicare recipients in the United States. They’re concerned that a recent story out at Insulin Nation, plus a couple others here and there, might be giving people the idea that Medicare coverage for continuous glucose monitors is a done deal, or a nearly done deal.
As much as I would like that to be true, the facts are that this is not true.
And that makes this issue similar to many issues when it comes to living with diabetes and getting the coverage for things that will help us live a better, healthier life.
You name it, insurers are doing their best to keep from covering it: the insulin of our choice, coverage to see a psychiatrist for our mental well being, coverage to see an orthopedist to look at frozen shoulder problems, and yes, Medicare CGM coverage.
Even when one patient wins a case, do you think that ends it? No… insurers are still going to try to appeal and get a legal authority somewhere who will agree with their point of view. Even when their point of view is not backed in science, or even recent science.
If I were to improve healthcare in this country, I would start by disassociating the budgetary (and for companies, profitability) concerns of every facet of managed care. The first question should always be, “what will help the patient the most?”. Only after that question has been answered should we begin to ask how expensive something truly is. And once we have determined how expensive the best treatment will be, we should commit ourselves to making it affordable for patients. Not if we can make it affordable; we should commit our resources and our best minds toward making it affordable. And accessible. For everyone.
When we dedicate ourselves to the idea that everyone deserves the best care, period, not the best care one can afford, we free ourselves from the burden of “how are we going to pay for it?” or “how can we get someone else to pay for it?”. It will happen. It will happen through grants for healthcare innovation, additional competition from insurers (not less, as some politicians are suggesting, unless they want to go single-payer-all-in), and through price controls. I still believe that the part of our government designed to protect the people should be bigger than the part that wants to help companies prosper. Companies never cured a soul.
Companies pursue mercenary agendas based on profitability. They will keep defending their right to do so. All I’m doing is defending my own right to manage my care with the tools I need to be successful. At a fair price, which, in case anyone is wondering, is a lot less than what I’m paying now.
So friends, don’t be fooled by the “Medicare might be covering CGM!” rhetoric you might read from time to time. Our issues are not going away until we collectively knock out every brick in the wall of managed, for-profit care that so many of us have run into during our lives with diabetes. Patients over profit, every time.