Diabetes is a Disease. Diabetes is a Business. We MUST FIND Middle Ground.

Post author By tomkarlya
Post date May 10, 2016
3 Comments on Diabetes is a Disease. Diabetes is a Business. We MUST FIND Middle Ground.

Diabetes is a disease. No question to that point.
Diabetes is a business. Don’t fool yourself for one second to think it’s not.

With the ‘buzz’ circling about the recent decision about insurance giant United Health Care allowing Medtronic as their preferred pump of choice and leaving others to scramble—-we need to take a hard look at this situation.

As I stated yesterday, this has been going on for some time and these decisions are nowhere near new. I do not blame Medtronic, from a business perspective, who would not make this deal? And it is there I lay my point for today’s article; ‘from a business perspective’.

As you are well aware, these decisions impact people. Adults and children alike who live with diabetes (although United Health Care HAS STATED that at this time this decision will not impact children). But as I stated and will continue to say; this recent decision is not a new development in how business works. To all those who are out there now raising a ruckus about it for the first time, I state—-welcome to the party.

We can run around blaming Medtronic and United Health Care or we can bring our collective minds together to figure out how we can change the parameters of patient choice in this country that is much worthy a discussion than this recent decision. THIS IS THE DISCUSSION. A huge undertaking. But certainly worthy of a dialogue. Not sure how to do this, but collectively we should be able to figure something out. While we are at it; let’s bring a representatives/advocates from other disease states to the table…..they have to be fighting this battle as well, don’t you think?

As we look to collect the many stories out there, which we will need and I encourage you to share your insurance story here; I caution with everything I know that this is a roll-up-your-sleeves-and-dig-in kind of battle. We MUST RAISE OUR VOICES but spending our energy blaming companies for their business choices is NOT the way to do it. We have got to come together and figure this out. We have to bring the right people in the room to advise us. We have to collectively seek answers.

Certainly having a diabetes company involved with us in seeing the bigger picture cannot hurt. Any takers?

Over the years there have been many large companies that have tried to change the parameters and have failed because, mostly, it was nothing more than a marketing campaign to ‘show’ how much they care. If we all keep our focus on those living with diabetes and allow them the choices they deserve…..we can all win. Having diabetes is no one’s choice; but the best way to manage diabetes……………absolutely should be.

Let’s come together and figure this out. It has to make sense to the business platform as much as it does to the patient’s desire…….I’m confident there is middle ground. Let’s come together and seek what could work for all. Anyone want to meet?

I am a diabetes dad.
Please visit my Diabetes Dad FB Page and hit ‘like’.

3 replies on “Diabetes is a Disease. Diabetes is a Business. We MUST FIND Middle Ground.”

Back in October or November of 2014 my Medtronic representative contacted me and told me that my insurance company, Medica, was no longer going to be covering my enlite sensors as of December 1. This was before the Affordable Care Act and I was covered through my state’s high risk pool for uninsurables. But I learned it wasn’t just for us misfits, they were discontinuing coverage for all type 1 diabetics covered through Medica and they didn’t even bother to tell us. When I confronted them I was told based on verbiage on the Medtronic web site they could classify it as “experimental”. Nevermind they had been covering it for more than a year and there was ample anecdotal evidence that the threshold suspend feature was saving lives or at the very least ambulance calls. They essentially were declaring they were willing to risk my life to save a few hundred dollars. By the way, at that time my monthly cost between my premiums, saving for my deductible and copays, was $850/ month. As I was getting nowhere being reasonable, I published my letter outlining the dire affect their decision would be on the type 1 populations onto several type 1 on line communities. If Medica got away with it, you knew soon other insurers would follow. Oh and by the way, I gave a customer service rep’s phone number. He called me begging me to call them off after receiving several hundred calls, I said ” Sure what number would you rather I put up?” That resulted in their decision being tabled but not rescinded. So I brought it to the attention of the Insurance Commission of my state and the Attorney General of my state who opened an investigation. Suddenly I was “in the loop”. My Medtronic rep’s job was threatened because she had told me what the insurance company was up to and my personal facebook page was being monitored my my insurance company. I got a personal Medica Representative who kept me informed of where they were in the process and in late January 2015, I was informed they would continue paying for the sensors. I maintained then and I maintain now, we fight this disease 24/7, in my case for more than 40 years, we ought not have to fight “OUR” insurance company for the tools we require.