Tag: #diabetesaccessmatters

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’.

There are companies that serve the public with more feeling toward their stock holders than toward their patients.  I have said time and time again, health insurance companies fit this bill more than any other company I know.  I also believed that little can be done to fight these corporates giants…………..until recently.

There was a two-year-old young lady who was denied by Heath Insurance giant, Humana, an insulin pump and a CGM even though her doctors stressed the importance, their policy allows it, and her mother followed every step necessary in application and appeal.  But once the Diabetes Community became involved in an avalanche of feedback; the young lady not only received her devices; her mom shared that she received a letter of apology from Humana.

Our voices were heard.

Little did I think, at that time, that it was a testing ground for a larger and swelling problem facing so many of the people who battle diabetes.  It’s actually a problem so many are well aware especially with the recent letter by a pump company that they were squeezed out of a health insurance company’s coverage-plan.  Insurance companies making decisions on what gets covered and what does not get covered.  Many times leaving the patient out in the dark on what to do.

Recently United Health Care made the decision that only one insulin pump would be their ‘preferred’ insulin pump leaving many to scramble or prepare to fight to keep the pump they use and have covered.  Another insulin pump company released a letter stating the unfairness this will be toward the many patients who use their pump, as well as others.   My cynicism tells me that the pump company was not as concerned about our welfare as much as their own pockets except that the company is Tandem, and Tandem is a different company for many reasons as many of us have come to know in the diabetes community.  That said, Tandem outlines a growing problem.  And the diabetes community is gearing-up to react.

Decisions being made that patients have little, or no, say but must bear the full force of inconvenience and or healthy concerns needs to be changed.   This is about insurance companies making decisions based on ‘bean counting’.  If 70% of their covered patients use the device, and they can negotiate a really good price and under-cut the competition; great for the 70%.

Problem is, that leaves 30% of a health insurance company patients to figure out if they are ‘grand-fathered’ in or fit the bill or have to switch devices.  Multiply that by quite a few insurance companies….and we have a problem……a BIG problem.

This problem is growing.

What I learned from our situation with Humana, is that our voices matter.  But they must be loud; and they must be clear.

This is not about one insurance company’s decision; this is not one diabetes company accessing a better deal for their stockholders; this is about US.  US not having a choice in what decisions are being made, but yet, have to burden the brunt of something that impacts diabetes care hugely.  We need to have some say.  Right now we have little; if any.

We need to collectively do something.

The first thing we need to do—is collect stories—–lot’s of stories.  Let your voice be heard.  If you have been denied anything related to diabetes; if you have had your coverage changed; if your insurance company has changed anything and not asked your input in any or all of the examples listed, or you have your own story—-please share your story here.

There will be more on this topic in the future—-but for now—do one thing—–go to the link above and share your story.  Do not be afraid to use names and be brutally honest what it meant, and how it, impacted you.

The first step is to show a problem.  Please do so.  Click the link and tell your story.

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