The High Cost of Care

Welcome to Day 2 of Diabetes Blog Week.

Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?  For those outside the US, is cost a concern?  Are there other factors such as accessibility or education that cause barriers to your diabetes care?

As I thought about this post, I felt the urge to start with a disclaimer or an apology. But I’ll start with thankfulness. I may complain about having been forced into an insulin that doesn’t work as well for me or having to wait on hold to get a real person to talk to about my supplies, my medicine or my next appointment. But at the end of the day, I’m very lucky when it comes to diabetes costs.

And I don’t use “lucky” in a flippant manner. I generally refuse to refer to myself as being lucky, blessed (or in some other way gifted what I need) to be where I am in my life when it comes to career, home and relationship. I work hard and make choices to get to where I am. But when it comes to the access to what I need to not only stay alive but be healthy, I’m really lucky. I have insurance, I have an HSA, I have the means to pay my high deductible and I have the best medical care in the world right in my back yard. That, my friends, feels a lot like luck.

High Monetary Cost Continue reading

Creating a Better Healthcare Experience

Today’s Diabetes Blog Week prompt is all about the healthcare experience. Here it is:

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!

I have to acknowledge that I’m in an excellent place when it comes to healthcare. I truly have access to world class medical care living in Cleveland. Overall I have a good team and I can’t relate to all of the horror stories that I hear from others, but my care is not perfect.

There are always areas to improve. In U.S. healthcare, the first area to improve is insurance. Somehow in our twisted system, the insurance companies started determining care, not doctors. Pharmacies will literally fill prescriptions differently than written if the insurance company pushes back. Even doctors will bow to the demands of insurance. Continue reading

Does diabetes interfere with your job or daily activities?

I do a health check in with my disease management program every several months and the most recent check in call came at a time when my Dexcom had died and my request for a new one was still under review with insurance, my Apidra prescription had been denied and a moron fill-in doctor wrote me a new prescription for Humalog without contacting me (and he called me “Mr.” in a message, clearly he didn’t read my chart) so when my doctor returned from vacation we started the circus of trying to get my Apidra covered by insurance that resulted in 3 attempts and fails to actually get the right paperwork to the right people and had me fearing that I’d run out of Apidra before I had a ruling. (Apidra arrived yesterday, now I’m trying to get the Humalog they sent me and overcharged me for returned.)

Anyway, one of the questions that my health coach asked was, “Does your diabetes interfere with your ability to do your job or other daily activities?”

My answer was “no” but I could have given her an earful. Continue reading

Healthcare in an Ideal World that For Some Reason Hasn’t Cured Diabetes

In an ideal world, diabetes wouldn’t exist. Neither would cancer or the myriad of other medical issues. In an ideal world, we wouldn’t need healthcare.

But in an ideal healthcare situation in a world that must include diabetes, here’s what I want:

Doctors who discuss care with their patients. I never again want to see a prescription for Humalog (when I take Apidra) sent to my retail pharmacy (when I use mail order) with an unfamiliar doctor’s name on it. Continue reading

D-Blog Week: Share and Don’t Share

Last year, I double-timed it for D-Blog Week. This year, I’ll see what I can do.

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?  (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)

When I go to any of my doctors, I feel like I turn into “super patient” and answer all questions precisely as if I’m being tested and just let the medicals lead the appointment. I’m married to a man with “white coat syndrome” so I know that’s not my issue, my issue is that I need to take control of my appointments. I did better at my last endocrinologist appointment, when I started a sentence with “while we’re talking, I need to ask you about travelling.”

I try to schedule my appointments online so it’s handy that I can type into the comments/reason for appointment box what I need to talk about and it ends up on my chart… whether or not that gets seen before I do, I don’t know.

Look at that! I’ve already strayed from the prompt!

What I wish they could see.

I wish they could see the life around my numbers. I mentioned about a year ago that I had an issue with a resident fixating on a string of low numbers and kept trying to change my basal programs to avoid them and somehow she didn’t understand they were outliers (because three days with lows in a row couldn’t be an outlier when you’re painting an entire house!). I explained over, and over, and over that those were not normal numbers. At that very point in time I wished I could snap her back to those days movie style so she could watch not only how active I was, how on top of treating those lows I was.

I wish that my healthcare team could see the things that I may not think to tell them about. I’m “new” at this whole living with diabetes thing and don’t always identify things they should know about. Although I doubt they should know about my sore neck from sleeping oddly, but I bet they should know about the tingly feeling in my hands that I only get in the mornings.

What I don’t want them to see. Continue reading