What a load of...

This post is written in honor of this past weeks's Health Care Reform Summit where President Barack Obama and Congressional leaders came together to discuss differences and agreements. With my work deadlines, there wasn't a chance to watch Thursday but instead I spent much of Saturday watching it on You Tube, where it was divided into Part I and Part II. Aside from all the political tugs of war, there are a few elements that should be central to any plan impacting the Diabetes Community.

First, we need to better distinguish between the different Types of Diabetes. We have Type 2, which can surely have the umbrella phrase "Diabetes" (I am serious. And don't call me Shirley.")

But, we'll no longer have Type 1, a term that too often gets lost in the abyss of the worldwide epidemic of Type 2. Instead, those of us who've been insulin-dependent since childhood or have reached a stage where we now must take insulin to survive, will have something else:
"Catastrophic Ruthless Attack on the Pancreas." Also known as: CRAP.

We don't know why it happens, but suddenly we forced to live with this chronic condition that is uniquely a load that must be managed daily. Sadly, we must clean up or manage the mess with dollar bills that we never ever have enough of.

While clever and funny, the CRAP concept isn't mine. It first came up in a TuDiabetes Discussion a few years back. Bernard Farrell gets props for coming up with the term. But it seems to be quite appropriately utilized with all the crazy misconceptions about overall "diabetes" and that's even playing into the health care reform debate now.

There's been much debate in the Diabetes Community lately, and through the years, about renaming this chronic condition because of the generalization and misinformation out in the mainstream. The ADA likes to tout what it's doing about Type 2, but in many ways it helps feed the misconception. Its unfortunate, but the vast majority of people are very ignorant regarding diabetes and such statements are indicative of that ignorance. In March 2007, Medtronic Minimed hired Harris Interactive to do a survey that found 80% of the of the 2,436 American adults surveyed could not distinguish between Type 1 and Type 2. Even more troubling was the finding that nearly 67% of those who responded to the poll incorrectly believed there is already a cure for Type 1. Other key findings:

- 51% knew there were two types of diabetes
- 36% thought there was either a "type 3 or 4" diabetes
- 25% believed that proper diet could "cure" or "reverse" the disease
- 32% believed exercise could be a "cure"

So, this makes the case for CRAP. While it cause problems distinguishing between CRAP and #2, that's a problem we can leave to the ADA and those in Congress who dole out enough of their own CRAP on a regular basis. It fits right in, and clearly illustrates why our CRAP should be weaved into their CRAP,

That's the first point for reform.

Secondly, there's a lot of fuss about pre-existing conditions. Everything under the sun appears to be lumped into this category by insurers, such as backpain, acne, etc. So, I say we embrace it.

We create new ones that should be covered:
-Chronic Health Insurance Headaches, or CHIH.
-Health Coverage Emotional Distress, or HCED.

Full coverage. The logic is simple for insurance companies to understand: You create the problem, therefore you pay for it. Specific reasons on how the Insurance Industry creates these conditions can be clearly seen here, and here.

Of course, the way the system currently works, even though it SHOULD be covered, it likely won't. So, we take it a step further.
We throw CRAP at them to make them listen. We can hire some monkeys (Congress men and women??) to toss it their way, and make them see why our CRAP-PY conditions and subsequent CHIH and HCED are so smelly and undesirable. Our CRAP can clog the toilet of the health care industry, but together we should have a chance to work with insurance companies and lawmakers to plunge that big toilet.

So. That's that. Here's to Health Care Reform, as long as I am a part of the solution and it's not left up to the Federal Government or Insurance Industry to inadequately plug things up or create more clogs.



While I agree with your sentiments on the (lack of) serious intent of Congress regarding healthcare reform, I must disagree a bit about the nature of the T1/T2 confusion. Type 1 diabetics are by far the better known variety. Some may be confused and think that Type 2 treatments work on Type 1 diabetes, and that must be frustrating to you. Imagine how much more frustrating it is for me, a Type 2, when I'm told they can't afford to insure me because I have the Big D. My meds cost a pittance. Metformin is $4 a month, BP meds (prophylactic for the kidneys) is another $4, and the "optional" vitamins and such are about the same again (but wouldn't be covered by health insurance anyway). So... though my "burden" is $8 a month, far less than deductible, I still get lumped in with the T1s that spend hundreds of dollars every month to stay alive.

Solidarity amongst diabetics, my brother, but you're not the ones suffering from the ignorance when it comes to health insurance. I can't even get it. I'm a Diabetic. So yes, time to separate the insulin-dependent from the pill-poppers, but are you sure that'll be a good thing for Type 1 diabetics?
Anonymous said…
John: Thanks for reading and responding. Always appreciate the feedback. However, I must disagree with you that Type 1 is the more "better known variety." Maybe you're forgetting that we Type 1s are only 10 or less percent of the population. Or that Type 2 is of "epidmic" proportions. Or that a vast majority of people in the world believe that diabetes is something you can control through eating, diet, lifestyle changes. If your claim of Type 1 being the more well-known part, then I'll challenge your defintion and understanding of Type 1 and popular thought on the umbrella "diabetes." As you've likely been following the Oprah episode reaction, you'll also realize that the danger here is that all diabetics - Type 1, 2, LADA, etc - can "prevent" or "reverse" their D simply by changing their lifestyles. This is false, and dangerous, as it can also influence the federal funding of D-research to determine what ultimately causes both Type 1 and Type 2.. We can argue about insurance, but it's because of Type 2s that Type 1s can't get it ("Just change your lifestyle" is what I've been told). Yes, we all share in similar possible complications someday. And the causes are likely similar, if not the same - that must be the point. To research and cure ALL FORMS of diabetes.
SarahK said…
I have to agree with you, Mike. It is because of the nature of Type 2 diabetes that us T1's can't get insurance. Because of the "popularity" of T2 and the media saying "diabetes" is caused by us being lazy and eating the wrong foods, they have the misconception that ALL types are preventable. Now, granted, not all T2's are fully able to reverse their diabetes either, and it's not always caused by lack of diet and exercise, but they at least have a chance to make it better... a ray of hope. We don't. Grates my nerves to no end. If it were preventable, trust me, I would be doing everything in my power to reverse it.
What a bunch of CRAP. :-) I knew that living with this CRAP would cost me big.

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