Monday, December 6, 2010

The Domino Effect

One falls, the others are close behind.

That's the Domino Theory. It's what is happening now with the diabetes dominos and our circle of dominos necessary for the best health possible.

We People With Diabetes have much to fear, because some of those dominos have already tumbled to the ground and more are staggering.

Fellow D-Blogger Wil DuBois recently wrote about this over at Life After Dx, with Scott Strumello following on this footsteps. They spell out what's happening:

Medicare changes are on the line, nationally and at the state levels. Indiana is one of those. Currently, Medicare’s “guidelines” allow for one strip per day for diabetics on oral meds (Type 2s) and three strips per day for insulin-dependent diabetics (Type 1s and some Type 2s). Getting those one-or-three strips covered requires some paperwork and record-keeping on the Medicare-recipients part, but it is possible to get more strips if a doc pushes to override. But now a proposed Medicare rule change would make this "guideline" permanent and make it so docs couldn't request an override for additontal strips.

Most importantly for all of us non-Medicare folk: Whatever Medicare does Medicaid does. Whatever Medicare and Medicaid do private insurance does. It’ll be a falling domino effect that’ll fall on your head faster than you can read this post.

This scares the hell out of me, as we're already watching this unfold at the state level. We see the state of Washington is doing legislative research about how state-funding might be limited to one strip a day for children. Others states are closely watching these types of issues, as they've already experienced the falling domino of being cash-strapped and in need of massive budget gets wherever possible. These states have little money and insurance company fueled propoganda, specifically since Type 2 diabetes management is the more common public perception of what's needed, could be pursuasive.

Does the blood strip makers in Pharma have more power and influence than Big Insurance? Well, that lobbying battle may be what it comes down to. We'll see whether one of those players has the power to stop a falling domino.

But some docs and endos are also taking up arms to defend us patients. Dr. Steven Edelman was calling on his fellow docs to “stand up as advocates for the rights of our patients to receive quality care and for our rights as physicians to practice appropriate medicine."

We must help and join the fight.

Call the Congressional switchboard at 1-866-220-0044. If you give them your zip code they’ll connect you with your Senator’s office. You can also find your elected lawmaker's number through this online directory. Each Senator apparently has a Healthcare Liaison. Give that person your thoughts on what blood testing means for you.

Personally, I've had insurance try to limit my BG strips to only about three a day. I appreciate and am incredibly glad my Endo was able to override that and insurance improved a higher amount, leading to my better health. But we're at a crossroads here, and our very health and lives are in jeapordy because of the bottom line.

One domino falls, so do they all. Unless we step in and block that from happening.

As Wil did, I leave you with this quote from Martin Niemöller about the Holocaust:

They came first for the Communists,
and I didn't speak up because I wasn't a Communist.
Then they came for the trade unionists,
and I didn't speak up because I wasn't a trade unionist.
Then they came for the Jews,
and I didn't speak up because I wasn't a Jew.
Then they came for me,
and by that time no one was left to speak up.

Please, speak up.

4 comments:

Kelly said...

DONE. Totally freaks me out!! I'll fight this one to my grave...GRRRRRR......

Sysy said...

I wrote about this the other day too...it's been keeping me up at night. I hate having thoughts like, "Should I move to Europe?" I've already been making those calls, I hope everyone else does too! Great job Michael :) I enjoy your journalistic style of writing. I don't read the newspaper but I feel like I get the experience of reading one when I come to your site.

Anonymous said...

My son test about 10 X's/day so I am definitely not in agreement with this but maybe, just maybe this will drive the costs of our strips down. By limiting our supply the strip makes will have such a decrease in sales they may have no option other than to lower costs to the consumer. Comeon $1.00/strip, that is robbery. I really wonder how much they cost to make. I'm thinking around $.03 and its probably less. I hate insurance companies but maybe in the end this will bring all of our costs down and if we have to buy strips out of pocket we can afford them. Just a thought..

Scott said...

Thanks for the shout out ... I would like it if we took a more collective stance on some of these issues, because sooner or later, we're all going to be dependent on Medicare (if there's anything left to it once the Baby Boom retires). The logic of short term cuts escapes me; while private insurance can justify these because of high turnover of patients and the fact that the same patient is unlikely to be covered by the same insurer by the time complications are incurred, the same logic does not apply to Medicare. We WILL eat those costs, if not now, then later!