The Cash Cow

I suspect that many diabetics or their family members are afraid of poverty issues. From my diagnosis in January, 1962, until present—how much money have my parents and I already spent on diabetic supplies, insulin, and new inventions that promise to make me better controlled, though never cured? I do want to thank those responsible for the breakthroughs that have bettered diabetes care, and therefore, hopefully, the lives of diabetics.

However, a simple perusal of the internet tells anyone that there are many out there who fear our diabetic condition is perhaps a bit too lucrative to warrant a cure. There even seem to be diabetics who fear a conspiracy! After all, hospital personnel, medical research firms, pharmaceutical companies, health insurance companies, and perhaps even malpractice attorneys, not to mention the lobbyists of all concerned, all of these groups depend upon my condition for an income, do they not?

As to pharmaceutical companies, I am grateful for many of the improved products. However, what about the ones the diabetic uses that come out, with not only an outlandish price, but those that increasingly come out to be followed later with “recall letters” due to some functional problem or other. Shouldn’t that be shocking? Shouldn’t that be a shocking problem to even those who are not diabetic—the fact that medical equipment is found to be shoddy, if not totally non-helpful or nonfunctional? Are doctors then protesting or are some of them on company boards and/or do they hold company stock? Have most of us noticed the offices and hospitals overrun with pharmaceutical agents, and who holds their stock?

Do diabetics dare speak up? Can some arm of government fine, not so much the research arm, but the manufacturing arm of medical businesses that seem not so concerned with quality control and/or the patient? Or why should such fines and/or corrections be passed onto the consumer; that is, the patient? Just speaking of justice here. Actually, I am quite in favor of the companies who help diabetics that cannot afford expensive products for their care. However, is that free care coming out of a company pocket and/or again, a consumer or diabetic/patient’s pocket? The poor helping the poor, in other words.

The question becomes why, within all the parties there are to blame—the medical establishment (doctors, hospitals, and subsidiary businesses), pharmaceutical companies, and insurance companies, the patient is yet again made to feel like the victim. I am not only ill, I cannot afford my own care, sometimes even when I do work and work hard. God forbid, I should want savings for my family.

What of the T1D diabetic who, before 2014, had no health insurance, for whatever reason, and those were turned down for that “pre-existing” condition? No one in our mainly capitalistic country minds a “modest profit.” Still, why do I still have nagging suspicions that certain “higher management” or “leaders in the insurance industry” are living well at my expense?

Speaking of wealthy CEOs does bring us to the cost of health insurance. Before recent changes as to pre-existing conditions, as a diabetic, I was always asked by health insurance agents how much insulin I took or told point blank, “We sign up no diabetics.” More and more, especially on the matter of health insurance premiums, I’m grateful to know that diabetics over the age of 26 can supposedly get health insurance even if laid off or unable find a full-time job. After all, although a person like myself has always worked full-time and received company insurance, I was laid off when I was over 55. Luckily? I was allowed to purchase the same health insurance I’d had from a branch of my old employers. $1,000 a month. I paid.

At any rate, as I’ve worked exhaustively for many years in my life, I have noticed the trend of premiums going up and up. Also, I have learned while working and supposedly having “good insurance,” that the deal seemed to be that the pharmaceutical companies try to get a health insurance provider in their corner, thus giving the insurance provider lower prices for a whole lot of business, and/or vice-versa That is, the insurance company gets a drug company in its corner, again giving itself savings, thereby more profits, but meanwhile, the company insured must use the “drug provider.” I’ve never understood as an insured person what people were talking about as to choice in healthcare. The insurance company was or is chosen, the drug providers, the hospitals, and often, the doctors were then approved or no. I’m afraid my choices were all limited.

As a result, what I noticed was that no one had much choice as to a career either then—how good is it for our economy that people are working solely for health insurance? How good is that for a company even? I’m not even sure some of the rich have so much choice—depends on how rich, I guess. Yes, the lesson medicine teaches these days, I fear, is that one is rarely rich enough. Also, never quit a full-time job with benefits, no matter how bad the situation is.

More puzzling to the hardworking employee is the large company that increasingly divests itself of insurance oversight. Let’s say there’s a patient from the last two or three decades that does manage to stay employed with a company, while paying pretty high group health insurance premiums, various co-pays, deductibles, and so forth. However, what if that hard-working employee, temporarily a patient, then has some problem with a claim and goes to a Department of Human Resources or Personnel Office, only to be told that the department no longer acts on the patient’s behalf—no, no, that’s all up to you, the ill person! The Department of Human Resources no longer “fools with that.” My, my, my—that budding career you have is great isn’t it—as long as you and your children can stay on your feet and working as long as humanly possible.

Certainly, as the average American worker, I could say that if I wasn’t sick already, I certainly could have been made sick by having to argue with my insurance company over what was covered and what wasn’t. Furthermore, I’m sure you’re already tired of hearing me rage. However, if you are a lowly employee, or worse, if you are only “a wife,” you are only going to be able to talk with a call center as to an insurance claim. Perhaps more shockingly, you’ll find yourself talking with “a temp” who can do nothing for him- or herself, much less the patient who pays the premium.

At least one person who was probably fired from a health insurance company in a taped call once sadly told me: “The employees here (in the insurance company) get no health benefits at all!” No wonder attorneys are needed by individuals involved with healthcare. Heaven knows, all the companies involved have legal counsel I assure you. Not to mention those figuring out what “the average cost is” as opposed to what the insurance company is willing to pay. All I know is what most patients know—profits within even the companies in which we are employed, rarely go to us. One is always chasing that brass ring just out of reach. Sad, when that brass ring is not a promotion, a higher salary, but of all things, a chance at relative wellness. How many American workers do not suffer undue, crippling stress? The idea being, what about that Hippocratic Oath: First, do no harm. Of course, perhaps the medical industries do not take such an oath. Still . . . . . .

Now I worry that I have read that some want to cut diabetes supplies as offered by Medicare. I’m delighted to learn that recent health laws not only give diabetic children hope for the future, but they have in a very republican way offered grants to states who can experiment and find ways to keep health care costs down. (I was continually misinformed about this by one former a local Congressperson.)

Meanwhile, much of the research sponsored by the Juvenile Diabetes Research Foundation sounds very plausible. Of a number of clinical trials, I like the experiments on the implantation of encapsulated beta cells (no transplant drugs needed), all in a strip the size of a band aid under the skin; also, “smart insulin.” It adjusts itself to the sugar in your bloodstream. None of this is science fiction anymore—within the next few years, all might be so. Type 1 Diabetics, many children are funding their own cure! Isn’t that a joy and inspiration?! I feel reborn. Surprisingly, I feel younger these days, not older. Besides, I don’t feel any of us should die just to benefit the already wealthy. Don’t do it. Live and leave our poor scarred earth better in some small way.

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