Health Care Reform is all over the news now and is quickly becoming a major part of the national dialogue. How will current initiatives affect the health care of the greater than 20 million people diagnosed with diabetes (and the large yet-to-be diagnosed population)?
First and foremost, we at Western Diabetic Supplies firmly believe that everybody in this country must have access to health care. This is not only a moral argument, but is also an economic one. Those without health insurance either avoid treatment in the presence of severe symptoms until their conditions significantly worsen (and become more expensive) or receive expensive treatment in emergency rooms. The cost of non-emergency emergency room treatment dilutes resources for urgent care of others, and, more pertinently to this discussion, is transferred to those with insurance through higher premiums or less coverage.
Universal health care coverage, however, does not mean single-payer (think Medicare/Medicaid expanded to everybody). Single-payer government health care will result in more people having coverage, but with the likelihood that such coverage will be less comprehensive and, quite possibly, less effective. We are concerned that a cookie-cutter approach will be used to define specific coverage for specific conditions in a one-size-fits-all methodology. The government will only pay providers for their preferred treatment regimen, dis-incentivising physicians from new, potentially more-effective treatments or treatments which are customized to the needs of individual patients. Why not just type symptoms into a algorithm designed by Congress and let it dictate your treatment according to their idea of what’s best for you? Who needs doctors anyway?
It is already more difficult to obtain reimbursement for Medicare patients with diabetes who test their blood-glucose frequently (the sickest patients). Thus, single-payer reimbursement may tend to make the sickest stay the sickest, and drive more expensive downstream complications.
Also, for those with traditional Medicare and no supplemental insurance, the sickest must pay the most. Accordingly, self-rationing frequently occurs. Many private insurers (even those that offer Medicare plans) pay 100% of the cost of testing supplies and are not as stringent about those with more difficulty controlling their glucose levels (and subsequently testing more). The Government is in the process of reducing funding for those private Medicare plans (called Medicare Advantage plans). Many of these plans reduce or eliminate the out-of-pocket for diabetic test strips, significant increasing the probability of better disease management. This will ultimately lead to poorer control of diabetes for many.
Our belief is that universal coverage should be based upon an approach of decentralized insurance plans, providers, physician’s clinics, specialty hospitals, etc. Broader coverage will increase demand, and provide opportunities for health care entrepreneurs to offer better, lower-cost, more effective service. Imagine diabetics having coverage which allows them to go to a diabetes center which contains endocrinologists, kidney specialists, lifestyle and treatment trainers, dietitians, supplies providers, etc. Think how this would ultimately reduce the extended costs of diabetes and other chronic diseases.
Online health-care records owned by the patient (and portable to any provider) would facilitate this decentralized approach. Online ratings/reviews similar to will-know online shopping sites will allow patients to choose the most effective (ultimately lower-cost) providers. The online patient records will prevent duplicative or unnecessary testing, and make it easier for patients to exercise choice and vote for the best treatment with their feet. Western Diabetic is working with the industry to provide glucometer systems with much-enhanced capabilities for on-line diabetes management data, which will be portable to any physician or clinic, or many at once.
In a move that we believe will be detrimental to both industry and patients, the government continues to steamroll the industry with planned National Competitive Bidding for durable medical equipment, including mail-order diabetic supplies. Previous false-starts have telegraphed the direction they are headed. If so, this program will result in a huge reduction of available suppliers (many predict 90% will go out of business) and reimbursements reduced to such insane levels that only inferior and poor-quality diabetic test supplies will be available to recipients. The program is moving forward apparently without fixing any of the conditions which will lead to these outcomes.
Patient choice, customer service, and product innovation (which has so greatly improved the outcomes for those with diabetes in recent years) will all be seriously compromised. We firmly believe that there will eventually be an increase in complications due to diabetes – blindness, loss-of-limbs, kidney damage, and more. In addition to increasing suffering, this will ultimately increase the national costs due to diabetes.
We believe the time is now for concerned people to contact their legislators to weigh in on health care reform and to stop the National Competitive Bidding program for durable medical equipment, including diabetic supplies.
Western Diabetic Supplies provides blood glucose meters, diabetes test strips, insulin syringes, insulin pumps and supplies, and other associated diabetes items nationwide.
For information on Western Diabetic Supplies or nationwide Easy Home Delivery of supplies for diabetes testing and management, please call toll-free (877) 937-8342, e-mail customerservice@westerndiabetic.com, or visit http://www.westerndiabetic.com.
