Diabetes Blog Week: Day Two – CO$T

So, today in #dblogweek, we talk dolla dolla bills ya’ll. Just a forewarning…

Below is the prompt:

Click here for the The Cost of a Chronic Illness – Tuesday 5/16 Link List – 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?  (This topic was inspired by suggestions from Rick and Jen.)

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My Response:     (… warning rant coming) 

Last September, when I turned the lovely age of 26, my insurance changed.  My new insurance covers about 80% of all durable medical equipment. There is no deductible, and no co-pay. I just have to pay 20% of whatever I need. Seems reasonable.

After nearly ten years of pumping, I was forced back to multiple daily injections (MDI) because my income wouldn’t allow for that 20%. So here I am, about eight months later, still royally pissed about it all. I’m not upset that I have to use MDI. I’m doing really well with it, best management in a while actually.

What I am upset about is the fact that my insurance is allowed to dictate what treatment and therapies I use by covering the cheaper options at a higher rate. I’m infuriated by the fact that our healthcare system prioritizes their bottom-line above my health.

In the past, I’ve argued the case that all chronic illness = disability –> because of the cost. In the US we are made to pay for the care and supplies we need to survive. The lives of those with more resources are seen as more valuable than are those without. This is undeniable if you just look at the rhetoric we use to talk about healthcare.

We talk about freedom – freedom to choose what kind of healthcare you want. Freedom to not help pay for your fellow citizen health, because what’s it to you anyway? Here’s the problem: We have a fundamental and systemic attribution error occurring EVERYWHERE. When a poor person relies on medicaid for insurance, we assume they are lazy free-riders. That is, we attribute their use of government funds to their character, or lack thereof. However, when we get fired and are forced to rely on government assistance to make up the income, we attribute our own use of it to circumstance.

At a systems level, people with chronic illness are punished through forced expenditure. My body doesn’t meet the norm. It requires more. So, I am automatically and forcibly entered into a market, in which those who do  meet the norm will never need to “choose.”

So, my “freedom” as a chronically ill person, is to choose between a therapy that costs me $500/month out of pocket, and a therapy that costs me $200/month.

It doesn’t feel like much of a choice at all. It doesn’t feel like freedom.

It feels like discrimination and deception.