In the Trenches: Diabetes Dad
There are companies that serve the public with more feeling toward their stockholders than toward their patients. I have said time and time again; health insurance companies fit this bill more than any other company I know. I also believed that little could be done to fight these corporates giants–until recently.
There was a two-year-old young lady who was denied by health insurance giant, Humana, an insulin pump and a CGM even though her doctors stressed the importance, their policy allows it, and her mother followed every step necessary in application and appeal. But once the diabetes community became involved in an avalanche of feedback; the young lady not only received her devices; her mom shared that she received a letter of apology from Humana.
Our voices were heard.
Little did I think at that time, that it was a testing ground for a larger and swelling problem facing so many of the people who battle diabetes. It’s a problem so many are well aware of. Insurance companies are making decisions on what gets covered and what does not get covered. Many times, leaving the patient in the dark on what to do.
Recently, United Health Care made the decision that only one insulin pump would be their ‘preferred’ insulin pump, leaving many to scramble or prepare to fight to keep the pump they use and have covered. Another insulin pump released a letter stating the unfairness this will cause toward the many patients who use their pump. My cynicism tells me that the pump company was not as concerned about our welfare as much as their own pockets. That said, it outlines a growing problem. And the diabetes community is gearing up to react.
Decisions being made that patients have little, or no say but must bear the full force of inconvenience and or health concerns needs to be changed. This is about insurance companies making decisions based on ‘bean counting’. If 70% of their covered patients use the device, and they can negotiate a really good price and undercut the competition, great for the 70%.
The problem is, that leaves 30% of a health insurance company patients to figure out if they are ‘grandfathered’ in or fit the bill or have to switch devices. Multiply that by quite a few insurance companies and we have a problem–a BIG problem.
This problem is growing.
What I learned from our situation with Humana is that our voices matter. But they must be loud, and they must be clear.
This is not about one insurance company’s decision; this is not one diabetes company accessing a better deal for their stockholders; this is about US. Not having a choice in what decisions are being made, but yet, having to burden the brunt of something that impacts diabetes care hugely. We need to have some say. Right now we have little say; if any.
We need to collectively do something.
The first thing we need to do is collect stories-lots of stories. Let your voice be heard. If you have been denied anything related to diabetes, if you have had your coverage changed, if your insurance company has changed anything and not asked your input in any or all of the examples listed, please share your story here.
I am a diabetes dad.