Diabetes And Insurance, The Devil’s Advocate

devilLike millions of other hard working Americans I pay exorbitant monthly dues to my health insurance company and in return I am not sure what I actually get.  At the ripe age of 21 I was diagnosed with type “1.5”diabetes which is hard to control and costly.  I tried countless medications, lost weight and still nothing.  I had given up and ignored the disease, after a while complications started to pop up left and right, that’s when I decided it was time to take control of it.  My doctor recommended insulin pump therapy, a small device that would stay strapped to me that would allow me to most accurately control high blood sugar. It sounded great; however, the insurance company did not see it that way.

The insulin pump is $10,000 dollars, sounds steep until you calculate the life time cost of hospitalization for things such as diabetic coma and other complications of high/low blood sugar. An average hospital stay can easily run double that.   I pleaded my case to the insurance company and happily received a 90% payment for the pump from them. Things started to go my way, that was until my first supply order came in.  The pump requires reservoirs and external injectable sites that are changed every three days, for a month’s worth of site changes it was $250.00 with insurance.  In addition, I needed to fill the pump with insulin, which cost an additional $70.00 to $140.00 a month. But wait the cost continues since I had to test my blood which required a least 3 tests a day at $30.00 a month.

Let me take a moment to do the math with you. I have a decent job, four kids and a ton of bills. The last thing I needed was to pay hundreds of additional dollars a month in order to survive.  I spent several years on and off of the pump, as expenses came up I forfeited supplies for things my family needed to get by. Finally a hospital visit for a deep tissue infection forced my hand, I had to make a choice, take care of the diabetes or die.

At first it took months of fine tuning to get the pump working, over which I gained a ton of weight. Sensing something was wrong I changed doctors and began experimenting with oral medications. I began eating healthy and dropped the weight that I had gained. Eventually, I was able to do without the pump entirely.  The problem was that while my pump supply cost diminished, my medication cost sky-rocketed. The two medications that I take, Janumet and Actos are not available generically. Under my “premium “insurance policy Blue Cross/ Blue Shield these necessary prescriptions cost me $140.00 each month. Not to mention, regular trips to my doctor who is considered a specialist at $40.00 a pop.   Just as I worked this debacle out, I was diagnosed with Rosacea a “harmless” yet disfiguring condition that causes flushing in the face and eventually if not treated it will progress.  The regime of medication for this dermatologic condition tacks an additional $150.00 a month to my healthcare expense for life.

On the flip side, if I didn’t work so hard and couldn’t afford my hefty insurance bill, most if not all of these medications would cost me virtually nothing thanks to Uncle Sam. The thing that really gets my blood boiling is watching people die because they needed to choose between keeping a roof over their head and maintaining their health.   What has this world come to?