Health Care Without Crisis

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“I’m sure lucky I got diabetes” is a phrase you’ll likely never hear. But “I’m sure lucky I got diabetes when I did” is something I’ve said in conversation a few times. I had the good fortune—if you want to call it that—to get diabetes at a time in my life when I was well-equipped to handle it not only emotionally and with good self-management practices right out of the gate, but also when I was fully employed with excellent health insurance benefits.

Prior to July 2005, I was a freelance editor—and as such had only a major medical policy that I’d shopped around for after graduate school. At that point, I worried a heck of a lot more about money than I do now (and although I still worry, a steady paycheck mitigates the stress somewhat). If I recall, my policy cost me between $100 and $150 a month and carried a $5,000 deductible on any medical procedures. My thinking was that if I had appendicitis or broke my leg or got stuck in the hospital for three or four days, I wouldn’t go completely broke; I’d have a painful out-of-pocket expense, but it wouldn’t bankrupt me.

When I began working at the University of Michigan a few years back, I was able to choose from among some pretty comprehensive health-care plans. I picked one that cost me about $50 a month and had a $15 co-pay for physician visits. Everything else was covered. And, although I didn’t know it at the time, the university also had a groundbreaking Focus on Diabetes initiative that eliminated co-pays for diabetes medicines as well as for drugs that affect or help prevent conditions related to diabetes. (And if it seems like I reference University of Michigan diabetes-related programs and practices often, I do so of my own accord. Sadly, they don’t pay me to endorse their programs.)

The American Diabetes Association estimates that, in 2002, medical expenses were $13,243 for each person with diabetes; for those without: $2,560. (See the full report here.) Since I’ve been diagnosed, I’ve spent only a few hundred dollars on my diabetes-related medical expenses. And they haven’t been cheap. I’m on insulin. I’ve had numerous blood tests. I’ve had four endocrinologist visits, two primary care physician visits, two dietitian visits, and attended five diabetes education classes. I see a therapist every two weeks. Oh, and I’ve been equipped with a $6,000 insulin pump. I’ve seen what the insurance company covers, what I do not have to pay. The ADA estimates, according to this per capita, are pretty close.

So, I’m one of the “haves” in the health-care system—a breed that seems to be dwindling. I was in the right place at the right time when a chronic condition became a part of my life. At times I feel guilty for my good fortune. I see how much a good health insurance plan and excellent health-care team can help, and I never want to give it up. But millions of people with diabetes aren’t as fortunate, and it is a crisis. I know that David Spero’s posts a few weeks ago (“Sicker Than Sicko and “How the Medical System Hurts People With Diabetes”) elicited quite a range of comments about the United States health-care system. It’s a conversation that must continue.

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