Diabetes Self-Management Blog

Since President Barack Obama unveiled his federal budget proposal on February 26, news coverage of the administration has focused largely on its reaction to the ongoing economic crisis. The president and his top officials have made clear, however, that they are also pressing ahead with other big plans, the first of which is likely to be health care reform. On March 5, the president convened a summit on health reform that included the chief executive officer of the American Diabetes Association, along with other medical advocacy and insurance industry officials and several members of Congress.

The Obama administration has already indicated a few of the steps it wants to take to reform the health care system. First, its proposed budget sets aside $634 billion for a fund to expand access to health care — presumably through tax breaks, subsidies, or access to government-run insurance. The American Diabetes Association calls the fund “a crucial first step toward positive change in reforming the existing health system.” It would be paid for by limiting tax deductions for high-income earners; by requiring competitive bidding among private Medicare Advantage Plans, reducing the amount insurers are paid by the government to provide care; and by making a variety of smaller cuts and changes to Medicare and Medicaid.

Administration officials have also suggested a complete overhaul of how doctors are paid through Medicare — a program that covers millions of people with diabetes ages 65 and over. Currently, Medicare pays doctors a fee for each patient visit and for every procedure performed; an alternative could be to pay doctors a set amount for the entire treatment of a patient based on his medical condition. Peter Orszag, director of the White House Office of Management and Budget, says in an American Medical News article that the goal is to establish “a better system of providing incentives for doctors to provide high-quality care rather than just more care.” (Read the article here.)

What do you think of the administration’s suggestions for paying for expanded health care? What else, if anything, should the government do either to limit health spending or to raise more money for insurance coverage? Leave a comment below!

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Comments
  1. The health care system as it stands is broken. With over 45 million people without access to basic health care, this number is growing everyday. Think about that next time a person bring you your coffee, they might not get the care they need for their TB and now you are exposed. It is costly, the cost of treatment goes up as lack of treatment goes on noticed. What a month ago could have been treated in the Dr. office has got to be treated in the emergency room. Currently according to the World Health Organization the U.S. has the most costly health care in the world, and yet ranks 14th as far as quality of care. If President Obama can at least get some dialog going we as a nation will all benefit from it and if we are able to nationalize health care under the one payer system that so many countrys have adopted we will way ahead of the curve.

    Posted by Thompj |
  2. While I applaud the idea of SOME overhauling of our healthcare system, we must approach this mindfully. We currently have one of the most innovative systems in the world, and individuals from countries where there is universal health care currently flock to the United States to obtain the health care that they, in their own countries, must wait for. These waits oftentimes results in irreversible deterioration in their health, and even death.

    Another problem - lack of personal choice. Do you want to be told, by some bean counter, that a procedure you need will NOT be provided for because either a) you’re too fat, or b) you’re too old, or c) your personal health care costs are too expensive? Universal health care results in RATIONING…and say what you will, but diabetes is very close to being an epidemic in this country, and if you don’t think rationing will take place because the costs are too high, think again!

    When I was a child, health care was more personal. The doctor came to your home, and you sent him (usually a him, sorry!) on his way with a home-baked pie — or something like that. If you had nothing to barter, well, you paid for the visit, but it was not an arm and a leg! Doctors in those days did not drive Mercedes and pilot yachts. They were generally in the upper echelons of middle class, and did not feel entitled to being treated as gods. That has certainly changed. On the flipside, however, do you wnat the GOVERNMENT to dictate what physicians are to be paid, like they are currently looking to oversee CEOs of corporations?

    The bottom line - if you don’t like the USA, go to France or Canada! If you like freedom, stay with the USA. For all its faults, it is still the greatest country in the world - with amazing medical advancements being discovered every day. That will be stifled under President Obama’s plans.

    Be careful what you wish for!

    I personally would gladly pay more for my health care if it meant helping to pay for the health care of another - but let’s now throw out the baby with the bathwater, and bring us all to the lowest common demoninator! Do you actually believe that the likes of Ted Kennedy will suffer under the same system that we would all have to suffer under? Think again.

    This is the greatest country in the world. There’s nothing we Americans can’t do if we put our minds together. We can fix the system without destroying it. So let’s move ahead thoughtfully, please.

    Posted by Mary |
  3. Does that include Agent Orange diabetes that some of us have from 10 years service as a civilian in Vietnam. My wife and my self have this condition and have been turned away from any Federal assistance on the subject. I beleive that the US Air Force is responseable for our condition.

    Posted by tervet |
  4. I WOULD LIKE TO SEE A BILL THAT LETS A HEALTHCARE CREDIT BE DIRECTED TO ALTERNET HEALTHCARE PROVIDERS.

    Posted by ED BOYD |
  5. I am very wary of what is being proposed. It will be more expensive and our taxes are going up. You better believe it.

    Posted by Char |
  6. I believe in universal healthcare. I also believe in choosing your own doctor and getting the care you need, when you need it. I think we can reconcile both of those. As a person involved in healthcare communications and patient wellness, I see far too often people in this country putting off needed surgery and office visits because they can’t afford it or have no insurance. So the argument that we have the best healthcare system in the world extends only to those with very good private insurance. To the 45 MILLION people without insurance and the additional 20-30 MILLION people without enough insurance, US healthcare is WORSE than Canada or France. That’s what the people with wonderful, private, EXPENSIVE healthcare have to realize. I had to buy private, individual insurance for both my kids when they switched jobs because they lost their insurance while they did so. And it cost me thousands of dollars for a very short time. Money I don’t really have and had to pull out from lifetime savings. That is not a great healthcare system. So I support Obama and his budget and his healthcare revisions, because I don’t want the good to be held hostage to the perfect. If we can make it work so everyone gets choice of doctor, that’s great. But first we need to make it work for EVERYONE.

    Posted by WithMetta |
  7. Just what we need a Socialist system like Canada or Great Britain. NO THANKS PRESIDENT OBAMA !!

    Posted by pfrancis |
  8. The only way to fix the health care system is to stop giving free medical care to all the illegals. They get better medical care than people who have insurance. No questions asked. There are millions of people that can’t afford to buy health insurance. How do we handle that? First off lower the salaries for the big honchos. Then get rid of all the people who think they are God and they can decide if coverage will be allowed. Then go after the medical shops that sell or rent wheel chairs and other medical supplies to Medicare patients. Their prices are triple what one would pay on Craigh’s list or ebay. Every patient in a nursing home does not get the care that Medicare is billed for. The nursing homes have psychiatrists come in to see the patients and evaluate them. Tell me why this is necessary and then they continue to bill Medicare even if the patient can’t talk. Investigations into the nursing homes is mandatory .Medicare should pay for all the diabetic supplies people need. If you give them the supplies they will take better care of themselves if the cost is not hanging over their head

    Posted by D |
  9. I wonder how this new arrangement will affect specialists? For instance, I see my internist who wants my diabetic information in order to treat my trig. and chol. then I also see my endo. MD for my diabetis. This concerns me because I cannot get these two together, on how often I see them and how often I have the same labs drawn. The lab won’t send results to the second Dr. unless I have an order and if I haven’t seen that Dr. recently; my next appt. is too away to have the lab results do any good.

    Posted by janetmarie |
  10. From a selfish standpoint, I wish Medicare Plus Blue would pay for the Continuous Glucose Monitor for those Type 1 diabetics who meet certain criteria.
    I have had controled diabetes for 56 years. I now experience hypoglycemic unawareness.
    I desperately need what this new technology could provide, but can’t afford it with my disability check.
    Am in the process of appealing the insurance denial. Not holding my breathe.

    Posted by muirland |
  11. He will turn our Health care system into the same mess Canada and England are experiencing. We will get less care instead of more…..catherine Egan

    Posted by Catherine |
  12. There are many problems with our current healthcare system in the United States. More government intervention is NOT the answer.

    If you think that it’s expensive now, wait until it’s free.

    Posted by phils1024 |
  13. Beware of those who proclaim “I’m from the government and I’m here to help you.” It’s precisely government meddling that is the cause of health care availability and cost problems. Government forced emergency rooms to take all comers whether or not they pay. The cost of emergency room treatment is much higher than care through a general practitioner. The end result is that people are going to emergency rooms for things that they should see a GP for, the costs are magnified, and the bills that aren’t paid are passed on to those who do pay. The government required everyone over 65 to have Medicare coverage, and then dictated such a low reimbursement rate that in the area where I live general practitioners refuse to treat medicare patients altogether. The clinic where we had been patients for over 12 years before going on Medicare instituted a policy of refusing to treat any Medicare patient. The only place here accepting Medicare patients is a teaching facility and treatment is by interns. A major budget problem for the federal government is Medicare and Medicaid. The federal government has not been able to resolve that cost problem, so we can’t expect that more mandated federal government health care is going to solve the problem. We can only expect that the problem will be worse and the costs attendant with the problem will make our economy worse.

    Posted by Sceptical |
  14. What fool things government can improve anything. If they touch this, our system will really be broken beyond repair. You will die before getting appropriate treatment.

    Posted by Quentin Bell |
  15. i think its good hes trying to do this for years i didnt have health insurance but i do now through my husband at his job. but when he retires we dont know what to do because im a diabetic. and i will need insurance . thankyou

    Posted by brenda stockwell |
  16. what about people who are like me 29 living as a diabetic with no job and no ninsurence right now who cant aford to see doctors is thier any help for me? iv been in and out of the hospital in diabetic commas about 8n times in the past 4 months i need help any ideas?

    Posted by jessistar27 |
  17. I have been a diabetic since 1953, so have been in the healthcare and insurance system for a long, long time. I could cite many examples of poor fiscal management in our healthcare system. First and foremost are the exorbitant charges by medical suppliers, physicians and other health professionals. The rental of different types of medical equipment exceeds in the longrun the cost of the particular piece of equipment and the supplies to use with it are outrageous (C-pap machines, which are the current rage among doctors now, are a good example). Doctors charge large fees. However, Medicare cuts their allowed payments down to such an extent that it is no wonder they do not really want to treat Medicare patients. I have already been told that I must pay for part of the cost of certain care because they cannot afford to treat me without it even though they have “accepted assignment.” I see all of this and don’t understand what the answer is. I think something must be wrong when I read in the paper that a 30-something family practice physician just sold his home for $700,000.00 (in my state that is astronomical). Somewhere our system has gotten so messed up that I’m at a loss to even say what I think is a good answer for this comment you have allowed me to give here. I do not think it is socialized medicine. We are not all like cookies from a cookie cutter. For years I’ve dealt with doctors thinking my diabetes should react just like any other diabetic’s, which is far from the truth for any of us.

    I pray that God will give wisdom to those working out whatever healthcare plan we wind up with.

    Posted by MayM |
  18. I think Health Care Coverage, for ALL Americans, is a wonderful idea.
    It’s working in other countries, but we need it to also cover you when you go to the eye doctor and the dentist.
    The first place Diabetes and any other life threatening diseases are going to show up is in your eyes and in your teeth, then it will show up in the other places.
    If you also take care of your eyes and your teeth, you will not have any of those life threatening diseases either.

    Posted by M K N |
  19. I feel that we desperately need a new healthcare system. The one we currently have is not working.
    With 45 million uninsured and many of the rest in inadequate healthcare, it’s definitely needed. My own particular case–I’m a 49 year old African-American female with Diabetes, Neurofibromatosis, Osteomylitis, Acid Reflux Disease and at least 7 more major diseases, I’m in constant pain from neuropathy and I’m in a wheelchair. I go into the hospital approx. every other month for 6, 7, sometimes 8 days or more at a time. I receive Social Security and Medicare, but they do not pay all of my bills. I can’t afford supplementary insurance and my husband’s been out of work for almost a year sohe doesn’t have insurance. We owe thousands of dollars in hospital and doctor bills and can’t really afford to pay them. I have had to go without my insulin and many more of the 11 medicines I take every day during the Medicare
    “Doughnut Hole” period so I got sick and had to go into the hospital again! Yes, the health insurance industry definitely needs a complete overhaul. I am willing to pay higher taxes if all my medical bills are paid for. It is a good trade off. Don’t be selfish, America! Help your fellow American out.
    Sincerely,
    vmceadylindsey

    Posted by vmceadylindsey |
  20. I am over 65 and have Type2 Diabetes.
    I see my Doctor every 3 months.
    He monitors my condition with blood tests
    etc.
    I feel that if he were paid a flat fee once,
    he would see me less often and monitor me less.
    This means that I could have a problem that he would’t know about.
    But, maybe this plan is meant to eliminate old,
    sick people.

    Posted by chum4464 |
  21. Something certainly has to be done. We spend the most of any nation, are the only industrialized country not to have universal health care… and yet we rank near the bottom of the pack in quality of life and health care outcomes.

    I’m getting sick of hearing about how horrid foreign health care systems are. I’ve had to go to the doctor in Canada - and as a tourist paying ‘rack rates’ it still cost me less than my co-pays here. And don’t even get started about rationing; Anyone who’s dealt with an insurance company knows we’re already getting rationed right into the grave.

    I *have* insurance. It costs well over a third of my pay each month in premiums, and I can’t afford the copays for all my medications, or the copays for a lot of the labwork and specialist visits I’m supposed to have. They also won’t cover a wheelchair (even a (relatively) cheap full-size manual one), even though some days I can’t make it to work because I can’t stand to be on my feet more than a few minutes at a time, and even though my doctor has told them repeatedly that NOT having one will cause me severe damage long-term. One of the clerks actually told me on the phone that it’s company policy to deny such things - If you lose enough function that you lose your job, then you’ll probably lose your insurance and they won’t have to pay for anything for you anymore.

    If someone with a professional job and “decent” insurance is having all these problems, I can’t imagine what the millions who are dealing with chronic illness on little more than minimum wage have to go through.

    Our people and our children are our most valuable assets. Why can’t we - as a country - take care of them??

    Posted by Sanacrow |
  22. My daughter has had type 1 diabetes since she was six. She was on our insurance until 21; after which she could not get coverage of any time. She is now 35; we live in Florida and no insurance company will insure her. The only way she could get insurance is through a group, but she is an independant contractor so no group insurance. When she must go to the hospital, they don’t believe that there is no insurance available for her condition. We had hope that the new insurance Cover Florida would cover her for they advertised that it would cover pre existing conditions after 12 months; so, we signed up only to be presented with a paper they wanted her to sign that she be aware that they would not cover her diabetes if she went to a doctor or hospital within the 12 months. She had to go to the hospital last week I don’t know what the answer is but there should be help out there somewhere.

    Posted by Lona Connell |
  23. While I believe everyone should have access to health care, I do not think our present system should be changed extensively. There is room for change but don’t take away from the ones who have decent coverage and are willing to pay their insurance premiums for this security. Let the changes be for those who can’t afford coverage. Don’t try to cover everyone with one blanket.

    As others have said — be careful what you wish for.

    Posted by ajc1103 |
  24. I am a type 2 Diabetic on the pump.

    I am also a Registered Nurse.

    I am opposed to ANY government regulation in the health care industry. Socialized health care/medicine is NOT the answer. Obamas plans will make things worse.

    Posted by Jon |
  25. I lived in Europe for 12 years and experienced their health care system that so many people say they would like to replicate. It was not only full of complicated restrictions, and doctors that did a lot of things to bypass the governmental controls (such as charging money under the table), but the doctors were not as well educated and dedicated as the ones in the U.S.

    I would like the government to get out of our healthcare system and stop regulating payment and other parts of our care and let us decide for ourselves what we want and what insurance (and, oh yes, whether we want no insurance). This meddling will eventually mean that government will ration our medical care and make life and death decisions based on expense.

    I haven’t seen a government agency that is efficient and cost-effective yet (look at our department of licensing or our U.S. Postal Service — both ineffective, inefficient and unwieldly).

    Posted by Delores Freeman |
  26. I need my medicare left alone unless they want to help me with more. I have had 2 heart attacks, diabetes, diverticulitis and a twisted bowel surgery ,arthritis,osteoporosis of the knees which need to be replaced but can’t afford it,psoriasis, and other things wrong with me, I almost died at the end of last year from many complications. my diabetes was a major factor as is for knee surgery. I ended up owing after medicare paid there part 63.000.00 ouch! I cannot afford a secondary insurance. I get around 12,000. a year and can’t believe I have to pay 96.40 for my medicare. I have been forced into filing bankruptcy. There’s another bill I don’t know how I am going to pay. I see 7 doctors every 3 months. medicare does not pay for all of them. I think obama should leave medicare and medicaid alone unless it it to help people like me. Ones that are just around the corner from being deadly sick and homeless. I worked and paid my share of taxes and such I had to work many hours over time to raise my children by myself because of a deadbeat exhusband who has gotten away with not paying his share of child support. My oldest grandson will be 19 soon. And my ex is living in hog heaven. Something just is not right for the people that work there ______ off and end up like me and Obama wants to make my life worse. I believe he can do great things but needs to think long and hard before he leaps.

    Posted by Kath |
  27. You people are focusing on the wrong things. The problem with American health care is that it is a for-profit business with multiple layers of players all taking a cut. Greedy insurance, pharmaceutical, and corporate hospital companies have milked this cash cow long enough. Insurance companies are the worst of the lot. They provide absolutely nothing to the patient’s care, but pull money out of the system by the wheelbarrow full. When we start to look at health care as a public service issue rather than a fortune-making opportunity is when we will have affordable, responsible health care for all.

    Posted by Common Sense |
  28. Oh, and for those claiming that government regulation is a bad thing, just take a look at what a lack of regulation did for the banking and food processing industries.

    Posted by Common Sense |
  29. Any thing the government sticks their fingers in turns to ruination. They do not belong in the business of health insurance/I might add that is an additional burden on the working class people. their numbers of the “uninsured” include illegal aliens and therefore more votes for the Democrats to stay in office. This spending spree will be the destruction of our country.

    Posted by dld |
  30. When a US citizen who has worked and paid into the system all her life gets sick, lost her job and went to a clinic and was told she does not qualify for medical care but, the clinic is full of illegals who: 1. are not citizens, 2. have not paid into the system, and 3. are flooding hospitals and getting medical care. What’s wrong with this picture?

    Posted by Concerned citizen |
  31. I believe we are headed towards socialized medicine.I do not think this is the answer. I know that the Medicare coverage of pharmacy to retirees is a farce. Anyone taking lots of medicine will end up paying several thousand dollars duing the gap in coverage. If coverage in medical areas is like this we are in trouble. I had better coverage in pharmacy when it was included in my supplemental insurance policy. Due to several reasons I take a lot of meds. I have tried to cut back but I need every last one especially for diabetes which I inherited. I really can’t afford the meds.

    Posted by Sally Mettler |
  32. The best way to improve healthcare would be to reimburse doctors and hospitals in a more timely manner. I get letters showing the doctor/hospital was finally paid a year or more after my procedure! This is rediculous and is stifling our health care system.

    Another big step in the right direction would be to educate more people about eating healthful meals to reduce obesity, whioch is causing all kinds of health care probles/costs in this country.

    Posted by Theresa P. |
  33. i like this plan,and hope that i get a chance to see it comes to reality,my insurance company said that i make too much is $1300.00 a month,this year the Government gave me a raise of $ 13.00 and they said i make too much money,so i am losing part D on medicare,please help me and others in alabama.

    Posted by Truman Reynolds |

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Flashpoints
The Costs of Innovation (04/09/14)
Diabetes to Go (04/02/14)
Veggie Persuasion (03/26/14)
(Un)healthy States of America (03/19/14)

 

 

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