Sorta Got It Wrong… But Sorta Got It Right Too.

In reading and re-reading and yet re-reading again the article that caused quite a stir in the New York Times, I have to say, they sorta got it wrong… but they mostly, in my opinion, got it right too.

Yes, the cost of health care is soaring in the US, no doubt. This does leave many who are not able to pay for the advanced technology out. I can say from experience that it is great to have the devices as they have helped me tremendously go from iffy control to good control to great control, but if you don’t have the money to pay your part of the cost, whether 100% or just 20%, you won’t have access to it. The fact that companies make so much money off of the technology that so many of us rely on is a shocking one when you have to pay full price for it. What I do agree with that the article points out is the difference in cost between countries. The cost of an insulin pump or even a bottle of insulin is SO much more expensive here than it is in other countries, and that baffles the heck out of me. I even recently had a discussion with a girl who lives overseas and pays only what would be the equivalent of $22 US dollars for one bottle of NovoRapid, which is the other version of Novolog, which has a price tag at my local CVS of $145. My one vial cost could buy her 6.6 months of insulin – a half year supply. That in itself is outrageous. And the fact that the Bionic Pancreas study has an iPhone controlling the pump… a $700-800 piece of technology – controlling a $17,000 setup (two pumps and a CGM) is just…. wow. It makes one think why on earth does a pump cost so much when a phone that has everything but the pump mechanism cost so much less? Is it strictly because it’s a medical device? Is that the area we need to be looking at and wondering if there’s a way to advocate for lower device cost and industry profit?

There was also a post not too long ago in the Dexcom Facebook group that pointed out how much executives of the Dexcom corporation made every year. The amounts per year angered me, but then what am I supposed to do? I can’t run a company of that size, for sure. So, I just order supplies and go on about my business and figure out what I have to shift around for the next few paychecks. Same with pump supplies. If you look at how much profit they make, yes, you will get upset. You will get angered. But you also don’t get to see things from the back-end. The reports that show how much in legal costs and production costs and all of the other fees associated with making these devices that we use. Yes, the cost is going up, but it’s not just the industries’ fault. It’s the fault of the US’ amount of greed from every angle. Think of it this way. There is an end-product of an awesome chocolate chip cookie. In order to make this chocolate chip cookie, there are things needed like eggs, sugar, chocolate, etc. Each component needs someone to make it. The farmer wants more money for bringing you the eggs because the cost to feed the chickens and his family is increasing. The production plant that makes your sugar from the sugar cane wants more money because they have to pay higher wages to the workers so they can feed and provide for their families. The company that harvests the cocoa beans needs more money to pay higher wages to their workers. The electric company that provides the electricity to both the sugar factory and cocoa factory needs more money to pay higher wages to the workers that are working both in and out side of the company to provide electricity to that factory, as well as buy more wire to run the electricity to the factories. The wire company needs more money to pay the higher wages needed for their workers…. once you get down to it, that one cookie cost a LOT of money to make, much more than it would have 50 years ago, and it’s all due to rising cost of, well, everything. And I am by no means saying that a medical device such as an insulin pump or CGM is a cookie, but making the point that these are devices that are nothing more than plastic and wires are designed together in a way that the effort, time, energy and research that are put into these products is what is driving up the cost, as well as the point that it is not just the device manufacturer itself that is making a profit from us, but the companies that are supplying the component parts making a profit from the manufacturer and so on. But, this could also be said of any other company, like Apple or Hewlett-Packard or Android. So, again, what is it about when it comes to medical devices that the cost is so much higher?

Does the industry promote their newest devices? Yes! They are after profit, after all, as is every other company in the world. Are the newest medical devices always needed? No, not necessarily. But the fact is that the cost of practically anything medical these days is outrageously inflated here in the US than it is anywhere else. And while, yes, the cost of controlling diabetes has risen in astronomical proportions over the years, so has almost every other disease. While, yes, it is possible to live with diabetes and manage with a meter, syringes and insulin, it may not be the best option for some, and that’s where the author of the article got it wrong. For some, a pump is indeed needed. For some, a CGM is certainly needed. For some, a talking meter is an absolute must. And to blanket us and assume we are all alike in how we control our diabetes is almost laughable.

No, the problem is not that having or not having access to devices is a “first world problem”, but a medical world problem. You’ll never find a medical company who’s heart is truly and purely about the health of their customers without also having the need for profit, and I doubt you’ll find one who settles for just a mere profit either.

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2 Comments

Filed under dblog, Diabetes

2 responses to “Sorta Got It Wrong… But Sorta Got It Right Too.

  1. Very well put, Sarah. I’ve struggled to put my own thoughts on the article into words (many false starts), because I too find parsts of the article I agree with.

    With regards to the topic you discussed, I don’t know what is an “acceptable” profit for these manufacturers, but I do believe they should not only be entitled to one, but that they should enjoy some element of luxury. I’ve worked for companies that preach “tightening-the-belt” and “doing more with less”, and quite frankly, those jobs suck.

    Though I can deal with a disgruntled waitress or cashier from time to time, I want the person who’s building my insulin pump or infusion set to enjoy going to work each day and take pride in what they do, not to do so begrudgingly and angry at an employer that doesn’t treat them well. I can’t afford to trust my life with someone who’s not totally committed to what they’re doing. Treat the workers right, so they can consistently deliver quality products.

  2. Yes, the whole system costs too much. No argument there. I agree the cost elements are important topics that need discussion, and this NYT piece served that purpose well. But just as we in the D-Community argue that insurance companies shouldn’t be looking at cost alone, and shouldn’t be interpreting what “medical necessity” means between us and our doctors, that’s exactly what this NYT article does, IMHO. The tone implies that these aren’t necessary or important, across the board, and that basically our insurance companies and all the CMS and government officials trying to limit access to devices, meters, supplies, strips, and so on are doing good because they’re looking at the important issue of overly-high costs. And this is the NYT we’re talking about, a newspaper that is regularly cited and used by decision-makers to justify their points or explore issues. That is my concern, that this article looks at cost alone, and regardless of how good that journalism may be on cost factors, the paper doesn’t balance that cost aspect out and leaves all of us in a dangerous position. One that is counterproductive and goes against a lot of what we’re advocating for to these same NYT-reading decision-makers.

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