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Wednesday, October 17, 2012

Health Insurance With A Side of Condescension


About a year ago, I shared news with you all about my plans for some new treatment measures for my diabetes. While the continuous glucose monitor (CGM) didn't work out for me as well as I'd hoped, it was a useful short-term tool, and I have to say that I've taken much better care of myself this year. My numbers are good (but not so good that I'm battling lows regularly), I'm exercising and watching what I eat a little better, and importantly, testing my blood sugar at least three times a day to keep myself on track. The CGM has become the threat for me, that if I don't keep myself doing the right things, I will force myself to go back on it. It made me so stressed out and miserable, that it's a very effective threat.

I've said before that I'm not the model diabetes patient, but on the whole, I do a lot of what I'm supposed to do. I always take my meds. I keep my blood sugar in a good range. I get annual eye exams and blood work done regularly for all of the testing I need. Apparently, though, that's not the norm, and rather than seeing me as an exception, I'm lumped into this class of diabetes patients that, evidently, are total idiots. Otherwise, why would I get the following call from my insurance company? (Follow the link to listen.)

"Hello, this is Blue Cross Blue Shield of Massachusetts calling Cheryl with an important health-related message. This is not a telemarketing or election-related call. If you have diabetes, or know someone who does, please note that there are several diabetes tests that should be performed on a yearly basis. People who have diabetes have an increased risk of eye disease, and that is the reason why an eye examination specially designed for diabetics called a dialated [sic] retinal eye exam is recommended at least once every year. It is also recommended that people with diabetes have a cholesterol check, foot examination, special blood test called HBA1C to measure blood sugar levels and a urine test for kidney function on at least a yearly basis. Too often, events in our lives are outside our control. However, lifestyle changes within our control can enrich our quality of life. If your physician has already prescribed medication, or recommended lifestyle changes, a healthy diet, regular exercise and tobacco-free lifestyle, we encourage you to follow your physician's advice. Please continue as instructed. If you have diabetes and have not had all of these services, Blue Cross Blue Shield of Massachusetts encourages you to call your physician to discuss if you need any of these tests. Thank you, and as always, we wish you the best of health."

Eighty-seven seconds of a voicemail message that left me quite upset. Regardless of the fact that if anyone should know if I've gone to my doctor for those tests, IT'S THE INSURANCE COMPANY THAT'S PAYING FOR THEM, I can't imagine there are too many doctors out there saying "you have diabetes and never ever need to do anything about it ever again." Or that there are so many diabetics who receive a diagnosis and don't do anything about it themselves (trust me, high blood sugar makes you feel horrible, and you can't go on living that way indefinitely). You can't even watch television without ads for glucose meters popping up every few minutes. The HBA1C blood test is the minimum standard for care, a test I've probably had at least two dozen times. There are so many built-in checks in the healthcare system too, like prescriptions that expire, forcing you to make contact with a doctor to get them renewed. And there are a whole class of diabetics like myself that "lifestyle changes" aren't going to help very much. Yea, having diabetes is an event that's "outside my control."

I don't mean to make light of what my insurance company is trying to do here (except for where they pronounced the name of the eye test wrong. Come on.), but simply calling every single patient with a "diabetes" box checked and no further refinement of their data is obnoxious. I'd actually had my blood work done just two days before receiving this call. Rather than empower me to take care of my health, the message made me feel like people with diabetes are incapable of managing their lives. The elementary level diabetes education it provided, to someone who has been dealing with this disease for a very long time, and aware of it for even longer than that, was simply condescending.

As always, I am very grateful to my employer for providing me with health insurance in the first place. But with so much political discussion around healthcare reform and insurance, it seems to me that this message isn't an effective use of anyone's premium dollars. Except maybe as blog fodder.

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