Bleeding the system?

 - 
04/21/2011

I couldn't resist this headline: Diabetes: Making people bleed for profit.

The premise of the article was that the recent trend toward having Type 2s test their blood sugar 8x to 10x per day is unnecessary, and could cause anxiety and depression.

Tell me about it.

I actually happen to agree that most Type 2s don't need to test this often. I would also posit that most don't. The writer, (a Canadian, by the way, eh), figures all this wastes about $10 million a year (I assume he's talking Canadian dollars).

I've had some interesting talks this week with diabetes providers (Americans, yo!), about newspaper ads popping up seeking to buy excess strips from patients. HME providers don't do this, but they can be sure it will come back to bite them in the ass (can I say that here? too late).

I've also spoken to folks about companies that call up patients, trick them into giving up their Medicare or other insurance info and then selling those "leads" to other providers. The result: patients get multiple shipments and eventually, someone don't get paid (we're into Medicare here right now).

Test strips cost big bucks so companies seeking new ways to turn a buck on the taxpayer dime are only too happy to keep shipping and shipping and shipping (which I think is also against the rules). But rather than crack down on these practices, which cost the system millions, and cost HME providers customers (and payments), CMS comes along once in awhile with proposals to to limit the number of strips dispensed based on a one-size fits all formula. Or they rescind payments from providers who didn't get the doc to chart the way Medicare wants it charted. Or something else ineffective and, uh, wasteful.

Unfortunately, all this waste eventually harms everyone. That's money that could go toward other things. It gives HME providers a bad name.  It doesn't address whether patients know what they hell they need to do. It practically guarantees that down the road, all payers are going to try and seriously restrict strip quantities for all of us, regardless of diagnosis. Which will then increase other costs.

Or maybe, the manufacturers could admit they haven't made any real improvements in strips in a decade or so and start dropping the price so its less attractive of a money maker.

Of course, one can always hold out for a cure.

Theresa Flaherty
Type 1