Worried about competitive bidding? So are others


This blog headline caught the attention of my Google alerts: Why Medicare's Attitude Toward Diabetes Could Kill Senior Citizens.

The blogger has Type 1 diabetes and, judging by her picture, is nowhere near Medicare age. She is, however, concerned about the national mail-order program which she believes will reduce access to high-quality supplies.

To be sure, the blog, which I wound up skimming because it's rather legnthy, hits on some critical points, including the AADE survey of contract suppliers which I wrote about in February and problem with FDA standards for meters (which aren't reassuring).

That second item is relevant to the bidding problem, but also presents a much larger issue, which then circles back to potential problems with bidding. If a meter isn't accurate, what's the point? It's hard enought to keep those sugars steady without the meter throwing a monkey into the works. 

The blog includes a link to a recent US News and World Report article. Did you know that 98,000 (!) seniors over the age of 80 wind up in the ER every year because of insulin-related hypoglycemia? That sounds like a lot. If meters aren't providing accurate enough info to calculate an insulin dose, that's a serious issue, for both the FDA, which really needs to tighten its standards, and CMS which is paying, if not for the actual meters, for the related supplies and, when necessary, ER visits.

To get back to our weird little niche, if 98,000 people are having issues with just insulin, what are the long-term ramifications of less obvious problems associated with the bidding program? Here, I am not talking specifically about faulty meters, but bennies who become less compliant because they get a new meter they don't like, for example.

Slowly, insidiously, the blood sugars creep up, causing a host of very expensive complications (heart and kidney failure, anyone?). And we're not talking just the over-80 crowd. We're talking anyone of Medicare age, including those who are still working because they are, well, able. What's the cost to Medicare here?

It's heartening to note, at least, that the (sort of) broaders public is indeed, well aware of the problems and dangers of short-sighted cost-cutting measures like competitive bidding.

Theresa Flaherty