“Paula Deen caught eating a cheeseburger.” Oh, dear, it didn’t take long for the food police to start watching Paula’s eating, this time in the guise of news (if you can call TMZ a news organization). Are we going to start getting daily updates (complete with unflattering photos) every time Paula eats food deemed inappropriate?
It appears the whole, “should you be eating that?” myth is alive and well when it comes to diabetes. Is this how far we haven’t come?
Let’s get one thing clear: a diabetes diagnosis of any flavor doesn’t mean you are condemned to a lifetime of lettuce (although I proudly eat more salad then anyone I know). Yeah, sometimes I eat a cheeseburger. With bacon. And a beer. Diabetes be damned. But, I certainly don’t eat that way often. Even if I did, that’s my problem.
Until Paula Deen announced she had diabetes, she didn’t make headlines for what she ate. Why does the diabetes diagnosis change that? Put another way: If Paula was merely overweight, but diabetes free, would she be called out for eating the cheeseburger because only thin people should get to eat what they want?
I see people eat crap every day. I see them feed it to their kids. Does it bother me? Sometimes. I am a big proponent of nutrition. Do I say “should you be eating that?” Nope.
If you missed the in-depth reporting, TMZ also reported that, gasp, Paula had fries on her plate.
Diabetic fire sale! Millions of leads for sale.
100,000 in house produced diabetic leads for sale.
1st position diabetic data available. Call for details…it will go fast!
This, dear readers, is what awaited when I clicked onto my weekly LinkedIn group digest for durable medical equipment.
I realize that the practice of buying and selling leads, within certain parameters, is legal, but it all seems so…tawdry. Is this what I have to look forward to when I reach Medicare age? People buying and selling me like a commodity?
Which, I guess, technically I am. Still, is it hard to understand why CMS and other payers are often tempted to treat diabetes supplies like a commodity when the leads are flying faster than you can say, “here’s my credit card number”?
Don’t even get me started on the horror stories I hear from providers about unwanted auto shipments of supplies which wastes millions of health care dollars; identity theft, which wastes millions more; and a host of other potential pitfalls that can befall us when something is commodified like this.
Can we expect more of this, as the diabetes population explodes? Who’s doing the buying, anyhow? And finally, is this the best LinkedIn has to offer?
I think what gets me about this whole “Paula Deen has Type 2 diabetes” news is that, a few short months ago, fellow TV chef Anthony Bourdain criticized Deen’s cooking for being so unhealthy. “She revels in unholy connections with evil corporations and she’s proud of the fact that her food is f—ing bad for you.” As I recall he was shot down by Deen and her loyal followers.
Turns out, at the time, and indeed, for the past three years, Deen has continued to serve up high fat (really, really high fat) recipes, all the while knowing she had Type 2 diabetes. Now, it’s her right to keep her private life to herself, but suddenly stepping into the limelight as a paid spokesperson for a diabetes drug? And saying she needed to wait till she had something to offer? Give me a break.
Paula Deen is not only an example of what NOT to do in “lifestyle” choices (she’s already started beating that euphemism to death), she’s an example of one of the problems with American health care. Why treat the cause when you can take a drug, instead?
I had the misfortune of catching a few minutes of her saccharine show once, before I cancelled cable. I gotta say, anyone can fry something or roll it in butter and sugar. It takes true skill to be able to create flavorful foods using natural ingredients.
I had to look up a few of her “southern” recipes, just for fun, although I find it hard to believe most southerners of generations past would recognize this stuff. Needless to say, calorie counts aren’t provided.
Fried butter balls
Deep fried lasagna/Deep fried cheesecake/Deep fried stuffing on a stick
Brown sugar bacon
Twinkie pie/Krispy Kreme bread pudding
Just reading this list makes my blood sugar go higher.
When I arrived at work Friday morning, I found the Wall Street Journal on my chair, with this article circled: “Diabetic tester that talks to iPhones and doctors.” Then, Editor Liz forwarded me a link to the same article.
OK. I can take a hint. Here’s my blog on the matter. The article was a technology review of a new product, set to debut this week, the Telcare, that allows users to transmit real-time readings to an online database that can be accessed by said user, and other approved folks. It can chart trends (and in diabetes management, it’s all about trends, except, of course, when it’s about anomalies) and spot potential problems. In other words, it’s pretty cool.
The only drawback, said the author, was the price. However, at $150 (not including strips), it costs a lot less than a lot of fancy gadgets people willingly plunk money down for. I can only imagine the Telcare is the advent of bigger and better (with technology, I guess that should be smaller and faster), diabetes products on the horizon.
And, as with every step forward, there must be a step back. Today, I came across this article, about how high school students with diabetes (it doesn’t specify, so I will assume it is about both Types 1 & 2), are more likely to drop out of high school and face bleaker job prospects. (note: I was a college senior when diagnosed so can’t speak personally to all of what the study claims to have found).
One thing I agreed with: Those with diabetes or more likely to stick with a lower paying job if it offers good health benefits, something called “job-locked.” You’ll never see me strike out on my own unless I win the lottery, or marry someone with good benefits (not sure which has the longer odds these days).
What I didn’t like: The part that said diabetes could alter a person’s desire to enter the workforce (c’mon, you are not disabled); and that employers could be less partial to hiring someone with diabetes (this is probably true, but I have been lucky—and I don’t include it on my resume under “special talents.”)
I guess what bothers me about the first part is it makes people with diabetes sound helpless, or, gasp, lazy. Bring on the government benefits! In fact, it could reinforce employers’ beliefs that hiring a person with diabetes would be an unsound investment, something that was quite a common perception not all too long ago.
Fortunately, I read far more these days about people with diabetes who say it has inspired them to (fill in the blank).
We’ve all heard the stories: HME providers are crooks, out to scam Medicare, etc. etc. Sometimes it’s as simple as a local news brief about what I would call a “so-called” HME provider who has been busted for Medicare fraud. I say so-called, because many times it’s obvious these are no providers.
Sometimes it’s more egregious, like say when a CMS official or lawmaker, rabid for cost savings, starts throwing around Internet prices for oxygen and questions why Medicare pays so much.
Or maybe its the latest anti-fraud measures, aimed at protecting the Medicare program, although in the case of widespread audits, CMS is barking up the wrong tree.
Whatever the case, the industry does a pretty good job of trying to keep these stereotypes at bay whenever they crop up. Which is what you need to do, because, left along, stereotypes can be harmful to the maligned group.
Which is why the following subject line in my email inbox gave me pause: “Stop spreading wolf stereotypes.”
Yup. It seems a recent ad depicting a pack of wolves attacking a man is harmful to wolves. The email says that such a depiction fuels anti-wolf sentiment in popular culture, at a crucial time for wolf recovery.
First, I had no idea there was a a popular anti-wolf movement about. I mean, who is anti-wolf?
I will admit, wolves, like HME providers, are indeed an endangered species, and there’s nothing funny about that.
But there are so many serious problems out there, so many maligned and stereotyped and underrepresented groups out there, howling for fairness that I gotta say, I am throwing this plea…back to the wolves.
Merriam-Webster chose “pragmatic” as its 2011 word of the year. For those not in the know, or in possession of a dictionary, the word is defined as “concerned with facts or actual events; practical.”
That seems like a good word for the HME industry to embrace in 2012. There’s lots of facts—many of them painful—that providers will need to embrace like they have never embraced them before. The biggest (barring a Christmas or political miracle) is that Round 2 of competitive bidding is, ahem, here. For providers across the country who kept saying “we hope it goes away,” it didn’t.
The pragmatic thing to do here, and I know many of you have begun, is to begin the process of registering to bid. And then continue to take the pragmatic next steps in the process of preparing to submit your bid. That bidding window opens sooner than you think.
With the economy continuing to be a downer, it’s also important to be pragmatic about business practices. I know this is often easier said then done, especially when it comes to patient care, but if you aren’t making money on a product, you aren’t making money. Cut your losses. If you aren’t getting paid, whether it be a patient or payer, stop providing them with free stuff. Other providers have done it and they are still standing. Businesses in other industries would never do it all. It’s not … practical. Nor is it profitable.
And finally, I hope there’s a little pragmatist in us all when it comes to daily life. To paraphrase the famous saying, there’s things you can change and things you can’t change, and you’ll be much happier if you understand the difference between the two.
Our most recent HME NewsPoll asked whether providers typically set business goals each year. The good news: 78% said yes. The bad news: 22% said no.
What does that mean, exactly? Do they not set goals for sales figures? Set goals for employees to have something to strive for? Set goals for getting their name out there?
I guess I don’t understand, how do you even run a business if you don’t have any goals? How do you know what to do?
Some days, my goals are loftier than others, ie, today I will post a blog, make 25 phone calls, write two stories and send an assignment to a contributing editor.
Other days, not so much, ie, this weekend at the bookstore, I will try to just make it through the day without throttling the first customer who asks, “where’s the nonfiction section?”
Is not setting goals kind of like not paying attention to competitive bidding, in the hopes that, if you ignore it, it will go away? Cause we’ve all seen how well that plan worked.
Had dinner with my friend Kellie last night who, when I went to check my blood sugar, was reminded of her recent frustrations with the health care system.
Kellie hadn’t been feeling too well. Achy joints, low energy and other vague symptoms that can point to any of a number of diagnoses. Kellie is pretty sure it’s Lyme disease, but was referred to an endocrinologist who kept insisting her symptoms might be related to blood sugars.
“It’s not my blood sugar,” she kept arguing. (Kellie eats well, exercises regularly, weighs about 100 pounds and is in no way at risk for Type 2 diabetes. She certainly didn’t have the severe symptoms of Type 1). Kellie does, however, spent lots of time in the great outdoors, where she certainly could have run into Lyme disease.
She might as well have been banging her head with a coconut. She wound up in an educational session with a diabetes nurse, and received a meter/lancets/strips so she could track her glucose numbers over a set period of time. All of which were in the 90s.
In other words, it wasn’t her blood sugar. She received a battery of other tests and is currently on a course of antibiotics for, yes, Lyme disease. She’s also taking a Vitamin D supplement.
She feels like her old self again, and now has a brand new glucometer and its related accouterments that she has no use for (I have a feeling I’ll inherit). She spent time and money (hers and the insurer’s) that didn’t need to be spent, in yet another example of how our health care system doesn’t always use its dollars wisely.
The morale of this story: Sometimes the doctor doesn’t know best.
Last week, in anticipation of a celebratory dinner (yay, we survived Medtrade), my coworkers were talking about how they weren’t going to eat much that day so they could, well, stuff themselves at the restaurant. My suggestion was to eat sensibly all day (they all tend to, for the most part), and then—wait for it—eat sensibly at dinner as well.
Needless to say, that went over like fish in an office microwave (I’m looking at you, Editor Liz).
But answer me this: Why must a celebration be all about the food, and large quantities of it at that? Why knowingly eat so much that, diabetes or not, you won’t feel all that great afterward?
This applies to Thanksgiving as well. Is it really all about the food? Because to me, that would be sad if one’s biggest enjoyment of the day was the mashies and butter or the pumpkin pie.
Yes, I look forward to turkey (about 3 oz), mashed potatoes, stuffing, etc (small servings). I’ll probably eat more refined carbs in one meal then I do in an entire month, and I’ll have the insulin dose to prove it. (I’ll probably also have salad because green bean casserole just isn’t my thing.)
I might even have pie.
But, I’m not wearing “fat pants” to the table. I don’t plan on lolling uncomfortably on the couch all afternoon, antacids clutched in hand. Actually, we’ll probably head to the beach for some fresh air, but definitely no swimming, I don’t care how far south Cape Cod is from where I sit.
OK. Providers have all heard that they need to get the beneficiaries involved on HME issues, like, say, competitive bidding.
While I agree with that, I have a feeling that there’s an obstacle there: the beneficiaries themselves.
Meet Wayne. Wayne is a beneficiary with longtime Type 1 diabetes. He uses an insulin pump. Wayne learned last week that CCS Medical would no longer supply him with strips. About a month before that, they told him they could no longer supply him with insulin. The reason, he was told, was that Medicare was not paying them.
This was all posted on a online forum, btw.
I don’t know if his doctor isn’t doing the documentation correctly, or they were referring to low reimbursements or what. Several people suggested it may have to do with competitive bidding, (CCS did not win any contracts) but since it sounds like Wayne lives in Oregon (I could be wrong about this), I doubt that’s the problem. At least for now. Several posters to Wayne’s post mentioned competitive bidding; a few mentioned he needs to let his lawmakers know the program is the problem, etc etc.
Yeah, Wayne doesn’t sound like he wants to do that. “As a diabetic, we do not have months to chat with political peoples, as without insulin and a way to test, we are sunk!” (his words, not mine. I would never call myself a diabetic).
OK, Wayne, if not you, then who? You are retired for crying out loud. Yes, this is bad, and I get your frustrations and fears. But seriously dude, make a call. Will it change the program? No, but neither will never speaking up accomplish anything.
In the meantime, he worries he won’t find another supplier, and he worries he won’t get the insulin and supplies he needs.
“I am mad as Hell about this!” he wrote. But not so mad that he’ll actually do anything to constructively channel his rant about how he’s entitled to his entitlements
