This morning I read a blog post about a woman whose perspective was shifted when she met a homeless young man who was begging for insulin. She commented on how sad it was to live in a society where a person was not begging for money for drugs or alcohol but having to beg for the life saving liquid that he required to flow through his system just to keep him alive.
A few hours after reading this, I received an email from a woman who need help funding an insulin pump. The coverage that she was sure she had did not icover someone of her age (over 18). She desperately needs a pump but, like so many, cannot afford to purchase it and the supplies herself. She was curious to know if I was aware of any compassionate programs that could help her out. Unfortunately I don't.
These two things brought me back to the ugly reality of diabetes--it remains a disease for the rich. That sounds crazy because we know that diabetes does not care how big your bank account is. It really doesn't care what type of car you drive, where you work, or how much money your grandmother left you in her will. Diabetes does not care if you are young or old. Diabetes just happens and we somehow learn to live with it.
The sad reality is that some of us can live with it more easily than others. Years ago I wrote about the reality smack I received one Christmas. I spoke with a friend who had been able to get some test strips to help a family who had a child with diabetes and no insurance coverage. Two hundred test strips meant the world to this family and would free up $200 for them to buy gifts for their children. I had spent that amount of money on one child without a thought and without having to worry about my son having enough diabetes supplies.
I live in a place that will cover most of my son's supplies including his insulin pump until he is 25 years old. That is something that I value because I have no insurance coverage and all of my son's pump supplies would have to be paid out of pocket if I lived in many other areas of Canada. The fact that we are lucky to live here also presents another glaring fact, because we are not amongst those who can "afford" diabetes, we are restricted in where we live in order to have the best of care.
If we lived in Ontario, my son would have all of his diabetes costs covered and I have heard we could even consider putting him on a Continuous Glucose System without having to cover any of the cost. If we moved to New Brunswick, my son would have no coverage at all and if we moved to British Columbia he would have some coverage. I have no plans of moving anywhere but am pained that, in Canada, as with the rest of the world, if you have diabetes your ability to receive the best treatment options depend on where you live...or the size of your bank account.
If you can afford the insulin, the test strips, the glucagon kit, the insulin resevoirs, infusion sets, pump, CGMS, and sensors then you can efficiently manage your diabetes to the very best of your ability. I am not saying that this will guarentee you the best control, but you will have the best tools to help you be the best artificial pancreas you can be. If you have to pay for your "new" insulin (be it rapid acting or long-lasting) because your province's formulary only covers things like Regular insulin and NPH then you have to watch your insulin consumption a bit more. If you have to pay for your own infusion sets then you want to cry each time sweat or rough play causes a site to fall out before at least reaching day three of use. If you have to pay for your own CGMS then you pray with each sensor that it will last and continue to provide data well after the supposed expiration date.
The items I have listed above are not luxuries. Its not about having a Hyundai Accent versus a Jaguar. These items keep our loved ones with diabetes alive, healthy...and ultimately active and productive members of the tax paying community. We have made huge strides in the past ten years regarding improved access to medical supplies and devices. I pray for the sake of my son and so many other people's children that we make bigger leaps towards seeing no inequity regarding medical coverage in the future.