Diabetes Blog Week - Day 3 - Clean it Out

Today's post asks, "What needs to be cleaned out about our diabetes, either physically or emotionally?"

I think you'll see some great posts today about the emotional burden of diabetes. You won't find that here, though.

What you will find is a short commentary about how health insurance has changed what it means to be a diabetic in the US.

What you see there is my back-up closet of supplies. There's probably about two years worth of Medtronic supplies (as well as two out of warranty pumps), and a much smaller supply of first generation Omnipods. (Let's be honest; the batteries in the Omnipods are likely shot and they should be disposed of.)

Those items were acquired during several years of auto-shipped supplies when I was on a low deductible insurance plan. The boxes showed up every quarter and they got added to the pile where they were stocked up as if I were preparing for either Diageddon or - more likely - unemployment.

What I didn't take a picture of is my first string closet of supplies, which consists of the stuff I'm actively using now; tSlim and Dexcom supplies. What you'd notice immediately about that supply is that it's much smaller, because it also corresponds to me switching to a high deductible healthcare plan, which means I'm paying out of pocket for a much greater portion of the supplies.

It's a much smaller stash, and if the larger one gives me comfort in knowing that if times get tough I can get by without having to go off the pump, the smaller one reminds me that the "quality of life" I enjoy using a pump and CGM comes with a real economic cost. Like a lot of Americans, the high deductible plan has forced me to think about the care I'm getting. I actually read the invoices. I consider when I need to order my next box of supplies.

And to be honest, though paying for this stuff stinks, that's because paying for anything stinks. I'm not certain it's inherently a bad thing to be thinking about your diabetes like a consumer and determining what's best for you. At the end of the day, I know I could get by without a pump and CGM; I did for several years. I wouldn't like it as much and my control would suffer, but in my case, not dramatically so. And I say all of this realizing that I am fortunate to be able to afford the choice. Not everyone is so lucky.

In the end, my closets represent the reality that in today's economy, we need to be active participants in how we treat and afford the treatments we feel are necessary. And we need to be thinking about the day when they might not be so full.


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