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Money Keeps Diabetics from Getting Optimal Care, New York Times Says

Posted Dec 18 2008 8:13pm

Anyone whose read this blog regularly knows how serious diabetes and its complications can be.  Left unchecked, diabetes can lead to heart disease, kidney failure, loss of limbs, and premature death. So you'd think the medical establishment's number one priority in diabetes care would be providing patients the information, counseling, and supplies they need to keep this dread disease under tight control.  But, after you read the excellent feature on diabetes in today's New York Times, the third of four such articles, you'll learn you might very well be wrong.

Writing under the headline, "In the Treatment of Diabetes, Success Just Doesn't Pay," reporter Ian Urbina catalogues the ways that money apparently comes before good patient care for New York City's type 2 diabetics. Urbina notes that four major New York hospitals opened diabetes care centers in 1999. 

These centers were staffed with nutritionists, diabetes educators, podiatrists, opthamalogists, and endocrinologists, whose role is to provide coordinated, intesnsive education, advice and treatment to patients.  Unfortunately, all but one of these centers shut down, Urbina reports, because they didn't make enough money. 

What does make money in diabetes care? Amputations, for one thing, for which insurers will pay more than $30,000, according to Urbina's revealing piece. Oh goodness!

By contrast, the Times article states, insurers will often refuse to cover $150 visits to podiatrists, specialists whose intervention could help patients avoid amputations in the first place. In other words, health doesn't pay, sickness does. (Or to put it bluntly, and perhaps crudely, insurance companies aren't into saving legs; they'd rather pay to chop them off.)

This is just one of several discouraging examples of how money trumps patient well-being that Urbina reveals in his outstanding article.  I urge you to read it as well as the first two installments in the series, which you'll find here and here.

Much thanks to my editorial assistant Jennifer Moore, for keeping me caught up with important news on this blog.

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