Wednesday, May 4, 2016

I Call BS (meaning Bull Shit, not Blood Sugar)!

A story written by DiabetesMine broke the news that United Healthcare has decided that, as of July 1st, patients with diabetes (over the age of 18) should only be allowed choose a Medtronic insulin pump if their doctors / health care team prescribe pump therapy.

A heath insurance company should not make medical decisions.  EVER.  If a doctor decides that a patient needs a certain medication, therapy, medical device etc., then that is the best choice for the patient and they should not have to sacrifice and use something that an insurance company says is the "only option."  Remember that the sacrifice may cause even worse health issues and can be extremely costly to the patient (can you say "out of network?"). 

Why did United Health Care do this?  I'm not sure (NO ONE is sure except them).  Maybe they and Medtronic have a special 'deal' and Medtronic has some sort of payback system?  Maybe they are too lazy to work with other pump manufacturers / suppliers?  I can't answer these or any of the other questions this generates.

The press release (linked above) was put out by Tandem Diabetes Care (they also make insulin pumps).  They state, most perfectly, "Having diabetes isn’t a choice. How people manage it should be. Insulin pumps are not a one-size fits all solution. Selecting which pump is the best fit for a person to manage their therapy needs should be a decision made between a person and their healthcare provider."

United Health Group is the parent company of United Healthcare.  If you visit their website, you will see their mission statement:

"We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities." 

 "We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price." 

"We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions."

Hmmmm. . . I don't think so guys.  I think you seek to make money, lots and lots of money.  And I think you seek to screw your customers in that process.

My friend Stephen Shaul at Happy-Medium wrote about this topic more eloquently that I can (please, please use the link and read his take).  He says, "Eliminating choice for patients is wrong, it reduces innovation, and in no way does it “improve the overall health and well-being” of People With Diabetes, or even save them money."  And he points out, "Choice isn’t just important… choice is necessary."

Is there a fix to this situation?  I'm going to tweet, blog, and Facebook about it as much as I can.  I'm going to tell everyone I know about it.  I hope that people who are looking for employment tell companies, "I'm sorry, I'd love to take the job but can't do so because your provider is United Healthcare."  Companies looking for good employees may be 
'forced' to change to a new provider if people don't want to work for them.  Maybe if United Healthcare loses business, they will realize what they've done.  Will any of this help?  I can only hope.


  1. Thanks Liz! We may seem powerless in all of this, but there is much we can do. I might also suggest calling your state's insurance commissioner to complain. Get it on their radar too. Great post... thanks!

  2. I agree. I have had to switch insulin brands several times because of insurance. It's not ok to be forced to switch meds or equipment.

  3. We are off to a good first start this week. The issue is if we can sustain the heat and increase the pressure. I trust we can.

    I referred your blog to the TUDiabetes web page for the week of May 2, 2016.

  4. Stephen - I will call the insurance commissioner this week! Good idea.

  5. You are right Erica - This isn't just about pumps. Insurance companies deny all sorts of medications and other things. The doctor and patient should make decisions and they should be able to access the things that are needed!

  6. Thanks Rick. I hope our collective voices can do something about this!