But sadly, comprehensive care may simply be a matter of finances. As the publication mentions, “The majority of physician study participants perceived that most of the 10 identified services are inadequately reimbursed—83% to 95% of physicians said Medicaid reimbursement was inadequate, 75% to 89% for Medicare reimbursement, and 67% to 86% for private insurance reimbursement—leading them to spend less time with each patient. This reduction in time was a limiting factor to providing comprehensive diabetes care.”

Is there a solution to this quandary of not enough reimbursement to encourage spending the time needed? Not that I’m aware of. There are, of course, some well-financed diabetes programs, usually in big cities and/or associated with medical schools or University hospitals. But for the average physician, there simply isn’t enough incentive to provide comprehensive care for people with diabetes.

And I don’t think the situation will improve with forthcoming plans to revise the health care delivery system in the United States. Call it rationing or what you will, patients and physicians will simply have to accept the fact that the “best” diabetes care will not always be available – it’s too expensive and too poorly reimbursed.