Diabetes is not to Blame for Rising Healthcare Costs
The Scarlet "D," a take off on Nathaniel Hawthorne's Scarlet Letter, has been used to describe being unjustly labeled for society's perceived wrongdoing and can be applied to everything ranging from divorce to depression to diabetes.
With healthcare reform commanding our attention and the headlines, many suggestions have been put on the table as to how to curb the upward spiraling cost of health insurance, whose yearly increases can be in the double digits - and even upwards to a reported 29%.
One of the ideas on the table is that those that are healthier should pay less for health insurance. The idea is that the better you take care of yourself, then the lower your health insurance costs ought to be. Smokers, for example, would pay more for insurance premiums than non smokers. Those who exercise regularly and maintain a healthy weight would pay less than those who do not.
This approach makes sense since the basic premise of insurance is to base rates and insurability on risk. Health insurance is like all other businesses: one of its primary goals is to stay in the black. It is understandable that it needs to adhere to the basic principle of its business model: those that have higher risk factors should pay more. For example: If you own a house in a flood or earthquake zone, you probably will pay substantially more for home owners insurance (if you could get it at all) than someone who does not.
Yet often you can control where you own your home, but you cannot always control all of the elements that will affect your health. Take for example, a diagnosis of a chronic condition like diabetes. There is nothing that a person can do to prevent a diagnosis of Type 1; it's the result of a bad spin of the health roulette wheel. Although Type 2 has been christened as a life style disease -- a term used regularly to describe the condition -- sometimes not much can be done to stop the onset of it, with its contributing factors including: a genetic pre-disposition (which I have), a prior history of gestational diabetes, and environmental conditions.
It is little wonder that those managing chronic conditions like Diabetes feel branded with a "Scarlet D." Insensitive outsiders make you feel that it is your fault that you have this condition and will ask why you didn't eat better or exercise more to slow or stop the onset of the disease. Furthermore, when it comes to the issue of group insurance rates at a company that provides health insurance, those with chronic conditions often feel almost wholly to blame for the skyrocketing cost of healthcare and health insurance rates. Those with holier than thou attitudes, which can include co-workers, human resource managers, and insurance representatives, can brand those noticeable chronic conditions, like Type 1, as the reason for the substantial yearly hike in premiums.
In support of this feeling was a comment to one of my recent posts, "Diabetic or Person with Diabetes": "I don't know about the rest of you but I'm going to just start wearing a scarlet D embroidered on my shirts. That way there won't be any confusion as to who [is a part of] that wasteful 20% of the insured [who] is driving up costs for everyone according to our HR representative at work. It will also make it easier to identify me when they down size to save on insurance costs and start rounding us up for relocation. I clearly contracted type one because of the terrible life choices I was making and will continue to be a burden on the system until I do the right thing and crawl out onto an ice flow."
The issue boils down to this: Are those with chronic conditions, like Diabetes, one of the primary causes of an almost unfathomable increase in healthcare costs and the corresponding jumps in health insurance costs?
I think not. Other, much more substantial, causes exist. Start first with the insurance industry itself. In this country built on capitalism, why must the vast majority of healthcare costs and the subsequent quality of service be based on a nearly monopolistic stranglehold by a very few companies - i.e. insurance carriers? Okay, maybe I'll drop the harsh term of monopolistic in favor of oligopolies based on collusion.
Too, why must drugs be so expensive in the U.S.? I understand the need for R&D, but I ask Big Pharma not to hide behind R&D as to why they charge high prices for their drugs. One reason is the outrageous amount of money spent on promotion for drugs we usually don't need for conditions we never knew that we had and probably could survive without knowing that we did have them. Pharmaceutical companies spend nearly double on promotion than that of R&D. Let me repeat that: for every dollar of R&D money spent, Pharma spends almost two dollars on marketing. I can't watch the 30 minute segment of Charlie Gibson's ABC World News without being bombarded by drug ads. Much to my chagrin, "Viva Viagra" is my 11-year-old son's favorite jingle.
Finally, shouldn't we Americans consider tort reform when it comes to healthcare? Maybe that will help to curb practitioners feeling the need to have every decision they make be backed up by expensive and often unnecessary tests and procedures. It's a well known fact that John Edwards and his focus on cerebral palsy cases contributed to the incidence of Caesarian Sections to increase by 22 percentage points from 1970 to 2003.
I've only glanced across the surface of the deep mired pool of the culprits that shoot our healthcare costs sky high. Many, many others exist.
Yet, for those wearing the Scarlet D or whatever other letter, rest assured you are not the sole or even primary cause for the astronomical cost of care. So get out your scissors, snip off that letter, and consider yourself absolved.