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Money. No one wants to talk about it, but it affects all of us. In the United States of America, having a health condition can put you in the poorhouse. In a recent survey, the U.S. Census determined that medical bills were the biggest cause of bankruptcy filings in 2012. Many people will even hesitate to take their necessary medications in order to slow the financial bleed.
This survey doesn't separate minor versus major medical conditions, so I can easily imagine people with chronic issues putting their lives in great danger, trying to find ways to apply a tourniquet monetary wounds. Money and diabetes just don't mix.
I have type 1 diabetes. Without insurance, my monthly cost of supplies can range from $1,400 to $1,600. Having reputable health insurance reduces the out-of-pocket cost of supplies to approximately $200 per month, but insurance costs money as well. Individual health insurance for one person with diabetes costs from $900 to $1,100 per month if your place of employment does not share the costs.
With health benefits offered through my workplace, the monthly cost of insurance is reduced to $500 per month, which covers my family of four. Finding a job that pays enough for living expenses as well as offers health benefits is difficult to do, even when you acquire the necessary skills and educational background for your career. If you do not have a strong resume built yet, finances are strained again to handle schooling and job training certifications.
My monthly supplies include syringes, insulin pen needles, lancets, glucose strips, two kinds of insulin pens, and sometimes metformin pills. I also strongly benefit from clean eating, which costs almost double compared to processed foods. The costs I've managed to cut from my medical needs are a continuous glucose monitor and insulin pump supplies, which ranged near $400 more per month: sensors, reservoirs, catheters, batteries, replacement parts, etc. I ended my relationship with these two devices years ago due to issues other than money, but I feel it's necessary to point out that people who are relying on these machines to control diabetes have an even higher cost of living than myself.
About a week ago, we received notification that the costs of our workplace insurance are increasing beginning January 2014, as well as the cost of prescriptions and all co-pays. Nothing about my family's health has changed in the past year, so the increase is out of our control. I thought the financial terrain we face today was difficult to navigate. But, the costs we are about to encounter next year, even having a secure job with reputable health insurance, are threatening to pull me under.
On top of raising two very small children, the stresses from financial burdens are taking a toll on my diabetes control. Physical and psychological stresses release the hormone cortisol. Cortisol is released by the body when we encounter stresses in order to spike adrenaline and sharpen our "fight or flight" instincts. When the stress is chronic and long term, cortisol is released on an almost constant basis. This affects our diabetes control because our bodies convert cortisol to glucose. It's then safe to say the price of my disease is actually making it more difficult to control.
Despite being in a healthy, stable relationship and leading a very happy life with my children, I am in a constant state of worry. I worry about keeping my children stimulated, keeping myself career minded, and simply keeping our little family healthy and happy. I worry about money as my medical bills multiply. I was involved in a car accident last year which cost nearly $20,000 for less than three hours of hospital assistance-most of which I spent lying in a bed, waiting for a doctor to see me. I had broken ribs and a fractured cheek, neither of which they could assist in the healing process.
My pregnancies were unexpectedly challenging and needed lots of special attention from several doctors that added up to several thousand dollars. The emergency surgeries to birth them cost nearly $5,000. Taxes are increasing, interest rates are climbing all over the country, and the basic needs of my family are growing as my children become older. I'm getting less sleep than I need and am pulled in more simultaneous directions than before. Plus, I'm balancing my checkbook which seems to be bleeding money.
I am struggling to understand why the cost of good health is so unattainable. I can't believe the cost of being a well-controlled diabetic is so high. All accidents aside, it costs a huge amount of money to get the medications and medical attention that we require just to survive. We don't have a choice whether to take insulin or to monitor our glucose, and it's a very heavy burden for families to bear. There are millions in this same situation, doing everything they can to pay medical bills, even at the cost of their short-term health. Does anybody hear me?
Katherine Marple was diagnosed with type 1 diabetes at age 14 in 1998. Tthe mother of two small children, she has battled insulin resistance, pre-eclampsia, and CGM and pump failures, leading to insulin therapy via MDI using Levemir and Apidra and sometimes metformin. She is the author of two diabetes-related novels: "Wretched (this is my sorry)" and "Deathly Sweet."
6 comments - Sep 22, 2013
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.