Category Archives: government

Private Insurance

our daughter has a pump – an insulin pump delivers a steady amount of insulin via a needle that stays in place for 3 days and then is moved to a new site. At present it is the closest thing to an artificial pancreas available and it allows her to live a much more ‘normal’ life. She can sleep in, she can skip meals and she can eat a big meal (like Thanksgiving).

On regular injections it is necessary to balance meals, have snacks available and to get up in the morning by 7:00 in order to have the first needle of the day and eat breakfast. Sure, this doesn’t sound like such a tough deal and in the scheme of things, it isn’t. We tend to coddle our kids, I know that, but after coming so close to losing her, we have damn good reasons for going out of our way to spoil her now and then.

The real benefit of the pump is that when kids go on them they don’t have as many dangerous lows and it’s easier to keep blood sugars down at a decent level. Okay, in our little sugar plum’s case, she hasn’t been doing so good at keeping the levels down but that’s another issue – the good thing is she isn’t having lows and we haven’t had to phone the ambulance or break out the emergency glucose once since she strapped on the pump.

Breaking out the emergency glucose is one of those things you do when you notice she isn’t responding to questions or making any sense. Her eyes are starting to roll around and it is only a matter of seconds before she’ll be unconscious – so find candy or honey or glucose and fight to get it into her mouth. … And plan on spending the next few hours or the whole day just napping with her and getting her back on track because brain cells have died and she won’t be able to focus clearly on much for the next little while.

It is one of those things that shorten lives, leads to amputations and all the other delightful complications of diabetes. And, to get to the point here, some insurance companies providing extended medical benefits cover pumps and some don’t.

My husband’s company switched extended medical insurers recently. Guess which one we have now.Well, not exactly…they said they would cover whatever the previous company covered. When the claim went in for our daughter’s new pump it was denied. We appealed based on the fact that they are supposed to cover whatever the previous company covered. Well, it seems, in the opinion of the current company, the previous one shouldn’t have covered it, it was a mistake and therefore this one isn’t going to.

There’s an old joke from the days of the Jim Crow laws in the southern United States.  An old black man is told he has the right to vote in the election and appears at the polling station. A good old boy is the returning officer there and smiles at the black man holding out his id.

“Well, boy, if y’all wanna vote, y’all gotta pass a litteracccy test. Here, read me a bit outta this newspaper.”

And he holds out a chinese language daily to the old man who takes it and looks it over for a minute.

“Well, boy, can you pass this here litteracccy test or not? … go on, tell me what it says….”

The man takes a long look at the paper and then at the returning officer, “Why sure I ken read it, suh”

The good old boy sat bolt upright and snarled “Whaddya mean you ken read it, you aint no more Chinee then I am..”

“Why look it this, see, it say right here, ‘This n-r ain’t gonna get no vote.”

I’m thinking of taking chinese lessons ’cause something tells me, we’re gonna need it for the next round with the insurance company.

Pumps and pump supplies are part of the medicare system in other provinces…that’s the difference between private medical insurance and public…Unfortunately we live in a province that is trying, by hook or crook, to move us to a privatized system.

Lots of us are gonna have to learn to read between the lines soon.

putting it in perspective

1. CVN-78 Gerald R. Ford – first of new class of super-aircraft carrier “Ford Class” – hull laid 2007 – $8 billion (not including $5 billion R&D) will carry >75 fixed wing jets. powered by 2-AIB nuclear reactors.
2. F-35 Lightning II fighter jet under development – cost per jet (in 2006) $83 million.
3. Queen Elizabeth Class carrier – Royal Navy – to replace the Invincible-class light carriers – will be equivalent to US Nimitz class carriers and carry 36 F-35’s. Current estimate on cost of carrier ?3.7 billion – not nuclear powered.
Estimate of JDRF Canada in a request to the Government of Canada of research funding sufficient to bring about a cure for Type 1 diabetes = $125 million.
So next time you see a picture of an aircraft carrier or a fighter jet or even a tank (M1A2 Abrams = $4.3 million) remember it represents money that didn’t cure diabetes or cancer or cystic fibrosis or Alzeheimers or…or….or…
It’s another reason to sniffle when you see a kid selling lemonade to raise money for JDRF

Now I realize we need these advanced weapon systems to protect ourselves from all those other advanced weapons systems out there the bad guys bought at a clearance sale from the people who are designing even newer ones for us but, gee whiz, maybe if we all stopped…Of course, that is just silly, fuzzy headed idealist stinkin thinkin. But maybe if we diverted just a little of the money we spend on thinking up new ways to blow people up better, faster and from further away…?

It hurts other places too

direct costs for aproximately 1 month:

Pump supplies – infusion sets – $318

– syringes – $118.

test strips $ 75.00

insulin $135.00

Pharmacare is an interesting system. It covers some things but not others, lancets but not test strips, for instance or one type of insulin but not another. It was also ‘improved’ so that it doesn’t start covering drugs until a you’ve paid out a certain amount on your drugs. At that point it starts at a scaled percentage of the cost, gradually increasing the amount it covers.

It resets every January 1 and despite paying in over $1,200 a month with all our different prescriptions, we still haven’t hit the pharmacare threshold and it is the end of March.

A good extended medical plan helps a whole bunch, fer sure and I can’t imagine how families without one manage to cope with all the costs. Yes, it is evenutally, tax deductible but between refund time and the next year, most folk like to eat and maybe pay the rent and, believe it or not, go to the odd movie. Yes, poor folk deserve a movie now and then too.

If it wasn’t for our socialized health care system, we’d have gone under a long time ago. That is why, next to Dr. Banting, my big hero is

Tommy Douglas

But more about him later.