If You Have to Ask the Price … (part 3)

It’s been a couple months since I last wrote about healthcare costs here and about a year since I took a more in-depth look at the subject. But the subject of health economics is on my mind all the time. If I didn’t have such a totally sweet gig working where I do — we’re hiring, by the way — I would probably try my hand at helping develop healthcare policy. That’s something for another stage of my life, but that doesn’t stop me from wading around in the shallow end.

I’ve been reading more about the healthcare cost landscape and different ways of trying to reduce (or even constrain the growth of) what the United States spends on medical treatment. Now that the GOP is trying to “repeal and replace” the healthcare reform law, there’s a chance to evaluate a different approach than “Obamacare.”* I am quite interested in seeing what serious conservative ideas for defining and managing the American healthcare system might look like. As always, I’ll apply my rubric for evaluating options:

  1. How will it improve patient health outcomes?
  2. How will it contain or reduce the cost of healthcare?
  3. How will it increase access to healthcare for all Americans?

For now, I’ll just throw a little anecdote out there that I plan to use as a touchstone for further discussion of healthcare choices and costs. It happened last month when I was getting trained on how to use my CGM.

Near the end of the training, after watching me insert a sensor and working through some fill-in-the-blank worksheets about calibration, the Medtronic rep made an unexpected diversion into the cost of all these supplies.

“The little transmitter you have here, it costs about $1000. And each disposable sensor costs $45. I know your insurance paid most of the cost of these things, but I just wanted you to know how expensive they are. A lot of people on insurance don’t know the actual cost at all.”

If I were to use the CGM sensors as they’re currently approved by the FDA, I would change sensors ten times per month, for a cost of $450 to my insurer. I’ll confess to wearing each sensors for a week — everyone uses these things for an extended duration — but that’s still about $180/month of new charges by yours truly.

Believe it or not, despite having really good insurance, I held off getting CGM for quite a while because I wanted to make sure that my additional demands on the healthcare system were actually going to be worthwhile. Don’t get me wrong, my main reason for buying into CGM is to have better blood glucose control so that I can have more freedom and options in my life. But the thinking is that having better self-management abilities should translate to fewer complications, fewer emergency calls for severe hypo and DKA events, and lower medical spending in the long run. But there are no guarantees; I’ve been blessed with good health despite my higher than optimal A1c values. (*touch wood*) CGM might turn out to be the amazing thing everyone says it is, or it could be another high cost aspect of an already expensive disease.

We’ll explore aspects of these arguments more in the coming weeks.

* — I have to confess that when politicians, pundits and Twitter peeps use the word “Obamacare,” I basically stop listening. If people poison the well, I’m not going to drink from it. We’re all adults here; let’s discuss the options and alternatives without resorting to prejudicial code phrases. I’ll try to be open-minded, too.

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