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Re: [IP] On My Soap Box

>>>>>>Yes.  Medical NEEDS, however, is not the same as improving lifestyle.>>>>>>

i have to say i agree with ryan here. while many people have posted many emotional, stirring
emails about how their pump is medically necessary for them (and thus should be so for every
diabetic), "medically necessary" is a term that has its limits. were we in a perfect world, then
the improvement of lifestyle would be synonymous with medical necessity. however, we're not; there
are limited resources out there and the insurance companies do have to decide how to distribute
what they have. that they often do so selfishly and unfairly does not change this basic fact. 

i believe ryan was trying to make the point that while it would be *nice* if every diabetic could
have a pump covered free and clear, it is not *possible*. our medical system cannot handle it; not
with the government-fixed prices of medications and the huge, money-sucking juggernaut HMOs. under
these circumstances, some treatments are more medically "necessary" than others-- while it is
conceivable that a diabetic on MDI *might* have problems and perhaps die without a pump, it is
certain that a child with cancer *will* have major problems and die without costly treatment.
under this definition, a pump (while somewhat necessary) is less so than radiation and chemo.
these are the types of decisions that the companies are making; lifestyles versus lives. if they
have to pick one over the other, the lifestyle's the first one to go; and that is as it should be.
as i said before, the fact that they are not doing a very good job doesn't change that.

this certainly doesn't mean that the pump isn't medically necessary for *some* people; for
instance, for me, who was spared from any further autonomic nerve damage than i already have by
the pump. likewise, the pump has saved the lives of many people on this list; and it is natural to
want every diabetic in the world to have the same benefit as we here do. the fact that we live in
a world with limited resources makes this impossible; hence, the designation of some treatments of
diabetes as not "medically necessary." it seems odious to some of us simply because we have
diabetes and the battle is a personal one; but there are plenty of people with other diseases who
are going through just the same thing and who are probably pissed at pumping diabetics sucking
away all the shared resources... we don't live in a very happy world.

it's a tough problem, and the fact that it exists is certainly not ryan's fault. so the
accusations of his being mean and insensitive are wholly unnecessary and uncalled for; he can't do
anything about it either, but the least we can all do is open our eyes to the fact that it exists.
not that i have any idea how to solve it, i'm only 21 years old. i also feel a sort of
embarrassment of riches at being able to treat my diabetes with a pump, but nevertheless i am
grateful and view it as a privilege rather than a right. perhaps if we ever learn to solve this
massive problem, pumping will become the "right," or undisputed medical necessity, of every
diabetic in the future just as disposable needles are now. but that will probably take a very long

becky (dx'd eleven years ago today (1/24/92); pumping since 11/21/01) 

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