Not written in ages as I have had so many other things to do - kids, decorating, work etc. I still don't have a great deal of time, but felt industrious this evening whilst watching England fail at cricket, and wrote the following email to an American asking about the situation for UK diabetics:
"Not sure whether you got an answer to the pump question about UK. I think I have a fairly balanced view of it (not common here):
In the UK, we pay taxes which cover most of our medical needs (socialised medicine). Our companies often pay for private medical insurance, but these do not cover chronic conditions like diabetes. As there are limited funds, everyone generally gets the same treatment (in theory) and an organisation called NICE (National Institute for Clinical Excellence) decided what is the best treatment for each condition based on cost and clinical outcome. They have decided (this is a summary) based on the clinical evidence that a) Type 2 diabetics are never eligible for pumps, b) Type 1 diabetics are only eligible if they have severe unforseen hypos or very high a1c's that have not been controlled by all efforts a using mdi.
They (NICE) are currently reviewing the scientific evidence, but as it stands pumps are not widely available and therefore clinical expertise is not great in this area.
It is possible to self-fund a pump, but you also have to fund the clinical assistance (physician consultations) so it is prohibitively expensive. Alternatively health authorities (governance of regional health policy) can decide how they use their finite funds. Some have decided not to follow NICE guidelines, so pumps are available. I expect these policies to change in the nea future but further scientific evidence for the success of pumps needs to be proved and the price of them needs to come down.
Finally, to complete the picture, prescriptions (notes written by doctors (physicians) for medications are charged at £6, $12 a time, but diabetics that are on insulin have free prescriptions for any medication, whether it be related to diabetes or not. Diabetes is one of the very few ailments that falls under this exemption.
Hope you haven't been too bored with this description. Maybe I'll save it to try and help some one else to understand the situation. It is not as bad a situation as some people make it. Just talk to an American diabetic without adequate medical insurance to find out the shortfalls of that system!"
Maybe it is of interest to someone reading this blog....
"Not sure whether you got an answer to the pump question about UK. I think I have a fairly balanced view of it (not common here):
In the UK, we pay taxes which cover most of our medical needs (socialised medicine). Our companies often pay for private medical insurance, but these do not cover chronic conditions like diabetes. As there are limited funds, everyone generally gets the same treatment (in theory) and an organisation called NICE (National Institute for Clinical Excellence) decided what is the best treatment for each condition based on cost and clinical outcome. They have decided (this is a summary) based on the clinical evidence that a) Type 2 diabetics are never eligible for pumps, b) Type 1 diabetics are only eligible if they have severe unforseen hypos or very high a1c's that have not been controlled by all efforts a using mdi.
They (NICE) are currently reviewing the scientific evidence, but as it stands pumps are not widely available and therefore clinical expertise is not great in this area.
It is possible to self-fund a pump, but you also have to fund the clinical assistance (physician consultations) so it is prohibitively expensive. Alternatively health authorities (governance of regional health policy) can decide how they use their finite funds. Some have decided not to follow NICE guidelines, so pumps are available. I expect these policies to change in the nea future but further scientific evidence for the success of pumps needs to be proved and the price of them needs to come down.
Finally, to complete the picture, prescriptions (notes written by doctors (physicians) for medications are charged at £6, $12 a time, but diabetics that are on insulin have free prescriptions for any medication, whether it be related to diabetes or not. Diabetes is one of the very few ailments that falls under this exemption.
Hope you haven't been too bored with this description. Maybe I'll save it to try and help some one else to understand the situation. It is not as bad a situation as some people make it. Just talk to an American diabetic without adequate medical insurance to find out the shortfalls of that system!"
Maybe it is of interest to someone reading this blog....
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