An Overview of BC’s New Insulin Pump Program

BC insulin pump program expandsThe internet has been abuzz. The provincial government of BC lived up to an election promise by removing the cap on its insulin pump program. There was celebrating in the streets…until the fine print of the new program was read.

You see, this program will be unlike any other program in the country.  It will be a two-tiered program that seems to favour one insulin pump company over the others.

The issue is complex and very emotionally charged. Let’s take a closer look and you can decide for yourself if this is a step in the right direction or a step on a new and slippery path.

No more age cap

This is big news.  Adults no longer have to pay for their insulin pump out of pocket if they don’t have private insurance.  One pumper I spoke with as spent almost $20,000 to purchase insulin pumps over the past 15 years.  That is a lot for an individual to come up with every 5 years.  It is not surprising that she sees this as a welcome relief!

A two-tiered program

This is the news that has some people scratching their heads and wondering if this is such a good program after all.

All residents with diabetes will be eligible for an Omnipod insulin pump and supplies under tier one.  There will be no deductible for this system.

If you do not want this insulin pump system and feel that a Medtronic insulin pump would be better suited for your needs, you will have to convince your doctor of this as well.  Under tier two, a portion of your insulin pump and supplies will be covered if your physician prescribes a tubed (Medtronic) insulin pump.  If you simply want to own a tubed pump but your doctor does not deem it medically necessary, you will have to pay all costs out of pocket.

You can read all of the details on the BC government website here.

A pump is better than no pump

There is a school of thought that any pump is better than no pump and I can agree with that.  If you want to use an insulin pump, then this is a fabulous option if you have no coverage. You can also work with your doctor to attempt to get some relief on a tubed insulin pump if that is your preference.

It’s a win for the little guy

Some people are claiming that this is a huge coup for the little guy.  The small insulin pump company Insulet is the preferred insulin pump for the province.  That is rather significant I will agree.

It’s a start

One thing that I always tell people who ask me for tips on advocacy is to think of their “ask” as a cookie.  Every piece of the cookie that you get is a step forward.  Often you don’t get the entire “ask” (cookie) at one go so you keep asking.  You keep enjoying each bite, knowing that you are working towards having that entire cookie.

Conclusion

For residents of BC, this is another step towards the ultimate cookie. There were pumps for kids. There were pumps for adults up to age 25 and now there are Omnipods for anyone who wants them and assistance on tier two, tubed pumps.  It another step towards the goal of coverage for everyone regardless of age who wishes to use a sensor-augmented insulin pump.

Congratulations BC residents on your new insulin pump program!

And then they grow up

Its September and that means back to school for many.  For my youngest son it means heading back to a classroom for his last year of high school.  How did that happen? We were only just preparing to send him to preschool yesterday and today we are discussing at what career he wants to explore.

This isn’t the first time this has happened to me. It was just as traumatic when my oldest son was graduating. He is now in the workforce and renovating his first home. I am way too young for any of this but somehow it keeps happening.

Despite my desire to keep them both babies, they have grown into young men but the challenges facing them are very different.  There is a big reason for that and it is called diabetes.  It seems to rear its head into every aspect and ways that I had not thought of.  My 17-year-old son in less than one year will no longer be eligible for his father’s private health insurance unless he pursues post secondary education.  If he doesn’t he will no longer be eligible to have his test strips and insulin covered.  Yes, we do have a provincial drug plan that he can apply to to help reduce his costs but he has to know to apply.

Thankfully he is planning to attend a post-secondary institution so he will continue with some coverage for a bit longer but will his chosen career have a decent medical plan? I am not sure. I think so.  His current career path will lead him into a union, the same one as his older brother, and I believe that he will have coverage at that point–I certainly hope so for his sake.

This is part of the reason for my desire to see changes to our current provincial insulin pump program.  For the past few months I have been working with people and have seen time and time again how expensive diabetes care really is.  It’s not like I didn’t already know this fact but hearing stories and sitting down to think about exactly how much money is spent each week, each month, each year can lead to jaw-dropping moments.

One person shared that they spend $8000 per year.  That sounds like a lot of money. I could enjoy a lovely vacation for that or buy my son a decent used vehicle.  In this case that $8000 is the cost after insurance so imagine what someone would be paying if they didn’t have insurance.  You are right, they are probably are not paying that much more.  Why? Because they have had to make ugly choices.  They most likely had to choose to go on injections rather than an insulin pump.  If they found the money for an insulin pump, they will  have learned how to stretch out infusion sets long after they should be changed.  They probably also know how to squeeze out every drop of insulin from a cartridge and perhaps they have even refilled a cartridge despite knowing the risks that such an action can bring.

For those who cannot afford the best medical tools, they are playing a game of  Russian Roulette on a daily basis.  My son and I have worked very hard for the past fourteen years to keep him healthy and he uses the best technology that we can afford.  That is the sad part however, that people with diabetes must only use the tools that they can afford, not the best tools that will keep them the healthiest and happiest for the longest–only what they can afford.

That is terrifying both as a mother and as a human being.  Imagine that your life depends on a clear liquid in a tiny bottle but you are not sure that you have enough to last you the month.  What are your choices? Perhaps you can beg your pharmacist and see if they have a compassionate program but you are proud person who works hard every day.  You don’t feel that you should have to rely on charity.  You could avoid eating for a few days.  That would limit the amount of “extra” insulin you need.  Perhaps if you didn’t test as often you could save that money to use for insulin.  That strange feeling you are experiencing might not be a low, perhaps its just stress over your supplies running low.  Maybe you really don’t need to test. Maybe you will be okay….or maybe you won’t.

The reality is beyond scary.  This is why I do what I do.  This is why I advocate for improved access to insulin pumps, devices and supplies.  Unless you live in this world, it can be very difficult to completely grasp and understand. I don’t want more people to live in this world so that they understand.  I would rather that they live in ignorance but my son and too many others should not have to know these feelings.  It is important that we take care of those in our society living with chronic conditions.  It is equally important to aid them to purchase the tools that keep them alive and healthy and allow them to therefore fully contribute to society through work and play.

first day of school 2003