Diabetes Funding Doesn't Focus on Long-Term Success

The New York Times coverage of the diabetic crisis in New York City continues with an alarming investigation into modern health insurance's coverage and treatment options for people living with diabetes. As the Times reports, most insurance companies do not focus on long-term treatment with intent to cure. Instead, the funding is directed to expensive procedures that address acute symptoms. Ultimately the patient remains sick and continues that way indefinitely.

Ian Urbina of The New York Times reports that in the treatment of diabetes, success often does not pay:

With much optimism, Beth Israel Medical Center in Manhattan opened its new diabetes center in March 1999. Miss America, Nicole Johnson Baker, herself a diabetic, showed up for promotional pictures, wearing her insulin pump.

In one photo, she posed with a man dressed as a giant foot - a comical if dark reminder of the roughly 2,000 largely avoidable diabetes-related amputations in New York City each year. Doctors, alarmed by the cost and rapid growth of the disease, were getting serious.

At four hospitals across the city, they set up centers that featured a new model of treatment. They would be boot camps for diabetics, who struggle daily to reduce the sugar levels in their blood. The centers would teach them to check those levels, count calories and exercise with discipline, while undergoing prolonged monitoring by teams of specialists.

But seven years later, even as the number of New Yorkers with Type 2 diabetes has nearly doubled, three of the four centers, including Beth Israel's, have closed.

They did not shut down because they had failed their patients. They closed because they had failed to make money. They were victims of the Byzantine world of American health care, in which the real profit is made not by controlling chronic diseases like diabetes but by treating their many complications.

Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.

Patients have trouble securing a reimbursement for a $75 visit to the nutritionist who counsels them on controlling their diabetes. Insurers do not balk, however, at paying $315 for a single session of dialysis, which treats one of the disease's serious complications.

Dr. Fuhrman continually stresses that the best way to prevent, control, and eventually cure diseases like diabetes is through nutritional excellence (as described in his books) and exercise. Many of his diabetic patients are able to maintain excellent health without any medications--some of their stories are in DiseaseProof's Success Stories.

In the member center of Dr. Fuhrman.com, he recently talked to members about the importance of exercise for diabetics:

The most effective prescription for diabetes is exercise. An essential component of my prescription for diabetes is daily exercise; it is more important than daily medication. Two hundred calories a day of formal exercise on an incline treadmill and an elliptical machine are a great goal to shoot for. It is not an official recommendation of anyone except me.

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anet - January 13, 2006 9:30 PM

call me a cynic but I think that the overdependence of current diabetes "treatment" upon diabetes drugs and half-hearted dietary 'solutions' is due to pharmaceutical companies influence on public health policy which ultimately influences individual "treatment".
When Pfizer can profit from "greens N beans" diet, THEN its promotion will become commonly accepted practice.

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