Falling through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes

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Abstract:

Health insurance is essential to the health and well being of people with diabetes – a
chronic health condition affecting 18 million Americans in which elevated blood glucose
(sugar) levels damage nerve endings and blood vessels, leading to serious health
complications including
blindness, kidney failure, heart
attack, and stroke. Diabetes can
be effectively managed, but
medical care and supplies needed
to monitor and control blood
glucose levels are expensive and
can easily cost hundreds of
dollars per month. Numerous
scientific studies have found
health insurance problems make
it harder for people to manage
their diabetes, often with
devastating consequences. Uninsured adults with diabetes are far less likely to receive
needed care and effectively manage their disease, and those with health insurance have
difficulty obtaining needed care when coverage is inadequate. People with diabetes need
– but often cannot get – health insurance that is simultaneously available, affordable, and
adequate.
As part of an initiative to train American Diabetes Association staff assisting members
with health insurance problems, researchers at Georgetown University studied the
experiences of 851 individuals to learn what caused their health insurance problems and
what helped. For 14 months, project staff worked with people who contacted the
Association’s national call center (1-800-DIABETES) because they had health insurance
problems. Calls were accepted from people who were younger than age 65 and who were
either uninsured, transitionally insured in coverage that was about to end, or insured with
other problems. The focus of this project was on private health insurance because this is
how most non-elderly Americans obtain health coverage, although some problems related
to public coverage were also studied. Callers were asked if they would be willing to
share their stories, and two-thirds said yes. Some are featured in this report.