[FigurativeVoid]

Yeah. I have a running joke with my Endo.

“A1c is good. Charts are good. No changes.”

“And that’ll be 700 dollars?”

“Yup. See you soon.”

Of course it doesn’t actually cost that much (copay wise at least), but the point stands. I manage my disease super well. I don’t need the middle men.

I’m becoming much more radical on universal healthcare the longer I’m on my own.

[m463]

> I manage my disease super well.

"If it tastes good, spit it out." - Jack LaLanne

[FigurativeVoid]

I find that movement has been key for me. More walking, more lifting, more of anything.

Getting a gcm gave me much better data around the impact of movement.

[bradleyy]

Could not agree with this more: with a little insulin on board, a quick walk (even 5 minutes) has a profound impact.

Calf raises are absolutely diabolical as well, if you haven't tried them. There's some lore around this that the calf muscles are better adapted to absorb glucose, I haven't dug in other than to verify they do work.

The invention of the CGM might only be second to insulin in improving the lives os T1Ds.

[FigurativeVoid]

I find I can induce a steep drop at like 15 mins.

I’ll have to try calf raises. I’ve never heard that.

[m463]

I liked the book "the glucose revolution".

hmmm

summary: https://ericsandroni.com/book-summary-glucose-revolution-by-...

[hellisothers]

Why do you think universal healthcare will make it easier to get the drugs you need? I’d imagine the opposite with additional bureaucracy.

[seanhunter]

It really is easier, and you can see how this works in any number of countries with universal healthcare. I don’t have diabetes but do have chronic health issues that need constant treatment. Here in the UK:

1. I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.

2. Prescriptions normally cost 9.90GBP per “item” (where an item is one type of medicine so may be multiple physical boxes of pills for example). This is a fixed cost and is independent of the type of medicine or how much it costs to the NHS. But…

3. You can get a prepayment certificate for 114.50 GBP per year which means you don’t have to pay per item. I have this so every time I go to the pharmacy I check one box and sign the bottom of a form and my drugs are free. The cert is a simple online purchase and took me about 5 minutes to apply and get accepted for. Zero friction. I have never been asked to show the certificate just state that I have one check a box and sign and we’re done. If I did have to show it, the “certificate” is just an email with a number so not hard.

4. The same app I used in #1 has messages from my GP in it so if there was ever a thing when they needed to talk to me, arrange a blood test, deliver test results etc it’s all in there (and I don’t pay a penny for any of those things either). Everything that’s in the NHS app is also on the NHS website which has excellent accessibility etc so works just fine on Linux for me when I don’t have my mobile device.

5. If you want to go outside the NHS you can go to a private practicioner and get a private prescription. That’s delivered to the same pharmacy you just have to give them this number that gets texted to you with the prescription and pay (a bit) more money for it. I had to do this recently and it cost me 22GBP for an “item”. You can also have private health insurance (I do) which means seeing specialists is easier than on the NHS and there is generally no wait time for tests etc. Private health insurance in the UK is much cheaper than it is in the US.

Bottom line: At least here in the UK the NHS may have bureaucracy internally but that doesn’t affect me at all as a “customer”. My healthcare is super-easy and convenient and far, far less expensive than healthcare in the US. You guys have the worst of all worlds. Both my wife and I have had medical treatment in the US and it manages to be eye-wateringly expensive and simultaneously worse than what I get for free on the NHS.

[seanhunter]

I looked up the US price for the private prescription I paid 22GBP for. On drugs.com it would have cost me 239 USD.

[xienze]

> I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.

We have that too. But that doesn't address the person's main complaint, that they have to consult with a doctor in the first place to get that prescription.

[sierra1011]

That only really applies to the first time it's issued. Repeat prescriptions can be issued with the NHS app. I've requested dosage changes on multiple occasions and they review it with the request and sign it off.

Any long term condition like diabetes isn't the admin overhead you're making it out to be.

[seanhunter]

Yeah exactly. Can't speak for diabetes but in the UK there is certainly zero admin overhead for me for my long-term health condition. I'd be very surprised if diabetes is different.

Every now and again I get scheduled for a blood test or a consultation to review my meds. The consultation sometimes happens by phone if mutually convenient and I don't need to actually be tested there and then etc. Repeat prescriptions just get issued and if there is any problem I can send a message on the app.

[gorbachev]

In the UK diabetes patients get automatically invited to followup appointments by the GP and eye screening tests every <n> months, where n depends on the severity of your condition. Adjustments to medication will happen at those appointments.

[inigyou]

Presumably by removing the existing bureaucracy which is much worse than the new bureaucracy.

[m4xp]

It would be one more layer of bureaucracy, I can tell this as an Italian, if you have a serious emergency you are better off paying out of pocket for a private clinic.

And this is for every aspect of society, I feel like all this burocracy is just made for people that liv e off the state, I get home at 6pm, offices are not even open, I have to take half a day off work to stand in a line every time...

[inigyou]

Then let's make the state better

[gumby]

Having lived in France, Germany, and Australia I can report that there’s a lot less bureaucracy in those systems than in the US system. Like telecom, the participants in the medical system put up tollbooths because they can.

[saagarjha]

You can just check you don’t have to imagine anything

[jfim]

Why would it be bureaucracy? In places with universal healthcare, you go to the doctor, show your card, then go to your appointment. Go to the pharmacy with your script, show your card and pay whatever is left to pay, if any.

That's it. No open enrollment, no surprise bills, no trying to figure out which ppo or hmo works best, no wondering if it's in network or not or any of that BS.

[glenngillen]

The apparent fear of universal healthcare many Americans seen to have is incredible.

And to call it out in a thread where someone has literally shared that they're forced to attend a pointless appointment at an exorbitant cost like that isn't itself some form of wasteful bureaucracy. But if the time and money is going to a corporation instead of the government it's better :/

[vjvjvjvjghv]

The US has managed to combine the worst aspects of universal/socialized health care with the worst aspects of an attempted free market system. It’s quite an achievement.

[anal_reactor]

It works as intended. It's a part of cutthroat capitalism. The goal here is to make sure that basic service is unevenly distributed so that people who don't have it are motivated to work extra hard and get it.

[iamnothere]

There’s no “cutthroat” about it. The system intentionally removes as much competition as possible. It’s cushy, taxpayer-funded socialism for the rich. (Also known as corporatism.)

At this point, China is doing capitalism better than us in its consumer industries. They actually have real competition, so fierce at times that the government worries about what it calls “involution”, or destructive competition (which Marx predicted as the end state of capitalism). Of course, its healthcare system is not run through capitalist competition like its consumer industries; it is fully state managed.

Some real competition might actually help if we’re going to keep pretending to be capitalists. Or we could move from socialism for the rich to socialism for the people. I don’t really care which as long as we move on from the current dysfunctional system.

[dash2]

> In places with universal healthcare, you go to the doctor

NHS experience: you might have to wait two weeks to see the doctor, and it will be a ten minute appointment. (Which in this case might be fine.) If you can use a nurse things tend to be much easier.

[HWR_14]

For a checkup? Or if you are sick?

[roryirvine]

The NHS relies on heavy triaging - so, for primary care, emergency cases will be seen immediately (either at a hospital or at the nearest GP surgery with an available slot), urgent will be seen same day (at your usual GP surgery), and non-urgent medical problems (eg. back pain that isn't getting worse) might take 2-3 days.

But everything else (eg. discussing blood test results, medication reviews, mental health issues) will get dumped into the "routine" appointment bucket and, yes, will often take 1-2 weeks.

You do hear occasional horror stories about the triage process, but my experience has been pretty reasonable. For example, I lost my voice last year but had no other symptoms - so I expected to have to wait a few days to be seen. But I was treated as an urgent case since it affected my ability to work, and got an appointment that afternoon.

[HWR_14]

These timelines sound remarkably similar to pretty much every other timeline for medical care I've heard in other countries.

[dash2]

I've had a checkup with the NHS once or maybe twice in my life, and it was not with a doctor. (I'm not saying that it should be, maybe a nurse and a blood pressure check is all you need?)

[bulbar]

There's actually less bureaucracy involved for the patient. In Germany, you normally don't do anything at all, just let the doctor's assistants read your card, then go to the pharmacy, let them read your card and get your medicine. Sometimes you have some copay of around 5 Bucks.

From what I read, healthcare had always been super complicated and bureaucratic in the US. Nobody here knows what "network" or "deductibles" even mean.

Going to the doctor or calling an ambulance is similar to calling the police in some sense. You don't think about "network" or cost when calling the police, right? We do neither for health care related things.

Btw. getting down voted for an honest question is a bad thing in my opinion. People should talk to each other and ask questions.

[freeone3000]

Well, it’ll make it not cost $700

[bulbar]

Insulin being expensive is the most weird and disturbing thing. It's just crazy. Don't they have Canada just in front of them to learn from their neighbors just how ridiculous this is?