18 Responses

  1. Sam
    Sam June 14, 2011 at 8:00 am | | Reply

    Great Article. One point to make. To quote “This is mainly because each area of the country gets a specific amount of money from the NHS budget to spend. I’m fortunate that my area has an extremely well-maintained budget, which gives me opportunities that people in other areas don’t get. It’s what’s ‘lovingly’ referred to as a ‘postcode lottery,”

    And “Technology seems to be ‘drip-fed’ though over here. It’s a long time before we get anything new.”

    That’s called GOVERNMENT healthcare = RATIONED CARE!!! And if you don’t think it is coming here under Obama, you’re so naive.

    1. Y.P.
      Y.P. December 2, 2013 at 4:33 am | | Reply

      The UK’s NHS is a bad example of a nationalised health care service. It’s missmanaged, underfunded and a nightmare for those diabetics living in the poorer areas of the country.

      The ‘post code lottery’ that the author refers to in her article is a gross understatment, a polite, politically correct, non-accurate descriptive of the whole situation. A more accurate description would be ‘disproportional classicism’ where the poor get worse medical care than the rich. The NHS still beats the US’s example of a halthcare service (if you can call it that) by miles.

      It’s sad though, how patients living in the two most powerful/wealthy countries in the world have to struggle with below average/mediocre health care services ranked 18th (uk) and 38th (us) amongst WHO memebers, below countries like Oman, the Domincan Republic, Morroco, Greece, France, Italy, Germany, Iceland and pretty much all of Europe and parts of latin America.

  2. David
    David June 14, 2011 at 8:05 am | | Reply

    One of the negatives as a T1 in the States is dealing with for-profit insurance companies and this is for the rest of my life. We Americans must worry about our insurance coverage through every job change and on through to retirement. Technically, I have access to pump and CGM but only if I can afford the copays. Your system has its trade-offs but I would prefer it.

  3. a.k.a Dia...Betty
    a.k.a Dia...Betty June 14, 2011 at 11:05 am | | Reply

    Great summary Becky.

    I’ve been T1 for 16 years now and have only met one pumper in all that time! The NHS is great, but I don’t see us getting access to CGMs until they’re a tenth of the current cost (and that’s probably optimistic).

    One more thing – whilst orange glucose tablets do predominate in the UK (actually, I’ve never seen raspberry) there is another much yummier way to go… lemon! :) (Okay, yummy here is obviously a relative term, since we are talking about glucose tablets!)

  4. steve
    steve June 14, 2011 at 2:13 pm | | Reply

    Don’t fret about not having access to CGMs. They are inaccurate in comparison to your monitor which measures blood glucose directly from blood. My view, as a person who has been a Type 1 diabetic for 30 years, and has tried the CGM… It is a machine that is more about making someone money than helping manage blood sugar. This shouldn’t be a forum to debate political issues. But, regarding the previously posted REPEAL OBAMACARE comment: Really? Do you believe we have a manageable, working health care system in place in the US? Really?

  5. Daisy @ Diabetic Dais
    Daisy @ Diabetic Dais June 14, 2011 at 3:04 pm | | Reply

    Really enjoyed reading your post, Becky.

    I agree, it definitely does seem as though the UK is a bit ‘slow on the up-take’ with regards to diabetes and diabetes technology. Nevertheless, I feel SO lucky that we have the NHS and don’t have to be concerned with health insurance, payment of prescriptions etc.

    To be honest, I think there are probably loads of diabetics (all types) in the UK who perhaps take the NHS for granted by not looking after themselves in the way that they should because the know that the NHS is there to bail them out. Okay, so we may not have the latest gadgets and gizmo’s, but we’ve got more than enough here to ensure that we are able to control our diabetes. Surely that’s all that matters :)

    P.S. There are also tropical flavoured dextrose tablets that you can buy from ‘Boots’ and most pharmacies! I think they’re quite nice :) I detest orange GlucoTabs.

  6. Diabetes Week (Tuesday) « perry55sblog

    [...] Diabetes in the UK: Free Care, But Behind the Times? ( [...]

  7. Stead
    Stead June 14, 2011 at 7:13 pm | | Reply

    Great post to the Diabetes Mine team and Becky. Really enjoyed this. Fascinating.

    Becky’s account helps to describe in a very detailed way…the differences with a single payor model and our system. It seems from this entry and the comments that there is good with the bad in both models.

    Rationed care indeed and lack of choice…but not a lot of self administration and consumer costs…some of the highlights.

    Our side: worry about coverage, self-covered costs to pay for choice, and dependency on your employer…some of the highlights.

    Thanks for the insights. Definitely need to find better solutions.

  8. Sam
    Sam June 14, 2011 at 8:19 pm | | Reply

    In response to Steve’s comments about my post – I’ve had Type 1 for 34 years similar to you. I am using the CGM and will say that it has probably saved my life several times by waking me or my wife up at night during a very low blood sugar incident. But that was not my main point. It was about the fact that government healthcare will always result in RATIONING. Just as Medicare does today, and will eventually lead to insurmountable costs, just as Medicare is almost today. I have worked in the Veterans Admin system and have seen govt care. I am a healthcare provider and have seen in person the goods and bads of our system and a govt run system.

    I don’t claim the current system is the ideal, it is far from it, but lets not throw the baby out with the bathwater. Make small changes instead of turning it all over to the Feds. What have they ever done to make you feel safe with them in control of your health. Do you want that? Do you think the VA is a “manageable, working system?” Really? If so, I’d invite you to go wait in the lines and/or wait 6 months to get to see a Primary Care physician as was the case in the Hospital in which I worked. I’m sorry for being so political, but if not here, where? It will effect us diabetics more than most.


  9. Dianabol
    Dianabol June 15, 2011 at 5:21 am | | Reply

    I’m a bodybuilder, been doing it with diabetes for the last 7 years. It’s quite a struggle. Thanks for sharing this article. I agree with most.


  10. Hans
    Hans June 15, 2011 at 8:12 am | | Reply

    I admit it’s O.T. Here:
    Your describing the UK as a little slow on the up-take reminds me of the question that has been haunting me for years: How come it was fast enough in the up-take of type2 in the mid seventies to design and produce the UKPDS, the mother of all typ2e studies with more than 8.000 participants? More than 5.000 to count all through to the end. Remember, that was the time of extremely high cut offs for the diagnosis and years before the first world wide definition in the late seventies. There were so many type2s for sure, but without any kind of systematic testing and testing only in hospitals most of them went and died undetected as was normal in those days. How would you try to explain that the UK was so much up front to take the lead in the study of what used to be regarded as an issue confined to the elderly, which was a relatively small demographic group in those days?

  11. Richard
    Richard June 16, 2011 at 4:13 am | | Reply

    A little bit weirded out by the comments people make about national healthcare on the basis of this post. I am Dutch myself and we also have a national healthcare system.
    As Becky already points out in her post, theres differences between national healthcare systems. Just because there is something in the NHS that you perceive as rationing, doesn’t mean that national healthcare automatically means rationing.
    Every national healthcare system has to make choices, it cannot supply everything because (as some people also mention) costs can get out of hand easily. What most healthcare systems aim to do is provide the minimum care that enables you to live a healthy life.
    Providing insulin, needles, test strips, meters etc. Is all free of charge and that is really the fundamentals of Diabetes management.

    I cannot speak much about the English healthcare system, but the Dutch system does allow you to add extras to your insurance: you just pay more.
    Also the Dutch system actively encourages you to use a pump. We don’t get CGM’s as a default option but lets say you have a hard time getting your glucoselevels under control or often wake up in the morning with odd values, your endo can give you like a week of CGM to help you work out what happens so you can work on getting better control.

    As for the drip-through of technology: CGM’s in the Netherlands for example are used already, but again not a common sight. The main problem with new technology is that basicly theres a long process of things becoming available: the costs vs benefits debate. Government often conducts their own research to asses this (to not be spoonfed by pharma) and this does take time.
    But it is not like new technology is never available, the whole subcutaneous pump thing the mine covered a while ago: I know Dutch diabetics that have it.
    It never mainstreamed here either, but the problem never was it not getting paid for by insurance. It eventually failed because the refills were no longer produced.

    I understand the hesitation and worries about a changing healthcare system. It is true that a national healthcare system cannot provide every single thing to make your disease easier and less of a burden, but they so very often provide everything you need to keep yourself alive and healthy and to just be able to live your life.
    I understand that maybe a national system cannot provide you with all the technology you prefer to use to treat your Diabetes and that you don’t like that. But knowing theres alot of people who struggle to get together the money needed for their basic Diabetes supplies in the US, I am always uncertain why people have to oppose the introduction of a system that helps exactly these struggling people get those basic supplies.

    I don’t know to much about every nations healthcare system to say anything with certainty except: don’t judge a national healthcare system like they are all the same. There are manymany ways to shape a system. And none of them are ever perfect; mostly because theres no such thing as perfect (though you should in healthcare reform strife for perfection, do not jduge something offhand because of what you perceive in other healthcare systems).

    Prolly didn’t get my point across, but I felt the need to try anyway.

  12. Clare
    Clare June 16, 2011 at 10:12 am | | Reply

    Hello, another type 1 in the UK here. I just wanted to comment on the ‘rationing’ discussion.

    As pointed out by others, the NHS is there to ensure the basic needs to help you manage your disease with good control are met. Of course this is not a perfect system, but from reading American websites, it seems that some people, especially type 2′s, really worry about whether they have enough coverage to fund those basic needs – those people who are not poor enough to qualify for state help but don’t get good insurance through work. In the UK, you would never have to worry about whether you can ‘afford’ to start insulin therapy, for instance.

    It would be great if pumps were more available on the NHS, although usage is going up, particularly for young children. But frankly the relief of knowing I will receive proper care, whatever my financial state, makes this something I can live with.

  13. steve
    steve June 16, 2011 at 10:30 am | | Reply

    Sam, The “baby out with the bathwater” comment is too cliche to just let it ride. Since neither of us, or anyone for that matter, has THE answer to our nations healthcare problems… Let’s just agree to disagree.
    The CGM however, is an inaccurate machine that will eventually fade away. My experience with the CGM was numerous false alarms during the night. It just wasn’t worth the inconvenience and lack of sleep for an actual low being caught for countless false low alarms. It’s a gadget, and you are hooked. But, be honest with the community. It is an extra device that is worn in/on your body that isn’t necessary if you use your traditional blood sugar monitor properly. I’m living proof, as are all the healthy diabetics using monitors instead of costly CGMs. Really!

  14. David
    David June 16, 2011 at 1:02 pm | | Reply

    @Clare, I could not agree more. The US system causes PWD to take on a whole other layer of stress and even fear financially and insurance-wise above and beyond the medical consequences. If you get a chronic condition, it does not take long to see the room for improvement in US system.

  15. Lindsay P.
    Lindsay P. July 7, 2011 at 6:34 pm | | Reply

    Wow, what a surprising article! I really was not knowledgeable about the UK health care system until I read this. I am an American with type 1 diabetes (since age 6), and I have to say, health care in the U.S. is awful! In my state (Florida), I cannot even get my own insurance plan because of my “pre-existing condition.” My job does not offer insurance. I am only able to be insured through my parent’s business, and the ins. premium is almost $600 per month. I have $50 doctor co-pays, $60 prescription co-pays, and I just sent nearly $400 to Animas for pump supplies. Nothing– absolutely nothing– is free here. I could only dream of a “free” hospital visit! On top of the diabetes itself, I experience constant stress about paying for my healthcare. It’s really disappointing considering the U.S. is such a “developed nation” and “world superpower.” Sigh!

  16. Frank Rubino
    Frank Rubino August 18, 2011 at 8:17 pm | | Reply

    Those who don’t think England rations care and we don’t are not in tune with reality. In the USA we ration care acording to ability to pay. If bills go unpaid you are sent to collections. Most patients don’t go back to that doctor. Oh yes “you can always go to the emergency room”……..for your emergency….heart attack … kidney failure…. but not really for diabetes education, insulin management etc. Can a primary care physician continue to see a patient for nothing and still pay good wages to his staff that expects a pay check every 2 weeks? NO! The endocrinologist will will see you once and say “you really need a primary care physician” (Internist, family physicain, or pediatrician) WE RATION CARE ACCORDING TO ABILITY TO PAY……PERIOD.

  17. Ariana
    Ariana September 27, 2011 at 11:46 am | | Reply

    I just moved to the UK, and it has been such a relief to be covered by the NHS, after 20 years of worrying about insurance and having to pay SO much money. In fact we had to declare bankruptcy after an uninsured hospitalization… I went to get my vision checked here last week, and when they asked me if I was diabetic, they told me my vision exam was free because of the diagnosis. It is just mind-blowing to me that I can get insulin and test strips for free! I have spent thousands of dollars trying to keep myself medicated and healthy in the US… I don’t know if I’ll ever want to move back!

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