Timewarp Tuesday: A Chat with Larry Soler

I'll admit it: I've read some of my fellow d-blogger's "flashback" posts and while some of them were interesting reading, I also said "that's just a cop-out, kind of re-hashing stuff that was already covered". But in retrospect, I must also admit they've proven somewhat helpful to have a look back to see where I was (and my colleagues, some of whom I hadn't met at that point) a few years ago, and what issues still remain open when it comes to the never-ending issue of diabetes management.

From my own perspective, I still remain focused on the prospect of a cure. I'm really no more tantalized about the prospect of an artificial pancreas than I was 5 years ago. My knowledge of the subject has grown, to be sure, and I see what's on the horizon is more of a semi closed-loop system than it is a truly smart artificial pancreas. That's a conversation for another day, however.

I've dubbed my posting today "Timewarp Tuesday", mainly because I was ready to post something last night, but I wasn't quite ready to adopt "Wayback Wednesday" so I needed a somewhat catchy (or maybe just a lame, but easier to say) title, and this was the best I could come up with. If you don't like it, I remain open to suggestions!

Anyway, I remain a tough cookie when it comes to interviewing big names in the world of diabetes. A case-in-point:
Larry Soler, who's JDRF's big cheese on the Potomac. I'd call Larry as the chief political strategist for JDRF, but officially, his title is "Executive Vice President, Government Relations & Operations". I hosted an online chat with Larry back in 2004, and the hot issue of the day was stem cell research.

That was driven primarily by then-CEO Peter Van Etten (JDRF is now on it's third CEO since then, as more recently, Arnold Donald stepped down rather unexpectedly, and has since been replaced by Alan Lewis). Mr. Van Etten's rationale was pretty understandable, at least from a business perspective.

Needless to say, since Yahoo! will be dismantling it's free Geocities web-hosting service, I'll be forced to move all my stuff there (rest assured, I already have a new, paid host I've had for quite a few years, but I still have to move everything before the October 24 deadline, so that's a work in progress), but since I'd saved my DiabetesStation.com transcript of that September 23, 2004 program, I thought it was worth sharing with everyone today. Have a look here!

Why NOT me?

As people who know me will vouch, I have a rather wry (and somewhat cynical) sense of humor. That's why today, Chris Bishop had a blog posting he titled "Why Not Me?", in which he makes some interesting points, but all I could think of when I read that was the scene by drag queen Charles Busch from the movie "Die, Mommie, Die!" entitled, appropriately enough, "Why Not Me?" Although this has really nothing to do with diabetes, it IS my Friday posting, and from MY perspective, I agree with this clip's closing statements when it comes to diabetes:

"The only part of this dump [meaning living with diabetes] that doesn't make me puke is the door, because that's the way I'm getting out!"

With all due respect to Chris, I'd be willing to trade life with diabetes for any number of things (then again, I wouldn't for something like cancer, for example) but I'm certainly not thankful for it. Truthfully, I'm counting the days until we'll be cured and can throw out all of the pumps, the meters, the insulin, the glucose tabs, the food scales, the CDE appointments and all of the other crap that goes with diabetes right in the trash! That's one reason why I, after 32 years of living with type 1, continue to do fundraising for the JDRF -- year after year.

A Staged Healthcare "Debate" Without Any Real Debate

Meet Wendell Potter

In the recent healthcare debate, Mr. Wendell Potter has gained prominence as an outspoken advocate for truly meaningful reform to the existing system, quite unlike some of the recent protests which are backed (financially and otherwise) by lobbyists for the healthcare "industry". The reason for Mr. Potter's recent celebrity: he's an industry "insider" and can testify just what the for-profit healthcare industry does in pursuit of profits, and the picture he has painted isn't quite as innocent as proponents, many of whom are protesting at town hall meetings across the country right now, would like us to believe.

Discrediting SiCKO!

Wendell Potter held variety of positions at CIGNA Corporation for over 15 years, most recently having served as that company's head of corporate communications with a role of acting as the healthcare insurance company's chief corporate spokesman. Prior to joining CIGNA, Mr. Potter also ran communications at Humana Inc. (another large for-profit healthcare insurer). However, after a 20-year career as a corporate PR executive for the healthcare industry, last year, Mr. Potter left his job as head of communications for CIGNA to assist "socially-responsible" organizations -- including those advocating for meaningful health care reform -- achieve their goals. Since May 2009, Mr. Potter has worked for the Center for Media and Democracy's (CMD) Senior Fellow on Healthcare. CMD was founded in 1993 as an independent, non-profit, non-partisan, public interest organization. CMD's mission is to promote transparency and an informed debate by exposing corporate spin and government propaganda and by engaging the public in collaborative, fair and accurate reporting. Potter has since testified before Congress (before the U.S. Senate Committee on Commerce, Science and Transportation) and appeared in several television interviews.

Most notably, on July 10, 2009, Potter was interviewed by Bill Moyers on PBS, and in that interview, he disclosed exactly how the for-profit healthcare industry put profits before patients, sharing some of the sleazier tactics used to drop patients when they are diagnosed with various illnesses, etc. -- including the industry's efforts to discredit Michael Moore's SiCKO movie!! It's pretty shocking!

See here for the full transcript, although the video below contains many of his most shocking admissions:



This week, MSNBC's Rachel Maddow interviewed Wendell Potter, and addressed some of the same topics (all within the context of our bigger debate on how to reform the U.S. healthcare "system" -- a term I use very loosely). We also learn that in 2007 alone, the CEOs at the insurance companies collected combined total compensation of $118.6 million-an average of $11.9 million each. See here for the Rachel Maddow interview with Wendell Potter:

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Corporate Control of the Healthcare "Debate"?

Of course, in recent days, what has made the news on America's corporate-controlled (from the likes of Viacom, Time-Warner, Disney, GE, News Corp. and others who dominate much of the U.S. media today) news outlets?

A lot of news about protests (many of which had been staged by opponents) at various town-hall meetings taking place around the country meant to serve as discussions about Congressional moves to address healthcare reform. Absent from many of these stories are the facts that many of these "disruptions" are being staged and funded by organizations that have obvious vested interests in preserving the status quo. Now, I'm not really a die-hard Rachel Maddow fan, but I did happen to catch a clip you should probably catch which aired last night that about summarizes what's going on in this whole "debate":

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Personally, I don't have an issue with protests even, but I do have an issue with organizations that are purposely and covertly misrepresenting themselves with a goal of stopping the discussion about reform altogether and presenting it as "news", which our media seem only too willing to suggest actually IS news.

Also, be sure to catch my previous posting on healthcare reform, or rather the lack thereof, here. What does anyone in the Diabetes O.C. have to say about this? Aren't we as a country entitled to a legitimate discussion? What about the media's role here?

The Los Angeles Times' blog is now reporting that supporters of the Obama healthcare reform proposal are now so outnumbered by paid opposition that they too are now recruiting paid supporters on Craigslist. My only response is that if the opposition is going that route, then supporters really have no other alternative unless they're willing to be steamrolled. Unfortunately, this drags the entire discussion into the gutter (literally) and denies Americans a fair and honest discussion about real healthcare reform!

Street Rats and the Future of U.S. Healthcare

Ever Hear of "30 Net 10"?

It's a trade expression, whereby you're given a 10% discount if you pay for your purchase within 30 days, and it's a pretty much standard operating in most trades.

You want to get paid immediately? Gimme a discount.

Increasingly, this is what U.S. healthcare might look like, too -- one where medicine is looks more like a Moroccan marketplace (such as this one from Disney's Aladdin) than a hospital or doctor's office. But it's the road our so-called healthcare system (the word Bazaar comes to mind, or maybe bizarre!) is headed.



That's not a scenario most Americans are accustomed to, but the reality is, it might look that way if Congress doesn't do anything to change things to address the healthcare issue soon.

There's no other place for it to go, as the current growth rates in U.S. healthcare costs are simply unsustainable. And I'm fortunate enough to actually be employed and have healthcare insurance, while many others aren't so lucky.

According to a Kaiser Family Foundation/USA Today Harvard School of Public Health Healthcare Costs Survey (conducted April 25-June 9, 2005), only 11% of Americans actually negotiated healthcare costs (although among the percentage of uninsured Americans, it was higher at 24%). But what's more interesting about this finding is not the fact that some enterprising people have decided to negotiate on price, but how many of them were able to get discounts, 58% of them to be exact. This suggests that's there's plenty of fat in the system that can be trimmed.

Today's Wall Street Journal featured a story that indicated that increasingly, doctors are seeking payment of the entire bill for patient share of the cost up-front. They claim they have to request their fees while patients are still at the office because bills sent later typically recover only about half of what a practice is owed, according to McKinsey & Co. (an even smaller percentage among uninsured patients). But most companies get a discount for rapid payment, in fact those practices are the basis of much of our economy.

At my last endo visit, my doctor asked for the full amount due. Now, I have a new insurance plan that began in July, and it has a relatively high deductible, but rather than switching endos yet again (this would have been the third time in 3 years I'd been required to do so thanks to insurance coverage changes from my employer -- so much for the Congressional argument that you can keep your doctor!), I availed myself to the out-of-network benefit of the new plan. But when I left, the doctor asked for the entire amount of the invoice, rather than a portion of it. Sure, I could have pushed back and said I'd pay only part of the bill that day, but since the total was like $150, and I can pay for it with pre-tax dollars thanks to my Flexible Spending Account (FSA), I just paid it and submitted the claim to my insurance to apply towards my deductible, while submitting another copy to my FSA administrator for reimbursement.

The practice of billing up-front is apparently pretty common, and is growing among doctors. The Wall Street Journal reports that "According to a questionnaire sent to its medical-practice customers by NaviNet Inc., which provides a Web service that allows doctors to communicate with insurers, found that more than half of the 650 respondents in a survey were trying to get money beyond just co-payments during patients' visits."

But suppose I wasn't able to cover this amount?

Knowing myself, I would have pushed back when they asked (in fact, I was a bit pissed they asked for all of it up-front since my insurer doesn't pay them immediately, and next time, I'm going to make them bill me for everything except my co-pay amount because I'd rather earn interest on the money than let the doctor's office earn interest on it!).

Having a closer look at the bill my doctor's office provided revealed some interesting findings. I had a regular appointment, and they drew blood for my HbA1c and other lab tests. Consider just one example of the waste in the system: $10.50 for "specimen handling"? Hello. Quest and LabCorp pick up the blood samples at the office, so basically the doctor's office just holds the blood samples in the fridge until they come the same evening. Needless to say, that $10.50 is a cost that my healthcare plan didn't pay for, and next time, I'm not going to pay for it, either. Plus, I want a 10% discount on everything for paying them up-front (back to the "30 net 10" I mentioned earlier).

I suppose all of this is meant to make us as patients more aware of exactly what we're paying for (and it does this, to some extent) but I'd prefer to have a system like I enjoyed when I lived in Finland, where it's all handled automatically, certainly not this s#!t. Plus all of the administrative work I encounter for submitting the invoices to both my FSA Administrator and another to my insurance company is a pain in the @$$, folks. It does nothing to reduce costs, efficiency and frankly, it's a nuisance. I suppose electronic medical records would partially address this, but as I've written before, these aren't necessarily the big cost-saver the proponents claim they are, plus Congress provides us almost no protections if someone should break into the system and steal these records (none of that is addressed in the bill Congress is blabbering about right now). And for those of you who are uninsured (as 47 million Americans are) this is a cost that's increasingly, out-of-reach.

This so-called "system" sucks, and it's a hassle, too. I'm lucky to have a plan, but it's nowhere near as good as what they enjoy in Europe or Canada (no matter what opposition is saying now in commercials), plus those socialized plans get to the core of what the so-called "system" is supposed to be about: healthcare, NOT how to invoice and pay for it, which is increasingly all the American system is worried about.

Anyway, it is starting to look like we may sooner (rather than later) have a healthcare system that resembles the marketplace in the Disney animated film Aladdin: where those who get the most from the "system" are effectively "street rats" are able to maneuver through (or around/over/under) the system, while others avoid it at all costs.

Welcome to the future of U.S. healthcare, street rats!