Where's Our Apology?

Among the bigger news stories last week was the report about how Australian PM Kevin Rudd delivered a major apology to the Aborigine people for past governments' policy of taking their children away from them.

This got me imagining a scenario where Dr. John Buse, President of the American Diabetes Association, would step up to the podium and tell a roomful of reporters that he was there to apologize on the behalf of the ADA for condemning three generations of people with diabetes to lives filed with unnecessary complications and early deaths because of the ADA's aggressive advocacy of the high carbohydrate/low fat diet which makes it impossible for most people with diabetes to control their blood sugars.

In my fantasy, Dr. Buse would announce from now on the ADA would refuse to take money from companies whose primary products are high carbohydrate foods. He would add that the ADA was going to dedicate a large part of the millions of dollars contributed by friends and relatives of people with diabetes to the task of teaching doctors that cutting out the carbohydrates is a more powerful tool for lowering blood sugar than any drug on the market. He'd conclude by announcing that he was appointing Gary Taubes to head a new Expert Panel whose job would be to rewrite the ADA's position papers on diet and medication and that Dr. Richard K. Bernstein would be heading up a panel to rewrite the ADA's recommended blood sugar targets.

Ah, well. I'm not holding my breath. But today's news did carry an encouraging tidbit. As of October, Medicare has announced that it will no longer pay to treat a list of medical conditions caused by the negligence of hospitals and doctors!

Medicare Won't Pay Hospitals for Errors--AP

I have always wondered why doctors could get away with charging customers to fix conditions that resulted from their own incompetence. None of the rest of us can. Now it looks like Medicare may be able to change this. Not only will Medicare not pay for treating hospital-borne infections, sponges left in bodies, inappropriately used catheters, etc. but the hospitals and doctors will be forbidden from passing on the costs of treating these problems to patients. Private insurers are already following suit, and doctors may finally start washing their hands and counting the sponges as if people's lives depended on it--which they do. The report in my local paper explained that it wasn't until hospital administrators learned that these errors would cost them money that they got serious about eliminating them. Before Medicare announced this policy, the hospitals were earning an extra $100,000 per patient for each medical mistake.

On reading this, it struck me that it may, after all, be the bean counters who save us from bad medical treatment. Will it be Medicare that prohibits hospitals from putting people with diabetes on the high carbohydrate diets that make it impossible to control their blood sugar, now that there is evidence hospitalized patients recover more quickly and with fewer complications when their blood sugar is kept in the true normal range?

Right now doctors have no incentive to get their patients' blood sugars down. They earn money only when the patient comes into the office with a problem. Hospitals don't see people with diabetes until they have that heart attack, need dialysis, or have that amputation, all of which earn them good money, too.

So its up to the bean counters--the people who know what it costs to fund all that bad medical advice--to save us. And who knows, perhaps someday we people with diabetes will get our apology AND the kind of hospital and medical treatment that would help rather than hinder our search for health.