[seacomp]

http://www.washingtonpost.com/wp-dyn...021401772.html

What do you think?

[gettingby]

Unless I misinterpreted something (and correct me if I am wrong) but this just sounds like another attempt of "Big Brother" invading our lives.
Ok, they will be seeing the blood work of diabetes patients, correct?? Then they will inform the doctor to try and change this person's habits?? Well excuse me but..... what if the problems with the diabetes control have nothing to do with the patient's habits?? What if there is some underlying aspect that explains the readings? Are they gonna take the doctor's word or are they gonna go on their first impression that it is the result of the patient not following his/her care plan? First impressions are not always correct.
I just see this as "Big Brother" envoking too much power into citizens lives. Just MHO !!!!!!!!!!

[Cyborg]

Sounds like they are setting themselves up for some major litigation. I thought medical records were private information. What's next, the fat police? The alcohol police? First the patriot act and now this. That's a pretty big step...

[seacomp]

The positive side to this, the only positive side is that at least they are paying attention to diabetes. But only because we cost too much.

[Cyborg]

Too bad they don't take all that money and effort and apply it towards finding a cure. Or at least making the final push towards a closed loop artificial pancreas (pump) until a cure is found.

[gettingby]

Originally Posted by Cyborg

Too bad they don't take all that money and effort and apply it towards finding a cure. Or at least making the final push towards a closed loop artificial pancreas (pump) until a cure is found.

:dito: :dito:

[Erin]

Originally Posted by Cyborg

Sounds like they are setting themselves up for some major litigation. I thought medical records were private information. What's next, the fat police? The alcohol police? First the patriot act and now this. That's a pretty big step...

As a direct result of the patriot act medical records are not 100% private and confidential. Yay Bush!

[Cyborg]

No kidding ! The patriot act allows medical records to be disclosed ?

[Erin]

I am of two minds about this issue.

1) like other people who've posted here, I think it's kind of creepy that Big Brother is watching my HbA1c. (well actually he's not, I go to the endo in New Jersey)

2) Diabetes education, care, and medical support is SORELY lacking in NYC, particularly in the poorer areas where type 2 is running rampant these days. (Old saying: Q: how can you tell if you're in a ghetto? A: KFC stands for Kennedy Fried Chicken (generic chicken place), and there is a McDonalds every two blocks.) So it's good that the local government wants to do SOMETHING because it's not JUST a matter of people not following their health care plan, sometimes it's people not knowing what they should be doing, or not taking enough oral medication and / or insulin because they can't afford to buy it, and don't have the knowledge they need to access Medicaid or other assistance programs. Or they simply don't have the resources to even eat properly. (a lot of you are going, yeah right... how hard is it? but let me tell you, in this city healthy food goes at a premium. Even getting decent vegetables requires a trip to the organic vegetable store or a farmers market, which simply cost too much. The ONLY place you can get affordable vegetables which are palatable is in Chinatown and you kind of have to know where to look even there.) AND all the "diabetic meal plans" that are commonly recommended by docs are very Euro-Centric, and the Latino and African-American patients (being hardest hit by T2 these days) look at the doc and go "yeah, right."

That said, I think the funding they are using to track diabetes patients could be better spent on free diabetes clinics in at-risk neighborhoods. Even bi or tri lingual education campaigns would help. But, humans are nosy, and we feel we need to get in everybody's business and tell them how to live their life... rather than step back and try to help folks make it work the way they see fit.

[Erin]

Originally Posted by Cyborg

No kidding ! The patriot act allows medical records to be disclosed ?

You being sarcastic?

but yes, I read the act a long time ago, so i can't be too specific just now, but i was astounded at how many ways Big Brother can legally watch us now.

And that's fine, if you're doing it to catch terrorists, but I don't think the sugar in my blood is gonna blow up anything any time soon... so leave it alone.

Slippery slope... slippery slope.

[rea]

Thats a brutal article.

on one side - maybe more people can get assistance, it will incourage more reasearch and government grants. but it is creepy in a way.

BUT, wouldn't time and money be better spent on health and nutrition education to America's youth, so if they get this disease, they have an easier time dealing with it? eliminate predjudices with education?

on the other side, I sometimes feel very bitter that a type 2 I see everyday scarfs down donuts daily at Tim Hortens, drinks high fat iced cappucinnos that are pre-made and high in sugar, and east whatever they feel like it, and is extremely overweight without any shown effort to control their diabetes. They are always complaining about health problems, but are either too scared or too ignorant of the dangers to change their lifestyle. It makes me angry that people are working hard (maybe not hard enough, eh?)to help someone like that, and maybe they need the extra pushing to be healthy.

Whats next, denial of health care coverage because you got your blood sugars high from eating birthday cake?

But I am way up here in Canada, so our goverment and privacy legislation is different.

[Cyborg]

Is this a New York thing? Why go to an endo in Jersey rather than New York? I don't understand?

I wasn't being sarcastic about the Patriot Act. I knew it gave many powers. How many, obviously I wasn't aware of that...

As far as food and eating better, I truly believe that anyone can do that. Whether you live in a middle class, lower class, or upper class neighborhood. All neighborhoods have grocery stores that sell fresh vegatables, fruits and meats. It is your duty, as a responsible person, to learn how to deal with your diabetes. Part of that includes learning how to take these raw ingredients from the store that you buy and put them together into healthy diabetic meals and eat them in the appropriate portions at the correct times. Your race or nationality does not come into play with this respect.

Medicine costs are extremely prohibitive to many people, including those on very good insurance companies with good incomes. I can't imagine what it's like for diabetics that are living day to day making minimum wage with no insurance. It is a terrible shame. I hope our Canadian friends have a better situation. I do hear stories of companies offering free medications to people with diabetes that cannot afford them so perhaps there is some truth there. I truley wish that our government would do more to help.

[Erin]

Originally Posted by Cyborg

Is this a New York thing? Why go to an endo in Jersey rather than New York? I don't understand?

I wasn't being sarcastic about the Patriot Act. I knew it gave many powers. How many, obviously I wasn't aware of that...

As far as food and eating better, I truly believe that anyone can do that. Whether you live in a middle class, lower class, or upper class neighborhood. All neighborhoods have grocery stores that sell fresh vegetables, fruits and meats. It is your duty, as a responsible person, to learn how to deal with your diabetes. Part of that includes learning how to take these raw ingredients from the store that you buy and put them together into healthy diabetic meals and eat them in the appropriate portions at the correct times. Your race or nationality does not come into play with this respect.

The Jersey thing is quite simple to understand. I grew up in Jersey, I like my endo, I'd rather commute a bit every couple of months than deal with switching. Now that this legislation has come into play, which only effects residents of New York City, I might NEVER switch.

About the food. Your reaction is normal, but it's really not as easy as all that. I have lived in some of the lower income neighborhoods here, and worked in others, and heath code legislation very rarely comes into play. The more affordable and conveniently located grocery stores have produce that will cause more harm than good if actually eaten. I'm talking about food that is LITERALLY rotting on the shelves. Supermarkets that smell like meat that's gone off. Bodegas and corner grocery stores that have plantains, potatos, and apples, and not much else that doesn't come in a box or a can. The nicer stores with produce that looks edible are more expensive, sometimes prohibitively expensive, depending on your income. It's go canned or go frozen or go home. (well that or take your chances with produce you bought from a guy off of a cart on the street... which is either really awesome or really awful) I know, because I went for a YEAR at one point without purchasing a fresh vegetable in my neighborhood. And that was from the standpoint of self preservation. I would go to my parents house every couple of months and gorge myself on greens, and once in a while I'd trek down to Chinatown and stock up on veggies and tofu.

I'm not saying race and ethnicity excuse you from eating well, I'm just saying it would be easier for people of non European decent to follow a meal plan, if the meal plan incorporated the foods they were used to eating. I love all kinds of food, but do you know how long it took me to figure out how to bolus for empanadas or fried plantains? I wasn't able to find ANY resources about those foods. (well, I didn't look that hard, but it should be easy!) Let alone sushi or pad thai (which got purchased when I got my $ more in check).

And don't get me started on take out. NYC is a city constantly in motion, and as such MOST of its residents eat at least 5 meals outside of their home every week (some eat ALL of their meals outside of the home). In the richer areas there are soup / salad / sandwich shops on every corner. In the porer areas it's pizza joints, McDonalds, and KFC. The society is setting up lower income people to have poor health. They have less access to medical care (ever go to a clinic in NY? you're more likely to GET sick than get healed, and the wait is prohibitive to people who work for a living) less access to quality food, and less access to the information that they need to make Diabetes work within their world. I was fortunate. I got the BEST diabetes education possible and learned a lot about food and nutrition, before trying to move to NY.

You know what Sinatra said about new york? If you can make it there, you can make it anywhere? He wasn't kidding. It's a hard place to survive if you're not rich. Sometimes the only thought that gets you through the day is... if I moved ANYWHERE else, life would be easier. (and don't say well if you moved to a village in Kenya life would be harder. If I moved to a village in Kenya I'd be the equivalent of a millionaire, and I can barely make rent here)