Parents of kids with Type 1 diabetes still have no guarantee from B.C. health minister George Abbott that his ministry will cover the cost of insulin pumps.
"That is an issue that is currently under review by the ministry," Abbott told the Georgia Straight on September 28, following the closing press conference for the yearlong public consultation called the B.C. Conversation on Health. "So, the health professionals who are evaluating that continue their work, and I expect that I will be getting a recommendation from them sometime in the weeks ahead."
Mary Polak–the B.C. Liberal MLA for Langley who acted as parliamentary secretary for the consultation–and Minister of State for Childcare Linda Reid (Richmond East) joined Abbott at the wrap-up, held in the ambulatory-care building at BC Children's Hospital. The press conference also marked the unveiling of an Ipsos Reid poll on child health, conducted between May 22 and June 4 on behalf of the BC Children's Hospital Foundation, involving 673 B.C. children aged 10 to 16. Not surprisingly, the focus of the wrap-up was almost entirely on "youth".
"The things we do today will have a huge impact on the health-care system they will inherit 20, 40, or 60 years on from now," Abbott said.
However, while they touched on Type 2 diabetes, the MLAs neglected to mention Type 1 diabetes in their comments. With Type 1 diabetes, the immune system attacks and kills beta cells in the pancreas, wiping out insulin production. Insulin absorbs blood sugar, which is converted to energy. In the more common Type 2 diabetes–often associated with obesity–the pancreas doesn't produce enough insulin or doesn't properly use the insulin produced. Type 2 diabetes can often be controlled with improved nutrition and medication, and Abbott told reporters it was "near epidemic in our society".
"The best way to reverse that is to adopt healthier lifestyles," he said.
This is cold comfort to parents like Cheryl Simpson. Along with her husband, Steve, Simpson forked over more than $7,000 for an insulin pump for their 10-year-old daughter, Ellery, who was diagnosed with Type 1 diabetes in 2004. Although Ellery lives an active life, she does require blood tests, which involve painful finger-pricking several times a day. She also required multiple daily insulin injections until her parents bought the pump, which Cheryl Simpson said is "the size of an MP3 player or a pager".
"It is the closest thing we have right now to an artificial pancreas," she said. "Inside the insulin pump is a small reservoir that you fill up with rapid-acting insulin. The pump has a function on it–and you calculate this with your diabetes administrator–for what your basal rate is. All of us with a normally functioning pancreas have a pancreas that gives out tiny bits of insulin all throughout the day. And when we eat, our pancreas says, 'Oh, you have eaten' and gives you more insulin to counteract the carbohydrates you've had. What the insulin pump does is give out this basal rate of insulin all day, and you can change how much it gives you overnight. Then when you eat, you”¦count the carbs, and your pump calculates how much insulin you should get for that meal."
The Ontario Ministry of Health and Long-Term Care pays the entire cost of insulin pumps for residents 18 years and under, and covers the cost of supplies up to $2,400 per year.
"We announced it in November 2006, but then we made it retroactive back to April of that year," ministry spokesperson David Jensen told the Straight by phone. "I guess it was identified as a need out there for young people with diabetes, and that this could be a useful device for them–especially those people that are not having success with the multiple daily insulin injections. If that young person is willing to be trained in the proper use of the pump, we saw it as an effective device for them to be able to use to help with their condition."
Cheryl Simpson said some extended medical plans do cover a portion of the cost of pumps in this province. "We were able to stickhandle around it and pay the money [upfront]," she said. "What really irked me was I knew how many children were out there whose parents could not afford a $7,400 hit and then [have to] wait for a percentage of the insurance to come back three months later from an insurance company. Running a pump runs anywhere from $300 to $500 a month, and that is for all the supplies."
In an interview with the Straight on May 10, Abbott said officials in his ministry were reviewing the PharmaCare program's coverage of diabetes medications and related supplies. Cheryl Simpson feels that this is unacceptable.
"By the time we hit any kind of number where the PharmaCare might kick in, it is [too high]," she said. "I don't think I or anyone [else] should be held hostage to what PharmaCare is going to cover, when you are talking about the life of my child. This is not cosmetic surgery. This is life or death. There is just no monkeying with that, especially when you see all the other stuff that is funded–it drives you insane."
It also bothers Dr. Bruce Verchere, director of the diabetes-research program at BC Children's Hospital. Verchere was not available for an interview, but on May 10 he told the Straight that pumps represent a "great improvement" on daily insulin injections.
"But it's only available to the more better-off," he said. "The same is true of some other aspects of care that the patients are on the hook for."
Provincial NDP health critic Adrian Dix told the Straight he was diagnosed with Type 1 diabetes in 1992 but does not use an insulin pump.
"But clearly if you give people with diabetes resources, that is the best way to address long-term health and chronic-disease management."