Arizona: Not the Land for the Obese, the Poor, Smokers or the Chronically Ill

Angela on TuDiabetes started a thread about the latest news about Arizona’s Governor Jan Brewer.  You can read all the comments in that thread here.  Apparently Governor Brewer now wants to fine Medicaid recipients $50 if they are obese, smoke or have a chronically ill condition and fail to meet their doctor’s goals.   This is her plan to fund the transplants that she previously took away from Medicaid recipients.

I totally get that people need to take more responsibility for their actions.  But really, is this the way to make people do that without even considering the circumstances?  Medicaid = poor.  Poor means you have limited money to buy food.  It is well known that fruits and vegetables cost a lot more than a pack of Ramen noodles that you can usually buy 4 for $1.  A pack of Ramen noodles has 380 calories and 60 grams of carbs.  Now we are going to punish poor people because they can’t afford to buy healthy food and try to survive on the cheap, calorie dense foods? 

A lot of diabetics also have thyroid or other metabolic issues that cause weight gain.  Some people are on drugs that cause weight gain.  What happens to the people who have other health issues that cause weight gain and it is impossible for them to lose the weight? I have now been thru two bouts of thyroid problems that caused weight gain.  I eat 1200 calories a day.  What should I have done differently?  I think I have the world’s slowest metabolism and gain weight if I don’t exercise.  I gained over 60 pounds when I could not exercise for two years because of my foot ordeal.  I was eating 1200 calories a day.  What should I have done?  I had a smaller ulcer after I was able to take some of the weight off.  Because I was not able to exercise again, I cut back to 1000 calories a day and still gained 8 pounds in two months because I could not get on my treadmill.  What should I have done?  I am currently struggling to exercise because I have asthma that is not being treated properly.  What should I do when not being able to breath makes it hard to exercise? How do people with other health issues that impact their weight fit into Governor Brewer’s plans to fine obese people?

In Angela’s post, she talked about her struggle to get a proper diagnosis.  Unfortunately, Angela’s story is typical of Type 1s being misdiagnosed as Type 2.   Type 2 meds are not going to work when someone needs insulin.  Should Angela have been fined $50 because her doctor misdiagnosed her and refused to give her the meds she needed to get her blood sugar in line with the goals he set? 

I have gastroparesis and before finding the DOC, my blood sugars were bouncing all over the place.  I had doctors that knew I had gastroparesis but criticized me because my blood sugar was bouncing around.  I even said to one doctor, “tell me what to do and I will do it.”  I was met with blank stares.  Should I have been fined $50 because doctors did not know how to help someone with gastroparesis and I was not able to meet their blood sugar goals?

A lot of doctors seem to think that all diabetics need to be on statins – I have heard that from several doctors.  I, along with many other diabetics, don’t want to take statins because of the nasty side effects.  I just got a copy of my latest rounds of labs the other day and my LDL was 95 – it is recommended that diabetics be below 100.  My HDL was 93.  I don’t know what “average” is, but I have had several doctors comment they don’t have patients with HDL that good.  My triglycerides were 66 – I was 38 last year.  I have seen an increase but is that really cause for concern when the lab has the range as being 0-150?  My total cholesterol was flagged because it was 201 and it is supposed to be below 200.  Part of the reason it is high is because my HDL is so high.  I had a heart cath done in July, 2009 and at that time, my LDL was 100, my HDL was 101, my triglycerides were 53 and my total cholesterol was 212.  The cardiologist did all the cholesterol ratios and told me my numbers were fine.  Should I be fined $50 because I don’t want to take a drug that is known to have a lot of side effects but some PCP thinks I have to be on a statin because I am diabetic?

When I was first diagnosed with thyroid problems, I was put on Synthroid, which is the most commonly prescribed thyroid medicine.  It caused seizures for me.  Even though the prescribing information says that it causes seizures, I have had two doctors tell me it does not causes seizures.  The problems I was having started when I started taking the drug and went away when I stopped.  Should I be fined $50 because I don’t want to take a drug that caused seizures for me?

When I was first admitted to the hospital for my foot infection, I was using Allegra for allergies.  The hospital did not have Allegra so they gave me Clairitin.  That caused my throat to swell up but yet the head nurse told me that I was refusing to take medicine when I did not want to take it.  Should I have been fined $50 because I did not want to take a drug that caused my throat to swell up? After all, I was non-complaint in the eyes of the head nurse! 

Last fall, I went to a new endo.  Right after she congratulated me for my A1cs being the 5s, she criticized me for using Apidra.  Maybe my choice of insulin had something to do with the A1cs, but hey, why not fine me $50 because I would prefer to take an insulin that actually helps the management of my blood sugars with gastroparesis. 

Like I said, I agree that we all need to take responsibility for our actions. I realize that we have a system that is in trouble.  But really Governor Brewer, is fining poor people who have no control over their circumstances the answer?  What happens to these poor people that don’t have $50 to pay the fine? Are you going to throw them in jail?  Yup, that will save a lot of money.  For the people that are obese because they cannot afford to buy healthy food, why not help them buy that healthy food?  That might cost more in the food department but you will most likely save more on health dollars than you spend on food. 

Are the doctors that fail to properly diagnose a person going to be held accountable?  When my foot was infected, I had a culture and an MRI that both said that I still had an infection, but the doctor said the infection was gone, stopped the antibiotics and put a wound vac on my foot.  Because I had an infection, the wound vac turned my bone to mush.  I switched doctors, was in the hospital for a week, had 3 surgeries, home nurses coming in, IV antibiotics, 8 months of seeing a doctor every 1-2 weeks and another 4 months of seeing a doctor monthly, three months of HBO treatment plus all the supplies and medicine that was used.  I don’t believe in suing people, but shouldn’t some of these doctors be held responsible for the costs because of their mistakes?  Medicare won’t pay for costs associated with hospital acquired infections or extra surgeries because doctors left sponges in a patient.  Governor Brewer, why don’t you hold doctors responsible for their screw-ups instead of fining poor people $50?

If you want to read some of the responses to Angela’s discussion on TuDiabetes, click here.
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