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Medical Forum / Diseases and Disorders / Diabetes / December 2005New York to monitor diabetics
>From MSNBC.com: "Hoping to save hundreds of lives, New York adopted a health code regulation Wednesday that will make it the first American city to keep track of people with diabetes in much the same way it does with patients infected with HIV or tuberculosis. The city will occasionally use its database to prod diabetics to take better care of themselves." The rest of the article is at http://www.msnbc.msn.com/id/10470060/ I am a strong believer in personal responsibility, This is too much big brother for me. I oppose this. If someone wants to volunteer to be in the program that is something else. jmo Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. I oppose it too. Volunteers only, as far as I'm concerned. -- Cheri Loretta Eisenberg wrote in message <23867-43A0C874-141@storefull-3237.bay.webtv.net>... I am a strong believer in personal responsibility, This is too much big brother for me. I oppose this. If someone wants to volunteer to be in the program that is something else. jmo Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. >I am a strong believer in personal responsibility, This is too much big >brother for me. I oppose this. > >If someone wants to volunteer to be in the program that is something >else. Bad idea. The database will be used by employers and insurance companies to discriminate against people. Also used by marketers. >>I am a strong believer in personal responsibility, This is too much big >>brother for me. I oppose this. [quoted text clipped - 4 lines] >Bad idea. The database will be used by employers and insurance >companies to discriminate against people. Yes, I'm just cynical enough to believe it would be used to deny insurance to those deemed noncompliant. "Sorry, Mr. Smith, but if you can't do your part and take off a hundred pounds, then we are under no obligation to help you." >I am a strong believer in personal responsibility, This is too much big > brother for me. I oppose this. [quoted text clipped - 10 lines] > of Israel, two bastions of strength in a world filled with strife and > terrorism. Is it possible that one day diabetics will be refused service at Krispy Kreme? > Is it possible that one day diabetics will be refused service at Krispy > Kreme? Why would I want a blob of raw dough with sugar on top?  SignatureWes Groleau Alive and Well http://freepages.religions.rootsweb.com/~wgroleau/ >> Is it possible that one day diabetics will be refused service at Krispy >> Kreme? > >Why would I want a blob of raw dough with sugar on top? Krispy Kreme opened it's first store in Ma. about a year ago. It closed it's last one last week. Sleepy "I used to think I was poor. Then they told me I wasn't poor, I was needy. Then they told me it was self-defeating to think of myself as needy, I was deprived. Then they told me deprived was a bad image, I was underprivileged. Then they told me underprivileged was overused, I was disadvantaged. I still don't have a dime, but I sure have a great vocabulary." -Unknown > >> Is it possible that one day diabetics will be refused service at Krispy > >> Kreme? [quoted text clipped - 3 lines] > Krispy Kreme opened it's first store in Ma. about a year ago. It > closed it's last one last week. Man those things are nasty! They came into CA just before I moved. My dad and I bought a box of them thinking the movers might want a snack. They didn't. Not those anyway. Smart move! I took a small pinch of one and tried it. Total grease. Yucko! Can't imagine eating a whole one. SignatureSee my webpage: http://mysite.verizon.net/juliebove/index.htm > didn't. Not those anyway. Smart move! I took a small pinch of one and > tried it. Total grease. Yucko! Can't imagine eating a whole one. Hmmm. They must have different recipes according to local management. The one that opened near me served little blobs of raw dough. Occasionally it was even runny. Kreme, yes. Krispy, no. SignatureWes Groleau You're all individuals! Yes, we're all individuals! You're all different! Yes, we are all different! I'm not! ("Life of Brian") > >From MSNBC.com: > [quoted text clipped - 7 lines] > > The rest of the article is at http://www.msnbc.msn.com/id/10470060/ Wow! That's horrible! I'm glad to see that currently 70% of the people polled agree with me that it's an invasion of privacy! Yes, the article said that people who felt their privacy was being invaded could opt out of it, but I can envision this backfiring against them. Such as a Dr. refusing to treat a person who refused to get with the program. I fail to see how such a system could save any lives. Diabetes is not contagious and it's one disease where much is placed on the patient. We always hear talk of "control" as though it is up to the patient to "control" it. And yes, many of us type 2's can "control" it with diet and exercise. Meds can help. But there are some of us who despite our best efforts and even to the point of micromanaging are "out of control". We are left feeling like failures or sometimes even liars! I remember the one Dr. I saw when my normal Dr. was out recovering from an operation. He told me I couldn't possibly be having hypos because "it was the holidays". And in fact we were coming up on Christmas, but I hadn't eaten a single sweet or anything else I wouldn't normally eat...aside from what was needed to treat the hypos. He acted like he didn't believe it still when my husband insisted that I always stuck to my diet. Luckily in that case, my A1c of 4.3 proved that I was right! Or in my case at present, I am left floudering at lunch time. I awake on most days with acceptable BG, but it starts going up after breakfast no matter what I eat. I spike and I stay spiked until I take my dinner meds. For a while, I was managing by eating no lunch. But sometimes this would cause a hypo while I was trying to fix dinner. Now this week, it seems to be a different game again! Skipping lunch does not bring my numbers down. In fact it shoots them up higher than if I do eat! It's nothing but frustration but neither of my Drs. have any suggestions for me. Nothing I've done in the past has helped. But some person in charge of this "new system" might look at my numbers and assume I'm one of those non-compliant diabetics who doesn't exercise and just eats what she wants! Bottom line, I fail to see how this will help anyone! Those of us who are having problems will have fingers pointed at us. Drs. will feel like they're failing us when they get a patient like me, or a brittle type 1 who can't seem to gain control no matter what! And most likely, the ones now who don't give a fig will continue not to give a fig and keep on doing what they're doing, even if it is a mark against them. SignatureSee my webpage: http://mysite.verizon.net/juliebove/index.htm "ankalime" <ankalime@yahoo.com> wrote in news:1134605575.349197.270870 @g49g2000cwa.googlegroups.com: >>From MSNBC.com: > [quoted text clipped - 7 lines] > > The rest of the article is at http://www.msnbc.msn.com/id/10470060/ "Prod"? My elected servants prod me and they'll need a flash light and some rubber gloves to remove their prod from their backside. Your tax dollars at work - no that's not right taxes are being spent for Rain Forrests in Illnois malls, bridges to no where in Alaska, and propaganda in Arab papers. This was probably paid for by money that we borrowed from China. It is amazing how much the current politicians seem to be more and more against individual rights isn't it. But then I'm still confused about our Supreme Court deciding to allowed developers to take family homes because a family home isn't as profitable as beach condos. It's really going to get wild when the police arrest young women after Roe v. Wade is overturned. But by then pregnancy will be outsourced or privatized. >>From MSNBC.com: > [quoted text clipped - 7 lines] > > The rest of the article is at http://www.msnbc.msn.com/id/10470060/ Yes. But they'll do nothing to lower consumption of the foods and additives which cause it to develop. Simpler to pick on us than on those "captains of industry". This is different from the proposal that was discussed a few months ago. That one applied to monitoring the A1cs of diabetics receiving public assistance for their health care. The idea was if their A1cs shot up, they would be flagged for consultation to bring their blood sugar under control. With so many diabetics who are non-compliant patients--don't test, don't take their meds, don't follow a diet or exercise--the idea was to concentrate on preventative programs so that the state doesn't end up paying for kidney dialysis and heart surgery instead of test strips and metformin. The intent was to better serve public assistance patients and give them better health for fewer tax dollars. This new program applies not just to patients whose medical care is paid for by the state but to everyone. This increases the concerns about civil liberties even more than the original proposal did. The plan sends the A1c test results to doctors with immediate notification of A1cs over 8, and sends a letter to each patient who has an A1c over 8. However that is all the "prodding' consists of. It is not entirely dissimilar to my Blue Cross plan which sends me a reminder once a year to go get a check up. The NYC Health Department presentation on this proposal, at http://www.nyc.gov/html/doh/downloads/pdf/diabetes/diabetes-presentation-a1c-reg istry.pdf contains rather sobering statistics. They are talking about the general population here, not a select group of well-educated diabetics. Only 10% of diabetics in NY know their A1c, only 37% have an A1c under 7, only 7% meet ABC targets for A1c, Blood pressure and Cholesterol--targets which most of us here would consider to be too high. The maps show a huge variation in the incidence of diabetes geographically in the city--in Harlem, West Harlem, Washington Heights, and the South Bronx, for example, 11-18% of the population has diabetes, while in the rest of Manhattan the incidence is below 6%, except for the lower East Side and the tip of Manhattan where it is 7-9%. Maps of death rates for diabetics are similarly "all over the map" and in 2003 there were 1731 amputations in NYC due to diabetes. Does anyone know the demographics of NYC well enough to explain the geographical diabetes patterns in the city? Are the darker areas on this maps just the lower income areas of the city? Or is ther more to it? None of this background information is really new, but they do present it quite clearly and graphically. > This is different from the proposal that was discussed a few months > ago. That one applied to monitoring the A1cs of diabetics receiving [quoted text clipped - 7 lines] > public assistance patients and give them better health for fewer tax > dollars. Even at that, the wrong people could fall under attack. Just because someone has a high A1C doesn't necessarily mean they are non compliant! Sometimes it's a case of the Dr. not prescribing meds, not the right meds, or not the right diagnosis...such as a honeymooning type 1 who is mistaken for a type 2. Also, many who are on public assistance have very little money to spend on food. It might not be that they're non-compliant. It may be that the only food they can afford is the starchy stuff like beans, rice and Ramen. > This new program applies not just to patients whose medical care is > paid for by the state but to everyone. This increases the concerns [quoted text clipped - 4 lines] > dissimilar to my Blue Cross plan which sends me a reminder once a year > to go get a check up. Well, I still don't like it! What next? Going after people with high BP? High cholesterol? Any lab work out of range? > The NYC Health Department presentation on this proposal, at http://www.nyc.gov/html/doh/downloads/pdf/diabetes/diabetes-presentation-a1c-reg istry.pdf > contains rather sobering statistics. They are talking about the > general population here, not a select group of well-educated diabetics. [quoted text clipped - 15 lines] > None of this background information is really new, but they do present > it quite clearly and graphically. I don't know NY that well. I lived on Staten Island for a couple of years. But from what I know of it, I'd say Manhatten probably houses those who are well off financially. Isn't that where the celebrities who live in NY live? SignatureSee my webpage: http://mysite.verizon.net/juliebove/index.htm > > This is different from the proposal that was discussed a few months > > ago. That one applied to monitoring the A1cs of diabetics receiving [quoted text clipped - 59 lines] > See my webpage: > http://mysite.verizon.net/juliebove/index.htm On who lives where: Yes the well to do live in Manhattan but so do about a million less well off. Manhattan, like all parts of NYC, has many different neighborhoods. Lou I live in New York, I personally would not be affected by the new regulation as I dont meet the criteria for being flagged. New York is comprised of the very rich, rich, upper middle class, middle middle class, lower middle class and then the working poor and the homeless and all those under the poverty level. Those people that have the money have better health care and so do those on medicaid, It is those people who make just a little too much to qualify that cant get proper care. This is a complex issue, But, I still think it is an invasion of privacy. Although it does have some merits jmo Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. Lou@goforit.net wrote: : > > This is different from the proposal that was discussed a few months : > > ago. That one applied to monitoring the A1cs of diabetics receiving [quoted text clipped - 59 lines] : > See my webpage: : > http://mysite.verizon.net/juliebove/index.htm : On who lives where: : Yes the well to do live in Manhattan but so do about a million less well off. : Manhattan, like all parts of NYC, has many different neighborhoods. : Lou The neighborhoods mentioned in the article as having higher rates of diabtes, etc, are the low income and minority areas of the borough of Manhattan. There are large numbers of African-Americans and Latinos of many origins in those areas. As there has been research that the incidence of diabtes is higher among these group, as well as Native American, it woudl not be surprising to find the numbers high in those neighborhoods. Whether the cause is genetic, economic, educational , etc, I have no idea, but that is the information. Poorer health care is also a factor in those neighhborhoods. Wendy There are many, many ethnic groups in New York, I was wondering if asians have a high incidence of diabetes. New York has a tremendous asian community. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. > There are many, many ethnic groups in New York, I was wondering if > asians have a high incidence of diabetes. New York has a tremendous > asian community. > > Loretta I have a strong suspicion that you will find a high incidence of diabetes in any group that has a soda bottle stuck to their faces from the age of two and upwards. SB : There are many, many ethnic groups in New York, I was wondering if : asians have a high incidence of diabetes. New York has a tremendous : asian community. : Loretta : -- : In tribute to the United States of America and the State : of Israel, two bastions of strength in a world filled with strife and : terrorism. That is certainly true, but not, by and large , in the neighborhoods mentioned in the original post except the tip of lower Manhattan which might well include Chinatown. New York is a delightful mixture of many paople from all kinds of places. Wendy > This new program applies not just to patients whose medical care is > paid for by the state but to everyone. This increases the concerns [quoted text clipped - 4 lines] > dissimilar to my Blue Cross plan which sends me a reminder once a year > to go get a check up. I think there is a vast difference between my insurance provider sending all of its policyholders a reminder to get a checkup once a year and the government "prodding" me when my A1c doesn't meet their standards. The assurances that the program is limited to sending a letter when needed and that no one else will be allowed access to the data really make the hair on the back of my neck stand up. Is there anyone here who lives in the city? If I did, I'd be thinking of ways to move out. I suppose that's one way to lower the statistics. Cindy : > This new program applies not just to patients whose medical care is : > paid for by the state but to everyone. This increases the concerns [quoted text clipped - 4 lines] : > dissimilar to my Blue Cross plan which sends me a reminder once a year : > to go get a check up. : I think there is a vast difference between my insurance provider : sending all of its policyholders a reminder to get a checkup once a : year and the government "prodding" me when my A1c doesn't meet their : standards. The assurances that the program is limited to sending a : letter when needed and that no one else will be allowed access to the : data really make the hair on the back of my neck stand up. : Is there anyone here who lives in the city? If I did, I'd be thinking : of ways to move out. I suppose that's one way to lower the statistics. : Cindy Ot does look scry in some respects, but I do know, that the City of New York has been collecting dta on certain infectious diseases (like TB) for generations and has kept the names from any public distribution. They pride themselves on this strong privacy tradition. I can only trust tht this will continue. Wendy in NYC > : > This new program applies not just to patients whose medical care is > : > paid for by the state but to everyone. This increases the concerns [quoted text clipped - 24 lines] > > Wendy in NYC Wendy, it is very scary. And it is very scary because of what you said: "the City of New York has been collecting data on certain INFECTIOUS diseases for generations". Diabetes is NOT infectious. THAT is a huge change. I am not a lawyer, but I work in health care. I think this sounds like a clear violation of privacy provisions in HIPAA. SignatureWes Groleau ----------- Daily Hoax: http://www.snopes2.com/cgi-bin/random/random.asp >I am not a lawyer, but I work in health care. > >I think this sounds like a clear violation of >privacy provisions in HIPAA. Does HIPPA only apply to the private sector? _____________________________________________ http://wave.prohosting.com/ugleeeee/ Health Diabetic Software - Free > >From MSNBC.com: > [quoted text clipped - 7 lines] > > The rest of the article is at http://www.msnbc.msn.com/id/10470060/ If their efforts/educational stuff etc. are approved by the individual, I can see it...... maybe. If it does not include personal permission by the individual I find it intrusive and possibly even insulting. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') >>From MSNBC.com: > [quoted text clipped - 7 lines] > >The rest of the article is at http://www.msnbc.msn.com/id/10470060/ If I was in NYC, I would get a new doc in NJ, or CT. That law should be ruled unconstitutional IMO. Sleepy "I used to think I was poor. Then they told me I wasn't poor, I was needy. Then they told me it was self-defeating to think of myself as needy, I was deprived. Then they told me deprived was a bad image, I was underprivileged. Then they told me underprivileged was overused, I was disadvantaged. I still don't have a dime, but I sure have a great vocabulary." -Unknown Nice to see you. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. >Nice to see you. > >Loretta And it always a pleasure to see you too Loretta! Sleepy "I used to think I was poor. Then they told me I wasn't poor, I was needy. Then they told me it was self-defeating to think of myself as needy, I was deprived. Then they told me deprived was a bad image, I was underprivileged. Then they told me underprivileged was overused, I was disadvantaged. I still don't have a dime, but I sure have a great vocabulary." -Unknown Actauly, if you did your lab work in NJ, you could keep your NY doctors and still evade the monitoring, if I am reading the article and plan correctly. |
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