Last week I was rummaging through an old file cabinet and came across a folder titled Medical. I was amazed to find envelopes of medical bills from 1976 to 1982. If I had to pick the most important seven-year period of my life, these years might win the prize with such defining moments as my marriage, my diabetes diagnosis, our first house, and the births of our two sons. Browsing through this paperwork was like taking a walk back in history and discovering long-forgotten facts to back up or alter some of my fuzzy memories.
First is the 1976 doctor’s bill for my diabetes diagnosis. In the blogpost sharing my diagnosis story, I mentioned only one doctor’s visit and my memory about the timing of my hospital admission was off. This bill clearly shows that I had a new patient visit on November 9 (Tuesday) and then what was probably a pre-admission physical on the 12th. Although I was thirsty and losing weight, I was not in DKA and did not enter the hospital until a week (!) after diagnosis.
Prices were just a bit cheaper in 1976…. Two office visits with lab work totaled $76.50 and according to my notes in pencil, Blue Shield paid the lab fees.
The total charge for my three-night hospital stay was in the ballpark of what I am now charged for an endocrinologist appointment with lab work.
A 1977 bill shows that my routine diabetes check-ups cost $12 for the visit and $6 for a blood sugar test. Home self-monitoring of blood sugars was not available in 1977, so this was one of the approximately 4-6 “Sugar” tests I had per year.
A insurance form filled out by the pharmacy in 1977 shows that I was reimbursed $3.91 for a two month supply of insulin. I was only on one type of insulin (Lente) in those days.
I have copies of lab results going back to the mid-80’s and I have always assumed that those reflect my first A1c tests. False memory for sure because this 1978 bill clearly shows a charge for a Glycosylated HGB.
Now for the fun and games! Here’s an insurance report with the charges for a 2013 routine endocrinologist appointment with lab work. Just a wee bit more than the 1977 total of $18.
A 2013 Walgreen’s receipt shows 4 vials of Novolog insulin at a retail price of $719.89 ($180 per vial) along with the insurance-negotiated price of $563.15 ($140 per vial). It is not the same insulin product that I bought in 1977 for $3.91 and a better comparison might be with the Walmart brand of NPH that you can buy these days for about $25.
Summary: Diabetes care has come a long way since I was diagnosed in 1976. One daily shot of pork-based insulin has been replaced by an insulin pump using a genetically-modified analog insulin. Urine tests with Diastix and occasional “Sugar” tests at the doctor’s office have been superseded by home glucose meters and a continuous glucose monitor.
The cost of diabetes care has gone up astronomically, but so has the quality of care. Last Thursday I played golf, walked the dog, and did yard work. My Fitbit showed that I walked over 23,000 steps for a distance of 10 miles. I am 62 years old and have had diabetes for over 37 years. If I were still using 1976 standards of care, it is doubtful that I would be in such good health these days. Who knows if I would even be alive? Yes, I wish that insulin still cost $3.91. But I am truly thankful for the medications and medical devices that allow me to get up every morning knowing that diabetes won’t stop me from living another day. Another good day.