Insulin pump funding scale needs adjusting
The story of a student at A.G Baillie school who, with her family, was hosting a penny parade to fund the girl’s new insulin pump has stuck with Tammy MacLaren.
The New Glasgow resident was shocked when she heard that there was no funding for insulin pumps and that Nova Scotia was one of the only provinces that did not have a program.
“At that time I had no connection at all (to diabetes),” said MacLaren. “I just could not get that young girl out of my head.”
She resident began an online petition to have a program to help fund insulin pumps for Nova Scotians. As the petition gained traction MacLaren was able to get the legislation put through when the Darryl Dexter NDP government was in power.
“When I finished that P.E.I. was the last province (without coverage),” she said. MacLaren helped people from P.E.I. get legislation passed and it become the last province to get coverage.
In 2013, MacLaren won a national advocacy award from Diabetes Canada; with only nine awards given out nationally, it was an honour for MacLaren to receive. Coincidentally, just a few months after the legislation passed, MacLaren’s daughter was diagnosed with Type One diabetes.
It was her hope that she would not have to advocate for the affordability of a medical necessity again but as the years passed, MacLaren heard of more people who are turning to fundraising to be able to afford an insulin pump. As she explained it, the coverage amounts vary based on family size and income; however, the sliding scale used to award this funding has become in need of monitoring and adjustment.
“It’s not given to all the families needed,” she said.
The current plan covers an insulin pump every five years as well as supplies, for those up to age 19, with coverage based on the sliding scale used. For diabetics ages 19 to 24, coverage for pump supplies is covered on the sliding scale. MacLaren is hoping that new adjusted coverage will also be made available for constant glucose monitors or Freestyle Libre systems that replace the need to have patients poking their fingers constantly to get readings.
MacLaren would also like to see the coverage move to adults as well since diabetes is not something you grow out of.
“It seems odd that at the age of 25 the government cuts you off from obtaining assistance. Diabetes is a very expensive disease to live with,” said Saquoia MacKinnon, a Pictou County native who created a go fund me page last year to help fund her new insulin pump as she does not qualify for the provincial help. “This year alone I paid over $3,000 out of pocket for my medication but $2,500 to have Blue Cross help cover more.”
McKinnon had been on a pump for over 13 years when she had to fundraise for a new one and added that having no coverage for something that is necessary can feel like you’re being financially punished for something you don’t have any control over.
“The cost of having this unpreventable disease is outrageous. Then tack on a $7,000-$8,8000 bill for a pump that does a better job maintaining it and prolonging your life… it makes you feel like your life is less valued than a healthy person,” McKinnon said.
MacLaren is encouraging everyone to contact their local MLAs, Tim Houston, the leader of the opposition and the current health minister to advocate for reform in the sliding scale and for information about how the program has been approving funds to be released to the public.
“They’re not forthcoming,” MacLaren said. She and other advocates have been requesting the scale that the government is using as well as how much most people are being given, but MacLaren said she was told a privacy issue was the reason this information could not be shared, even though she stated that she did not want names, just numbers. She is hoping that if letters start going out now that a change can be made in the legislation in time for the next budget.
According to Tracy Barron of the Department of Health and Wellness in Halifax the sliding scale for the insulin pump coverage works like this: “The family’s total income is reduced by $3,000 for a spouse/partner and each dependant living in the same household age 25 years or less. That amount is applied to the scale to determine the co payment the applicant would be required to pay for the pump and supplies.”
To see what it might cost you or a family member the department has a calculator on their site which can be found at https://novascotia.ca/DHW/NSIPP/.
There are currently 129 people enrolled in the program province wide.
MacLaren cited the story of a Tatamagouche girl whose family hosted a fundraiser hockey tournament to be able to afford the insulin pump for their daughter recently. Pumps generally cost $7,200 to $9,000, leaving many to fundraise or come up with large quantities of cash after the device has gone through their personal medical coverage and the provincial coverage.
“It needs to be taken a step further because diabetes doesn’t stop at 19 or 24,” MacLaren said. “Politics for this issue should be put aside; we’re dealing with children, we can work together and get this done.”
Tammy MacLaren sits at her computer looking at a recent article in the Tatamagouche Light featuring a girl whose family had to host a fundraiser to make up the cost to purchase an insulin pump for the nine year old.