It was recently suggested http://www.bbc.co.uk/news/health-35634524 – that women could get a £3,000 birth budget to allow them to allocate their own healthcare funds; so they can choose to spend that on a home birth, or one-to-one midwifery care and so on.
Do you think the same would work with diabetes? Would you prefer to have your own health care budget? How would you run it? Would you ditch the six-monthly consultations and replace them with a CGM; would you abandon a pump to get greater psychological support and counselling? How about binning eye and foot tests to get the latest fancy pants gadgetry?
The choice is yours!!!! (if you think it should be…)
Personally I’d ditch the consultations. I get nothing out of them. But I’d fight tooth and nail to keep my pump – with attached CGM if that would fit in my budget. I’d keep the eye tests but forego the foot tickling at this stage, provided I could change my mind on it in the future.
I dont know that giving everyone their own budget is actually a good idea, whether diabetic, pregnant or whatever. It might encourage people to spend on things that dont suit them just cos they can (getting a pump cos its got buttons and beeps, but not being willing to put in the work it needs to run it, for example), but I do think I should have more say in what the money ‘allocated’ to me is spent on (those 6monthly consultations, again).
The original idea for this came from a joke I made on Twitter along the lines of a one size fits all NHS pump (it better not come in the old NHS specs tortoise shell)
Now there are lots of features i like on my pump, but at the end of the day the important features are all the same.. Would i take a basic pump if it was available (yes), would i pay extra for the additional features (maybe).
We all have different favorite infusion sets, would i use a basic set (yes) would i pay extra for my favored set (probably not).
The NHS wouldn’t find me for cgm, could I cope with a basic range of equipment & partially or fully fund cgm?
I actually think it’s an interesting question, whilst some of is would spend every penny the government gives us & some would top it up with self-funding I figure there are more who wouldn’t put the enthusiasm in so it might actually save money.
I also think it’s interesting to see what the consultants think we need to avoid later more expensive complications & how much that’d cost.
The interesting (or worrying) part of this line of thought is I did 20yrs of biannual eye tests which always seemed a waste of time so is be inclined to drop them, GP checkups, etc, & reinvest in cgm…
But then last year they picked up a problem with my eyes & weirdly when my control had been brilliant for 6 years.
If this had happened under this idea & I’d stopped the checkups would/should I be liable for any additional costs to the NHS?
It’s an interesting thing to discuss, isn’t it? Re-reading the thread my reaction is that patients shouldn’t have to compromise on any sort of care or equipment merely because of money and what we’re provided with should be directly linked to quality of life improvements and long terms cost savings – if we really want to get into finances. These judgements should be based on long term meta studies of data.
But, that’s not what the question is – we’re in a hypothetical, slightly weird world in this question where we have a set budget.
I’m in real quandry, I really don’t know what I would drop and what I would adopt within my budget. Difficult!