Wil Dubois

Happy Saturday, and welcome back to our weekly advice column, Ask D’Mine, hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, Wil talks money -- a big topic for those of us with diabetes, because our meds and tech and tools are so very expensive. Is there any financial help out there, curious minds want to know. Read on…

{Got your own questions? Email us at AskDMine@diabetesmine.com}



Julie, type 3 and type awesome from Wisconsin , writes: In July of 2014, my husband was diagnosed with type 2 diabetes. As you can imagine, it rocked our world. As we were adjusting to that, in September of 2014, our youngest child became very ill and was diagnosed with type 1 diabetes. You can’t even imagine how that changed our lives. We have spent this past year paying off medical expenses, and accruing continuing bills with their quarterly doctor’s appointments (not to mention ER visits when things got out of hand).
 I read your article in the July/August 2015 issue of Diabetes Self-Management where you talk about finances and changing your spending habits. I used to laugh at those types of suggestions, because as a rule, we don’t drink designer coffee, go out all that often, or take expensive vacations when we do get away. So, my question is: What do we do if those are all things we don’t even have to give up? We are dipping into savings we never planned on touching until retirement, and paying the penalty on that is going to drain us sooner than the medical expenses. Are there options out there for help?


Wil@Ask D’Mine answers: Let’s be honest here, poverty sucks. There’s nothing romantic, noble, or beneficial about it. It’s a proven scientific fact that poverty negatively affects every aspect of human health. And I’m not just talking about one-dollar-a-day Third World poverty here. The lower end of the economic spectrum here in the USA live sicker and die younger. 

So you are right to want to avoid poverty. That said, pretty much the only people who can help the poor are the rich, and they don’t seem to have much interest in doing that. Instead, the very richest people in the country appear to be dead set on getting richer, at any cost. I mean, at some point, you have so much money that there just aren’t enough hours in the day to spend it, right? So what’s the point? I don’t get it.

Somewhere along the way, we’ve lost President Johnson’s War on Poverty.

Anyway, what I said in my article, which was on the subject of what to expect after diagnosis, was basically that diabetes is frickin' expensive and that you should both count on that fact and plan for it. Then I gave some generic examples of things that might need to shift in a typical American family after the diagnosis of a chronic illness; like shorter, simpler vacations and kicking HBO to the curb.

I didn’t mention the designer coffee that Julie talked about, but that could be another example. I summed up by saying, “Setting aside money to pay for your diabetes means giving up other things you are accustomed to.” I conceded that it sucked, but so too did funerals. Which are also expensive.

But the issue really goes deeper and is more complex than that. Julie and her family look to me like the poster crew for a new type of American poor—not those born into poverty trying to work their way up—but those dropping into poverty from above. The downwardly mobile. Theirs is a family that appears to have played by the rules, they even had retirement savings fer cryin’ out loud, and now an unpredictable and unavoidable health crisis has pulled the rug out from under them.

I don’t know what kind of health insurance they have, but it doesn’t really matter. Because what people who haven’t had to use their insurance much don’t understand (but what all of us understand only too well) is that health insurance in Costly Diabetes SuppliesAmerica, even under all these great reforms, doesn’t pay for a damn thing.

It only pays for a share.

Granted, sometimes it’s a large share, but the simple fact is that using your health plan will cost you money. And the more you use it, the more it will cost. And the more it costs, the less you have to spend on other parts of your life. Having a chronic illness in America not only impacts your health, but it impacts the health (and lifespan) of your bank account. And there are only two solutions to this money “problem” an illness causes: Spend Less or Earn More. 

I think we all know about spending less. On the home front there are stay-cations and thrift store clothing. No eating out. No going out. Cut the luxuries to the bone and live like a monk so the insurance barons can keep their penthouses, limos, and yachts. On the medical front, you can switch your drugs to generics, skip every-other doctor’s visit, test your blood sugar less, don’t follow up on referrals to specialists, and cut corners wherever you can. Of course, that will cut a few years off your life, but what choice do you have?

Well, what about earning more? How do you earn more in a stagnant economy? I’ve known people who rented out a room in their house to a border, worked extra hours if they could get them, or added side jobs flipping burgers. Many of these earn-more strategies exact a high toll in exhaustion, stress, or burnout, which perversely makes health worse. A few years back, one of my type 1 patients got fired from both her primary job and her help-pay-for-diabetes job in the same week because she wound up so exhausted she was doing both jobs poorly.

Other than robbing a bank, what can you do?

There are some Patient Assistance Programs that will help offset the costs of diabetes medications. But the truth is that if your financial woes loom as large as you explain, those programs won't bail you out entirely. So what else can you do?

Oh. Right. Well, you can borrow. Some people, like you, mortgage their future by cashing out their retirement. Others mortgage their houses. Still others borrow from family. But most commonly, Americans turn to plastic when they can no longer afford to pay for their healthcare.

And the credit card industry has cashed in on this trend by offering special healthcare credit cards that can only be used for health-related costs, including deductibles and copays. I see that the Citi Health Card, from the friendly folks that the government bailed out over at Citibank, features a default 25.98% annual percentage rate on “purchases.” But it can also be used to pay your veterinary bills, so there’s that.

Citibank... Citibank… Hmmm… Why does that name sound familiar? Oh, right, these are the same folks who were recently forced by the feds to pay back $700 million to their credit card users for “deceptive marketing practices.”

Anyway, where’s all this borrowing end when you are small enough to fail? Bankruptcy court, of course. A few years ago Harvard researchers found that 62% of personal bankruptcies were triggered by health crises. And by the way, nearly 8 out of 10 of those people actually had health insurance. Oh, and that was back in 2009, before healthcare got really expensive.

So when there’s nothing left to give, no money left to earn, and you’re barrowed out: Is there anywhere to turn for help? No. Not that I know of. While there are programs to help the destitute, there are no programs for the pre-destitute.

No help for the downwardly mobile.


Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.