Diabetes vs asthma
Discussion
Individuals with type 1 diabetes receive all NHS prescription medications free, whether they are prescribed for diabetes-related conditions or not. They also receive free NHS chiropody, eye tests and various other stuff regardless of personal/financial circumstance.
Individuals with asthma don't - unless of course they have type 1 diabetes.
Both are life-long, life-threatening conditions requiring constant and perpetual medication to control them. Neither are lifestyle induced. I simply don't understand why this difference should exist.
I'm not coming at this from any direction but one of simple confusion. Have I missed something fundamental?
Individuals with asthma don't - unless of course they have type 1 diabetes.
Both are life-long, life-threatening conditions requiring constant and perpetual medication to control them. Neither are lifestyle induced. I simply don't understand why this difference should exist.
I'm not coming at this from any direction but one of simple confusion. Have I missed something fundamental?
As an asthmatic, my understanding is that a fairly large proportion of kids grow out of asthma, and it usually gets less serious as you age (unless you smoke etc). Type 1 diabetes is completely irreversible.
Oh and asthma can be lifestyle induced - smokers can develop it in adulthood, for example.
edited (again) to add. Asthma doesn't need lifelong regular medication in the same way as type 1 diabetes does either. Forget to take your insulin (or take too much) and you could easily be dead within hours. If you don't take a steroid regularly, your asthma is likely to get worse but it's got a far less dramatic effect. People can also survive attacks without relievers, though it's an uncomfortable and quite risky business. Even way back when, asthmatics could survive into a ripe old age (e.g. Antonio Vivaldi) without any medication at all (Vivaldi used steam/hot vapour). Kids with type 1 diabetes died quite quickly, I beleive, until animal insulin medication was developed.
Oh and asthma can be lifestyle induced - smokers can develop it in adulthood, for example.
edited (again) to add. Asthma doesn't need lifelong regular medication in the same way as type 1 diabetes does either. Forget to take your insulin (or take too much) and you could easily be dead within hours. If you don't take a steroid regularly, your asthma is likely to get worse but it's got a far less dramatic effect. People can also survive attacks without relievers, though it's an uncomfortable and quite risky business. Even way back when, asthmatics could survive into a ripe old age (e.g. Antonio Vivaldi) without any medication at all (Vivaldi used steam/hot vapour). Kids with type 1 diabetes died quite quickly, I beleive, until animal insulin medication was developed.
Edited by oldbanger on Thursday 4th November 20:09
LBird said:
....They also receive free NHS chiropody.....
Not true, by a long way.Only get Podiatry treatment if there is a foot pathology or diabetic complication manifesting as such. They would all be elligible for an assessment though (generally speaking, all trusts are a bit different).
Carl_Spackler said:
Type 1 diabetes effects every part of my wife’s body in some way or other, from eyesight to her feet, the two are incomparable in terms of severity/care.
And things like peripheral neuropathy result in poor foot sensation, which means they don't feel cuts, so they get neglected and then infected which can lead to them needing amputation...as bill rightly says, diabetes can lead to many other problems if untreated. the worst of which are vascular which leads to numerous other problems including chronic kidney failure leading to proteinuria and thus weaker immune system (thus increased chance of infection, particularly fungal infections), oedema, clotting problems. retinal haemorrhaging and other eye problems. that is to name a few of the many, many serious complications of diabetes mellitus. not saying asthma isn't bad, but DM can be horrendous to just about any part of the body.
Using asthma as a comparison probably wasn't the best idea, but the point behind the original post is valid.
This is the full list of conditions which exempt patients from charges:
* A permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring an appliance or continuous surgical dressing.
* A form of hypoadrenalism (for example Addison's disease) for which specific substitution therapy is needed.
* Diabetes insipidus or other forms of hypopituitarism.
* Diabetes mellitus, except where treatment is by diet alone.
* Hypoparathyroidism.
* Myasthenia gravis.
* Myxoedema (hypothyroidism requiring thyroid hormone replacement).
* Epilepsy requiring continuous anticonvulsive therapy.
* Continuing physical disability which means the person can't go out without the help of another person. Temporary disabilities do not count even if they last for several months.
As well as cancer patients and "any renal dialysis patient who has a permanent fistula".
It's a strangely short list and I see little reason for the conditions above to lead to exemption while other conditions do not.
I have to get a variety of medicines every month and bought a three month 'pre-paid certificate' which makes it incredibly cheap. I'm happy to do that. I would, however, expect someone who requires a similar amount of medicine and care to incur the same costs as I do.
This is the full list of conditions which exempt patients from charges:
* A permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring an appliance or continuous surgical dressing.
* A form of hypoadrenalism (for example Addison's disease) for which specific substitution therapy is needed.
* Diabetes insipidus or other forms of hypopituitarism.
* Diabetes mellitus, except where treatment is by diet alone.
* Hypoparathyroidism.
* Myasthenia gravis.
* Myxoedema (hypothyroidism requiring thyroid hormone replacement).
* Epilepsy requiring continuous anticonvulsive therapy.
* Continuing physical disability which means the person can't go out without the help of another person. Temporary disabilities do not count even if they last for several months.
As well as cancer patients and "any renal dialysis patient who has a permanent fistula".
It's a strangely short list and I see little reason for the conditions above to lead to exemption while other conditions do not.
I have to get a variety of medicines every month and bought a three month 'pre-paid certificate' which makes it incredibly cheap. I'm happy to do that. I would, however, expect someone who requires a similar amount of medicine and care to incur the same costs as I do.
LBird said:
I'm not coming at this from any direction but one of simple confusion. Have I missed something fundamental?
Diabetes can cause eye, nerve and circulatory problems which is why the free eye and (potentially numb and or ulcerated) foot checks are there...Why asthma sufferers get charged for their essential meds I know not.
odd how many people when moaning aobut the cost of regualr prescriptions forget aobut the pre-payment certificates ,
http://www.nhsbsa.nhs.uk/1127.aspx
if you are on more than 1 regular medication a PPC is definitely cheaper ... 104 / 7.20 = 14.4 recurring
given regular meds are supplied in 28 day courses - so 13 scripts a year , you are up if you have 2 more scripts in a year ... if you are on 2 regular meds (26 *7.20 = 184 ) you are 80 quid up ... even more if you are on more meds and have other meds on an infrequent basis ... plus the stuff that 'might be cheaper to buy' isn't if you have a PPC and often the prescription packs are 'better' ( e.g. eumovate cream is 6.20 for 15 g in the P list tubes and the Presciption pack is 30 g - so even at the full 7.20 it's less money out of your own pocket)
http://www.nhsbsa.nhs.uk/1127.aspx
if you are on more than 1 regular medication a PPC is definitely cheaper ... 104 / 7.20 = 14.4 recurring
given regular meds are supplied in 28 day courses - so 13 scripts a year , you are up if you have 2 more scripts in a year ... if you are on 2 regular meds (26 *7.20 = 184 ) you are 80 quid up ... even more if you are on more meds and have other meds on an infrequent basis ... plus the stuff that 'might be cheaper to buy' isn't if you have a PPC and often the prescription packs are 'better' ( e.g. eumovate cream is 6.20 for 15 g in the P list tubes and the Presciption pack is 30 g - so even at the full 7.20 it's less money out of your own pocket)
I also quite often wonder why I'm having to pay out regularly for asthma preventer and reliever drugs which I need daily when other conditions allow free prescriptions. I do use the PPC to reduce the cost, but it's still a cost that I have to pay where other's don't and my asthma is not down to smoklng or the likes - and unlike common believe, mine is worse as an adult even though I've suffered all my life.
kirsty-s2k said:
I also quite often wonder why I'm having to pay out regularly for asthma preventer and reliever drugs which I need daily when other conditions allow free prescriptions. I do use the PPC to reduce the cost, but it's still a cost that I have to pay where other's don't and my asthma is not down to smoklng or the likes - and unlike common believe, mine is worse as an adult even though I've suffered all my life.
I also have asthma but can go for a year or more without needing a new inhaler so should I get free scripts too? I guess the justification for free scripts for diabetics and the like is that the condition is chronic and everyone who has it will need all the medication. Bill said:
kirsty-s2k said:
I also quite often wonder why I'm having to pay out regularly for asthma preventer and reliever drugs which I need daily when other conditions allow free prescriptions. I do use the PPC to reduce the cost, but it's still a cost that I have to pay where other's don't and my asthma is not down to smoklng or the likes - and unlike common believe, mine is worse as an adult even though I've suffered all my life.
I also have asthma but can go for a year or more without needing a new inhaler so should I get free scripts too? I guess the justification for free scripts for diabetics and the like is that the condition is chronic and everyone who has it will need all the medication. My original post was not intended as a complaint about some having to pay for meds either - it really was, as I said, a question born of confusion / not understanding and wondering if I was missing something fundamental. My question has been answered as far as I am concerned - I haven't missed something fundamental and it is just one of those odd things (of which there are many in the NHS)!
As an aside, many years ago I worked for a large pharmaceutical company who had done research into the cost of drugs to the NHS and the cost to the NHS of offering free prescriptions. The report concluded that if the NHS were to charge the patient £1 for every medicine prescribed, it would make a profit on drugs sales! (N.B. this WAS about 25 years ago - it would be interesting to know if the answer has changed). Edited to add that on re-reading this, the profit bit sounds far-fetched so perhaps I'm 'mis-remembering' that bit but you get the gist.
Edited to add
Edited by LBird on Sunday 7th November 12:40
My daughter (aged 3), has Type 1 diabetes. I think the difference is that any illness makes the diabetes more difficult to manage, (and possibly a trip to High dependency ward, which we have avoided so far), and diabetes also has well-known long term implications for feet, eyes, organs etc.
I don't think asthma has same sensitivity to other illnesses, or potential for wider impact, which would be the difference in what is available free on NHS - ie they want to cure illnesses fast, and pick up complications early, so make sure that cost isn't a barrier.
What someone would ask is why the NHS pays £3k for a diabetes pump, which clearly costs about £10 to make, and has the processing power of an alarm clock. That means waiting lists for most diabetics, and less money for other deserving cases.
No doubt replicated in all areas of procurement and treatment - the drugs companies' profits would be my first target for 'cuts'!
I don't think asthma has same sensitivity to other illnesses, or potential for wider impact, which would be the difference in what is available free on NHS - ie they want to cure illnesses fast, and pick up complications early, so make sure that cost isn't a barrier.
What someone would ask is why the NHS pays £3k for a diabetes pump, which clearly costs about £10 to make, and has the processing power of an alarm clock. That means waiting lists for most diabetics, and less money for other deserving cases.
No doubt replicated in all areas of procurement and treatment - the drugs companies' profits would be my first target for 'cuts'!
It does sound a little bit like some folk are forgetting that severe asthma, while fortunately rare, can be every bit as dangerous unmedicated as diabetes. Watching and hearing my housemate struggle to breathe while her airway got smaller and smaller, waiting for the ambulance and realising the inhaler wasn't working because she couldn't inhale deeply enough for the medication to work was one of the most frightening and upsetting experiences of my life - I think folk forget too easily how bad it can get and the kind of impact it used to have before there was widespread access to effective treatment. Definitely ought to be covered under the same rules - for a minority it's every bit as lethal off meds.
Interesting subject, maybe anunfortunate choice of conditions, Instead of a specific comment on Diabetes etc, isn’t it more a question of noting that free NHS treatment is no longer universal, if we accept that, and we all appear to accept that dental and optical treatment is not free, then how do we deal with conditions that are the result of life style decisions.
I would rather see all conditions that there the result of accident or hereditary problems treated free, (including asthma) but if it is a life style decision from eating, drinking, smoking etc then you pay, so asthma suffers who smoke are not free.
There was a heart surgeon in Manchester about 15 years ago who refused a third by-pass operation to a man who refused to give up smoking, and there was a public outcry in support of the smoker, I agreed with the doctor.
Of course there is then the problem of monitoring the life style of the patient, and what do you do if some one has a sport injury?
My personal leaning is that all life threatening conditions are free on the NHS, but things like cosmetic surgery, IVF etc are not, but even this has problems, like would I deny treatment to the ‘elephant man’.
I would rather see all conditions that there the result of accident or hereditary problems treated free, (including asthma) but if it is a life style decision from eating, drinking, smoking etc then you pay, so asthma suffers who smoke are not free.
There was a heart surgeon in Manchester about 15 years ago who refused a third by-pass operation to a man who refused to give up smoking, and there was a public outcry in support of the smoker, I agreed with the doctor.
Of course there is then the problem of monitoring the life style of the patient, and what do you do if some one has a sport injury?
My personal leaning is that all life threatening conditions are free on the NHS, but things like cosmetic surgery, IVF etc are not, but even this has problems, like would I deny treatment to the ‘elephant man’.
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