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From Iowa, USA:

I have a question concerning insurance needs and will try to state it briefly but hopefully clearly. We are considering chane it briefly but hopefully clearly. We are considering changing our health insurance policy due to steady increases in our premiums. We have a Blue Cross/Blue Shield policy. One of our options is to put our daughter with diabetes on a new state-mandated standard policy and move the remainder of our family into a 65% cheaper "select" policy which provides us with more coverage than we have now. (We have 2 other children without current heath problems now). My question concerns putting my daughter on this standard policy. It will continue to cover doctor visits, medication, and hospitalization if needed - after the deductible, but it has a $100,000 limit on transplants. It is the transplant dollar limit that I'm concerned about. Would beta cell replacement count as a transplant? If diabetes treatment became a matter of replacing beta cells every 6 months, would she quickly deplete these funds? I want to provide her with a policy that will meet her needs as an adult.

Our daughter is 12 years old and has had diabetes for 8 years. Her doctor has called her "well controlled" with glycosylated hemoglobins ranging from 7 to 10 but usually under 9. I realize this is a difficult question but if you have any advice it would be appreciated.


I am grateful every day I come to work that we don't have to worry about health insurance here in the UK. However, your question isn't really about insurance - it's about the likelihood of transplant technology transforming diabetes for well controlled young people in the foreseeable future.

I have frequently said that I think islet cell transplant technology is the route that I expect to bear fruit but this won't be for some years. If I am pushed, I would say that the chances of a well 12 (or 22) year old being in the market for islet transplants in the next 5-10 years are pretty small. I suspect that the following 10 years will be different. Of course, what I can't say is what the necessary procedure would cost and how often (if at all) it will have to be repeated. Like all health care breakthroughs, if it really works then the costs will fall and it will have to be properly evaluated on a cost benefit analysis.

My advice to you would be to keep your daughter happy and healthy with conventional therapy so that she's not in the vanguard for clinical trials - which will inevitably start with patients with problems - and don't worry about your health insurance yet. In any case, I am quite sure that insurance companies will be keeping a close eye on the situation and will load their premiums appropriately.


Original posting 10 Jul 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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