Companies that produce healthcare products that save the lives of patients with chronic illnesses have a moral imperative not to trap their customers as if they had signed a monopolistic Canadian media company’s cellphone plan. There, I said it. I realize that the idea of “moral imperative” in the same sentence as the word “company” is so ludicrous as to potentially earn me a trip to the asylum, but I don’t care. In the past few hours I’ve heard about the T-Slim, a new pump that looks like an iPhone and apparently has an even worse contract-breaking penalty: you can’t. If this pump isn’t working for you and it’s not making your life better in the first weeks, as far as I’ve heard, you can’t give it back. This is unlike most other pump companies, so it’s causing a bit of a stir. I’ve also heard that Dexcom generally won’t let you do a trial run of their CGM sensors, though admittedly my info is from a DSMA-er on Twitter (can I even say CGM or Dexcom in Canada?)
The only thing consistent about diabetes is inconsistency. Your Diabetes May Vary is the phrase that rules the condition. Being expected to spend large amounts of money, whether ours, an insurance company’s, or the province’s, on a healthcare item we’re not sure is going to match the YDMV plan, is not only irritating, it’s stupid, and against everyone’s best interests, moral or not.
The province of Ontario will pay for a new pump for me every five years. Let’s say the T-Slim is available in Ontario and I choose to change from Animas in 2015, because ooh, shiny. (Warranties on most pumps seem to be four years, so I eagerly await my one year of terror between the warranty expiring and the government coverage – also stupid. If it breaks, what? I get to choose between my health and my savings? My health declines and Ontario has to pay for more hospital care later on? What about the unlucky person who gets a pump right before the artificial pancreas comes out and has to wait five years for proper care? I really hope there are some practices in place to deal with this of which I am unaware.) So, I choose this new pump, and it just doesn’t work the way I want it to. I can’t give it back! Five years until I can switch back. A lot can happen to your health in five years. Maybe Ontario does that because “a cure is just five years away!” Ha ha.
Choosing this policy is bad PR in a number of ways. First, it signifies an unwillingness to engage in dialogue, or to understand that YDMV, which belies a lack of understanding of diabetes in general. I certainly want to give my lifetime (or at least five-year) business to a company who doesn’t understand my condition! Second, it intimates a lack of confidence in your product. “No backsies” isn’t really congruent with “we stand behind our product.” Third, it indicates a lack of flexibility, which diabetes demands. It scares me away from even dealing with the company, thinking that customer service reps will likely be trained in “No.”
Finally, these companies need to be aware that we are long-term clients, customers, partners. They have us, likely, for life. Most people with Type 1 diabetes don’t like to be locked in to a product they don’t know if they can use, because we are all already locked into a condition that we can’t get away from. It’s an uncomfortable psychological reminder, when a company says “No backsies,” that diabetes has “no backsies.” We can’t give it back. It’s like the phone plan from hell; you can only break the contract by dying. Do you really want your product to remind us of the condition itself in that way?
When I went on the pump, my Animas rep worked with me. Since my insurance was non-existent, she gave me a lifetime discount on supplies that would bring them just under the amount that the government’s ADP program would pay. That’s why, in the end (even though it was the pump I wanted in the first place) I chose that company. Flexibility. Your life may vary. Understanding that it sucks enough to be diabetic without having to lose scads of money because of it. And you could give it back, no questions asked, if Pumpy was Just Not That Into You. This is smart thinking. Animas could get a slightly reduced amount for supplies for at least the next five years, if not for the rest of my life, or they could stick to their guns, demand 100%...and I would go with the pump company that was new to Canada and offering large discounts. Diabetes care companies should have a moral imperative to treat their customers humanely, but until then, if it's going to be about business, customers can have their say as well.
Pump, sensor, diabetes paraphernalia companies: you have us. For life. Some of you are looking at nickels and dimes. We’re looking at the rest of our lives.
Get the (big) picture? Let us try it. If it’s the right Diabetes Variation, we’ll stick with it.
We’re not going anywhere.