The business of disease .

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At four hospitals across the city, they set up centers that featured a new

model of treatment. They would be boot camps for diabetics, who struggle daily

to reduce the sugar levels in their blood. The centers would teach them to check

those levels, count calories and exercise with discipline, while undergoing

prolonged monitoring by teams of specialists.

But seven years later, even as the number of New Yorkers with Type 2 diabetes

has nearly doubled, three of the four centers, including Beth Israel's, have

closed.

They did not shut down because they had failed their patients. They closed

because they had failed to make money. They were victims of the byzantine world

of American health care, in which the real profit is made not by controlling

chronic diseases like diabetes but by treating their many complications.

Insurers, for example, will often refuse to pay $150 for a diabetic to see a

podiatrist, who can help prevent foot ailments associated with the disease.

Nearly all of them, though, cover amputations, which typically cost more than

$30,000.

Patients have trouble securing a reimbursement for a $75 visit to the

nutritionist who counsels them on controlling their diabetes. Insurers do not

balk, however, at paying $315 for a single session of dialysis, which treats one

of the disease's serious complications.

Not surprising, as the epidemic of Type 2 diabetes has grown, more than 100

dialysis centers have opened in the city.

"It's almost as though the system encourages people to get sick and then

people get paid to treat them," said Dr. Matthew E. Fink, a former president of

Beth Israel.

 

Please read the entire New York Times Report at;

http://www.nytimes.com/2006/01/11/nyregion/nyregionspecial5/11diabetes.html

 

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