Diabetes Update! Managed Care revolutionizes management of Type II Diabetes

Meretricious Health Care has announced a major breakthrough in the way it will manage adult onset (type II) diabetes.  Using the same advanced math that developed the DRG length of stay guidelines, they have recalculated the standard diabetic diet.  

The amazing results, soon to be  published in a major medical finance journal, prove that the previous complex ADA diets and rigid calorie restrictions are completely unnecessary.  It follows that Meretricious Health Care will no longer have to reimburse Type II diabetics for dietary counseling or diabetes teaching.

If our one year outcome study shows positive results (cost savings for MHC) the dietary program will be extended to individuals with hypertension and primary obesity.

The new diet is as follows:

As we all know, it takes 1 calorie to heat 1 gram of water 1 degree
centigrade. Translated in to meaningful terms, this means that if you
eat a very cold dessert (generally consisting of water in large part),
the natural processes which raise the consumed dessert to body
temperature during the digestive cycle literally suck the calories out
of the only available source, your body fat.
For example, a dessert served and eaten at near 0 degrees (32 degrees
F) will in a short time be raised to the normal body temperature of 37
degrees C (98.6 degrees F). For each gram of dessert eaten, that
process takes approximately 37 calories as stated above. The average
dessert portion is 6 ounces, or 168 grams. Therefore, by operation of
thermodynamic law, 6,216 calories (1 cal./gm/degree x 37 deg. x 168 g)
are extracted from the body fat as the dessert's temperature is
normalized. Allowing for the 1,200 latent calories in the dessert, the
net calorie loss is proximately 5,000 calories. Obviously, the more cold
dessert you eat, the better off you are and the faster you will lose
weight, if that is your goal.

This process works equally well when drinking very cold beer in frosted
glasses. Each ounce of beer contains 16 latent calories, but extracts
1,036 calories (6,216 calories per 6 oz portion) in the temperature
normalizing process. Thus, the net calorie loss per ounce of beer is
10,200 calories. It doesn't take a rocket scientist to calculate that
12,240 calories (12 oz x 1,020 cal/oz) are extracted from the body in
the process of drinking a can of beer.

Frozen desserts, e.g. ice cream, are even more beneficial, since it
takes 83 cal/gm to melt them (i.e. raise them to 0 degrees C) and an
additional 37 cal/gm to further raise them to body temperatrue. The
results here are really remarkable, and it beats running, hands down.
Unfortunately, for those who eat pizza as an excuse to drink beer,
pizza (loaded with latent calories and served above body temperature)
induces the opposite effect. But, thankfully, as the astute reader
should have already reasoned, the obvious solution is to drink a lot
of beer with the pizza and follow up immediately with large bowls of
ice cream. We could all be thin if we were to adhere religiously to
a pizza, beer, and ice cream diet.

Managed Care Finds Cure for Diabetes;
Endocrinologists Take the Plunge 

Declaring diabetes mellitus non-existent, managed care companies nation-wide have managed to wipe out diabetes throughout the United States, it was announced today. It was explained that any patient insisting that they have diabetes will be re-diagnosed as having paranoia, and hence will be ineligible for medical care, as mental health benefits are essentially nonexistent in most managed care plans. The insurance industry also announced that their pre-existing policy of refusing to reimburse for syringes or blood glucose test strips, and discouraging patients' Primary Care Physicians from referring to endocrinologists, has been "totally vindicated."

An estimated three hundred endocrinologists were seen lining up to jump off the Golden Gate Bridge in San Francisco; there were unheard-of upsurges in bookings for flights to San Francisco noted by airlines nationally. The San Francisco Tourism Agency announced that it encourages all endocrinologists to spend their final vacation in their city, before taking the plunge.

According to an anonymous spokesman for a major managed care company, it is expected that curing diabetes, and terminating contracts with deceased endocrinologists, will allow approximately 57 more insurance company executives to claim 6-figure bonuses at the end of the current Fiscal Year, while only resulting in an additional 15 minutes loss of sleep per night for the average Primary Care Physician, and only an estimated 2,000,000 covered lives to become uncovered deaths.

 You may feel free to forward or reproduce this satire, provided you include the following copyright notice:
Copyright © 1997   by the Midwest Diabetes Care Center, Inc.

Insurance Companies who refuse to reimburse for Glucose Monitoring Strips Take Note!

An unnamed manufacturer of blood glucose meters is about to announce the development of a major breakthrough in medical care: a new meter that can measure blood caffeine levels.

This innovative device is due for release on April 1st.  

The "CoffeeMeter" will utilize existing blood glucose reagent strips (from most current manufacturers). Through a new method of optical processing, it will be able to measure caffeine consumption, which will be displayed on the meter in "CCE" (Coffee Cup Equivalent) units.

The "CoffeeMeter" has been tested in several clinical settings, including diabetes clinics, inpatient alcohol treatment units, and wellness programs. It has had great success (P The "CoffeeMeter" can also accurately discriminate whether the user had consumed caffeinated or "decaf" coffee.

More details on this very important new product should be forthcoming in the near future.

You may feel free to forward or reproduce this satire, provided you include the following copyright notice:
Copyright © 1997   by the Midwest Diabetes Care Center, Inc.

Job Application Form
Managed Care Customer Assistance

1)     The core value of managed health care is to view our jobs
 through the consumer's

(a) eyes
(b) file
(c) wallet

2)   A good opening to a consumer who has a 
complaint is,

(a) I'm sorry
(b)   I'm upset
(c) What's your problem?

3)   Remember, arguing with the consumer 
can only make a bad situation

(a)  worse
(b) better
(c)  more entertaining

4)   Make positive contact with a consumer by

(a) being open and interested
(b)   being enthusiastic 
(c) clearly demonstrating your 
intellectual superiority

5)   Using a consumer's first name is an example of being

(a) pushy
(b)  friendly
(c) patronizing

6)   While working with your present telephone contact, 
you get a call from a coworker. You 

(a) acknowledge the new individual and quickly 
get back to the original caller
(b) turn off your voice mail
(c) become interested in and leave the premises 
with the a co-worker.

7) Consumers feel you are happy to have their 
business when you smile and say

(a) nothing
(b) thank you
(c) feel free to skip your insurance premium this month.
(d)  boy, you really need psychiatric help...Sorry we 
don't cover that

8)   Friendly service is giving the consumer your full attention 
and making 

(a) eye contact.
(b)  hand contact.
(c) felonious intimate contact

9)      One way to show consumers full attention is to call them

(a) by phone
(b)   by name
(c) obnoxious

10) When communicating with a consumer or 
provider, use your speakerphone for

(a) hands-free operation
(b)  entertainment
(c) inaudibility
(d)  the amusement of your coworkers.

11)      A good opening to a complaining provider could be 
to tell them you are

(a) excited
(b) pleased
(c) sorry
(d) severely hearing impaired
(e) extremely busy and tired of their whining

12)      Providers and Consumers on hold waiting for service should be

(a) patient
(b)   ignored
(c) acknowledged
(d) required to listen to self-help tapes
(e)  disconnected

13)      What kind of telephone service should consumers get?

(a) quick
(b) friendly
(c) professional
(d) all of the above
(e) incomprehensible, arcane, and fear-inducing

14)      In managed care, it is our responsibility to ensure 
that all medical services are

(a) necessary and appropriate
(b) the least expensive alternative
(c) somebody else's problem

15)      If you handle a consumer's complaint according 
to our guidelines, you can turn a frustrated 
consumer into a

(a) satisfied consumer
(b)  psychotic bundle of nerves
(c) statistic 

Carol Watkins, MD (Please do not reproduce without permission.)