What does it mean?

What does it mean?

Now that election is over and we have a President elect the speculation has begun as to what a Trump Presidency will be like. Given his stance on ObamaCare many in the diabetes community are concerned that millions of patients who now have coverage thanks to ObamaCare will lose this coverage. Others believe given his pro-business stance there goes any chance at lowering the out of pocket cost of insulin. It’s unclear how Mr. Trumps election will impact the FDA, every candidate talks about regulatory reform but few have could bring about reform once in office.

To be completely honest we have no idea what a Trump Presidency means for the diabetes community. Like him or not any real change will come about not from the President elect but the people he surrounds himself with and the direction he provides these people. With the House and Senate also under Republican control there is a very good chance whatever reforms that are proposed will become the law of the land.

Yet like everyone else allow us to speculate a little.

The other day we offered up some suggestions on how we could deal with the out of pocket cost of insulin issue. At the top of that list was transparency which we now believe has little chance of happening given Trumps pro-business stance. The fact is no one wants transparency, not the insulin companies, payors or PBM’s. There is an old saying that says there are two things you don’t want to see made, law or sausage. Well you can add insulin pricing to that list.

Insulin companies don’t want transparency fearing once made public not only will the public have access to this information so too will the competition. PBM’s and payors don’t want transparency as they fear the public will find out that the insulin companies are not the villains here. That the rising out of pocket cost of insulin is what we’ve stated from day one, a situation brought about by a complex mix of factors. That this issue cannot be laid on the doorsteps of the insulin companies alone.

When it comes to FDA reform which is very needed its difficulty to get a read on this important issue. We see two areas which are in desperate need of reform, the approval process for biosimilars and the FDA moving into the future with interconnected diabetes management.  Given his distaste for regulations we would think FDA reform could happen during a Trump Presidency. Yet, as we have seen so many time the FDA is unlike other government agencies and plays a unique role. Just as physicians are supposed to do no harm, the FDA main responsibility is to protect the public. To make sure the drugs, devices and apps they use are safe and effective.

The biggest wild card is should ObamaCare be repealed as Trump and many Republicans want, what will replace it. While many in the diabetes community see ObamaCare as a positive, the fact is it has contributed to the out of pocket cost of insulin issue. We have long believed that ObamaCare needed to be repaired and not scraped. Today all bets are off and quite frankly this will open a can of worms that doesn’t need to be opened.

As we witnessed when President Obama fought for ObamaCare, next to Social Security, reforming health care is not easy. This is why we had hoped ObamaCare with all its flaws would be repaired and not replaced. That patients with diabetes who are no longer discriminated against because they have a pre-existing condition would not be in the position of choosing between eating and managing their diabetes. Those who think the out of pocket of insulin is high today, just wait as this issue will impact even more patients in the future.

Still this is all speculation on our part as like everyone else we have no idea what President Elect Trump will do when he becomes President Trump. We have no idea if he will surround himself with good people or if he will LISTEN to these people.

Governing this great country of ours is not easy, especially when half the population believes the person we elected shouldn’t have the job. Let’s hope for everyone that Mr. Trump and his team are up to the task.