Emily Gouthro says she’s fortunate to have health insurance. If not, she would struggle to manage her diabetes.
“Even if you do have coverage in Nova Scotia, sometimes it’s only 80 per cent of the pay,” said Gouthro in a recent interview. “And that’s if you have great coverage.”
Gouthro, a registered nurse, was diagnosed with Type 1 diabetes when she was four years old. The cost of her insulin is entirely covered by her insurance plan. But, as she explains, costs go well beyond the insulin itself.
People with Type 1 diabetes often rely on insulin pumps — which can cost thousands of dollars — to administer their medication. Then there’s the cost of reservoirs for insulin, infusion sets, testing strips and other equipment.
“A lot of people don’t realize that there’s so much to this disease,” said Gouthro. “It’s 24 hours a day – you’re thinking about it all the time.”
Emily Gouthro has been living with Type 1 diabetes for most of her life.
Submitted by Emily Gouthro
Goutro said under her insurance plan, she gets $10,000 to cover insulin pumps for her lifetime.
“But if you know anything about insulin pumps, they typically range anywhere from $4,000 to $6,000. That’s just for the pump itself, and the warranty’s only good for four years,” she said.
“They’re saying you only get $10,000 for your lifetime, but the insulin pump you’re only going to have for a couple of years. And then what are you supposed to do?”
As for the rest of her supplies, she has to pay hundreds of dollars out of pocket each month and wait to be reimbursed by her insurance.
“You’re always going to have something on your credit card or waiting to get paid back,” she said.
“Even if you do have coverage, and you’re lucky to have coverage, you’re still out money and you’re still waiting to get that back.”
5:55 Great Nova Scotian Fingerprick Challenge
Great Nova Scotian Fingerprick Challenge – Aug 4, 2021
When she was a child, her family had to fundraise to purchase her first insulin pump. Nova Scotia now has an insulin pump program, but that only covers pumps for people aged 25 and under.
“The coverage here is so behind and so lacking. It’s great that there’s coverage for up to 25, but your disease doesn’t go away after 25,” she said.
“It’s almost discriminatory that after 25, then you’re not getting the help, you’re not going to be able to have your pump covered, you’re not going to get the basic supplies that you need.”
Gouthro said if diabetes isn’t managed properly, that can lead to many more serious problems down the road, putting further strain on the health-care system — something she has seen in her work as a nurse.
“If you’re kind of going along, having the bare-minimum supplies, the bare-minimum treatment, then you get there and you can have kidney failure, you can deal with blindness, you have amputations. It’s all the scary things that you hear about,” she said.
“If our province could help give people the tools to have the best possible chance with their disease, it would be phenomenal. It would give everyone a better chance.”
She said she is hopeful that the Tim Houston government — which has focused much of its mandate on health care — will make changes so people with diabetes can afford their supplies.
‘Prohibitive’ costs
Diabetes Canada agrees that some other jurisdictions are doing it better. According to their website, B.C., Alberta, Ontario, Yukon, Northwest Territories and Nunavut all cover insulin pumps and supplies for eligible people of all ages.
Nova Scotia, New Brunswick, P.E.I. and Saskatchewan cap the insulin pump coverage at age 25, while Manitoba, Quebec and Newfoundland and Labrador cap it at 17.
However, in Manitoba, full coverage is given to those recommended by an endocrinologist, and Newfoundland and Labrador says it will cover people up to 24 who are already in the program and meet the criteria. New applicants over the age of 18 who meet the criteria will be income tested.
Coverage for insulin pumps is inconsistent across the country, Diabetes Canada notes.
“Canadians living in provinces with limited coverage or not meeting eligibility criteria for their provincial plan must pay out-of-pocket for insulin pump therapy, which carries a $6,000 to $7,000 price tag,” the Diabetes Canada website says.
“In addition, the ongoing expense of monthly supplies is a constraint to the use of insulin pumps, costing up to $300 every month. For many people, these charges are prohibitive.”
Brooks Roche, the manager of patient knowledge and connection with Diabetes Canada, has lived with Type 1 diabetes for most of his life. He described it as a “relentless” disease that calls for constant self-management.
“Every single input — whether that’s food, sleep, exercise, stress, sickness, weather — everything comes into play,” he said in an interview from Charlottetown, P.E.I.
“Basically, we’re always hunting for some sense of normalcy, and there are no breaks and no days off.”
‘Horrifying decisions’
Roche said people with Type 1 diabetes who use insulin pumps can expect to pay $6,000 per year for their supplies, while those with other types of diabetes pay around $2,000 a year on average.
He said the high price of diabetes is an especially big problem in the four Atlantic provinces, which are the bottom four in the country in terms of median household income.
“These out-of-pocket costs do not know what province or territory they’re in, so they eat up a much more significant chunk of people’s income in Atlantic Canada,” he said.
“It really does add up when folks have to make those horrifying decisions we hear about, where it’s: ‘Do I pay for all the groceries I need, or that my family needs this month? Or do I get this technology or treatment that I need to stay in a good quality of life?’
“Those are not choices that we want people to be making in a country with purportedly universal health care.”
Brooks Roche says the high price of diabetes supplies is forcing people to make difficult decisions.
Global News
He said the logic behind putting age caps on insulin pump coverage “falls apart really quickly,” as people of any age can be diagnosed with diabetes.
While Roche is encouraged by the federal government’s commitment in the last budget to fund a national diabetes framework, he said more work must be done on a provincial level to ensure people with diabetes have access to the equipment they need.
Noting that Sunday marks World Diabetes Day — and this year marks a significant anniversary of the discovery of insulin — Roche said now is the time for provinces to step up.
“It’s very important to take that momentum and roll it into provincial decisions that are being made,” he said. “This is the opportune time, because 2021 is the 100-year anniversary of the discovery of insulin … and we ought to celebrate that.”
2:18 Kelowna father, son living with diabetes, 100 years after discovery of insulin
Kelowna father, son living with diabetes, 100 years after discovery of insulin – Nov 4, 2021
In a statement, Marla MacInnis, spokesperson for the Nova Scotia Department of Health, said in an email that eligibility for the provincial insulin pump program is “based on meeting medical criteria and a determination of financial support based on family income and size.”
“The age associated with this program was based on an evaluation of the needs of Nova Scotians together with a jurisdictional scan at the time the program was implemented,” she wrote. “The Department regularly reviews its programs to ensure they are meeting the needs of Nova Scotians and welcomes feedback on the Insulin Pump Program.”
Meanwhile, New Brunswick Health Minister Dorothy Shephard told Global News last week that insulin pump coverage is an important discussion to have, but one that’s been delayed due to COVID-19.
“It’s always been my intention that we have this type of conversation … but it’s just the department has had so many fires to deal with that this conversation has been delayed,” she said.
The cost of not managing diabetes
Dr. Tom Ransom, a Nova Scotia endocrinologist with Capital Health, said there have been many advancements in the last century when it comes to managing diabetes and administering insulin, and there is now a “menu” of supplies that help people with diabetes manage their disease.
However, the cost of these supplies remains a barrier — especially for those who are uninsured, or whose insurance is lacking.
“People who are employed and have private drug plans will have these things covered. But unfortunately for the working poor — the people who are maybe self-employed or don’t have the best drug plan, or when they got work had pre-existing diabetes so it wasn’t covered — for these people, they’re in a real bind,” he said.
“Sort of sacrificing ideal care at a cost and putting themselves at risk.”
Dr. Tom Ransom says he wants his patients to have access to the medical supplies they need.
Global News
Ransom said the question is less about the cost of managing diabetes and more about the cost of not managing diabetes.
“If you’re not managing it, you incur the costs later,” he said. “You increase the risk of eye disease, which ultimately can lead to blindness, or kidney disease, which can lead to dialysis. Or neuropathy — people could potentially lose their foot — and heart disease, heart attacks and things like that, that are at a great cost.”
Ransom said he and others have been lobbying the government for “quite some time” to get insulin pumps and other equipment covered, but said things have been delayed due to the COVID-19 pandemic.
However, he remains hopeful that the province will begin covering these important supplies.
“I talk to people all day who have diabetes, and I advocate for them every chance I get,” he said.
“For me, it just makes sense to have these things covered.”
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.
In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
