Greek Health Foundation: Diabetic Foot Amputation Cheaper than a Pair of Shoes!

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If this isn’t an incredible story, I don’t know what it is! The National Social Security Foundation-IKA, the largest health & pension fund in Greece, has decided that diabetic foot is not necessary! Diabetic Footan umbrella term for foot problems in patients with diabetes mellitus, due to arterial abnormalities and diabetic neuropathy.

In a letter to the Panhellenic Federation of Associations of People with Diabetes, IKA wrote that the fund has ceased to grant funds for  diabetic shoes, as these special shoes do not prevent patient’s amputation. Amputation can be merely delayed for one to two years. “The expected benefit is less than the estimated cost, therefore the foundation does not cover the costs for the shoes” concludes  IKA.

As IKA sees more costs in shoes than in amputation, it apparently advices amputation here and now.

IKA-officials estimate that the “annual cost to be borne by the Foundation’s budget would be some of EUR 2.5 million for about 10,000 patients”. A cost that the IKA Foundation is refuses to pay as  special shoes have no therapeutic effect.

A pair of diabetic shoes would cost to IKA EUR 250. In the free market  they cost EUR 120 in the average and if you check any internet site and you will find them much cheaper from € 48 – €95.

Why does IKA pays such high prices? A) it has lots of money B) it is generous to suppliers C) everybody has to get a commission.

Federation Chairwoman, Athanasia Karounou,  says that IKA’s conclusions are not based on scientific research and draws attention to diabetic patients in Germany, where there is a descrease of  85% in amputations when proper measures are applied “Medical diagnosis & intervention, therapeutic shoes & appropriate footwear and patient’s education.”

She stressed that an amputation would cost to health insurance up to  EUR 70,000.

According to experts every year  2000-3000 diabetic patients are amputated. In fact, doctors point out that many amputations could be avoided if the patient is well-educated and trained and take the necessary measure.  In Greece the number of diabetic patients exceeds one million. But there is  no patient’s education (“diabetes school”) as in some other countries like Germany for example.
Macabre detail: The letter was signed by  IKA Supervisor: Maria-Eleni Charou (Maria-Eleni Death)!
UPDATE: Meanwhile, after the public and media outcry, general manager of IKA, Rovertos Spyropoulos said that IKA will come up for cost of the shoes!

NOTICE:    I personally know 3 cases of diabetes patients who have been or were to be amputated over the years. 

The latest case concernsan uncle of mine, 86, with diabetes mellitus and several other serious health issues. the man was literally dying… When he devoped a small gangrene spot on his one foot, the IKA doctor proposed immediately amputation although it was not suremy uncle would survive the operation. He was taken to a private clinic, they did a thorough surgical cleaning of the spot, the treatment continued at home. He died two months later after a heart failure.  What was the purpose of operating a patient with –% survival chances other that charging costs  and exploiting the IKA funds?

 The amputation issue is a matter of ethics, proper measures and  “commissions” I believe. By the way, my grandma managed to survive diabetes for 45 years, she died at 85 of heart failure.
I would like to hear about similar experiences and what do they do in other countries.