Aug 022009

My son suffers from diabetes.  A little over a year ago he went into a state known as diabetic ketoacidosis.  He almost went into a coma and if we had not gotten him to a hospital there is a good chance he could have died.  When he got out of the hospital he was told to follow up with his specialist, so I called to make an appointment.  The earliest I could take my son in to see his specialist was four months later.

I have been using Prevacid for years to control my acid reflux.  A condition that, if let unchecked, can lead to Barret’s esophagus and, subsequently, cancer.  This is the condition that killed my Father.  When my insurance providers switched at the beginning of the year I was told that my medical provider would no longer cover Prevacid, the medication my doctor wanted me to be on, and that I had to switch to Aciphex.

I have also been using Metrogel for years to control my Rosacea.  Recently my insurance provider decided they would no longer pay for that medication either and I had to switch to another one.

There is no generic equivalent available for the type of insulin my son has to take for his diabetes and my insurance provider considers it non-formulary.  That ONE medication of his is $60 per month.  This does not include his other insulin, his needles, or his test strips.  There IS a generic equivalent of his second type of insulin, but it does not work as well and we will be switching back to the non-forumlary kind after his next appointment with his endocrinologist.

Alex had a problem throwing baseballs and was diagnosed with a condition called little league shoulder.  My insurance company would only pay for about half of the visits that his physical therapist suggested.  After we had run out of therapy his condition still persisted and he still cannot properly throw a baseball without causing himself some pain.   At this point we’re holding on to hope that he will grow out of it.

Should I go on?

All of you people who think this shit only happens in countries where they have “socialized medicine” are fooling yourselves.  Insurance companies get in the way of you and your doctor all the time. They deny treatments.  They deny medications.  They tell you what doctors you can and cannot see, even if said doctors have huge waiting lists.

Is socialized medicine better?  Damned if I know.  What I DO know is that all this bullshit being spouted about how there is nobody between you and your doctor right now is a bunch of lies.

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  2 Responses to “A few brief notes on health care”

  1. Want another example of the absolutely fucked up mess our health care system is? I’ve got one for you. As you know, I recently quit smoking.

    My insurance company would rather pay to treat me for lung, mouth, tongue or other cancer or emphysema, or worsened asthma down the road than pay for a medication that drastically increases the odds of me quitting smoking right now. So, I’m paying 135$ out of pocket each month for the medication, and I’ve quit smoking.

    I have some more I can share if you want more. Ping me if you’re interested.

  2. And I’ll just stick with “Insurance companies are one of the biggest reasons the health care system in this country is !@#$%-ed up.”

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