“Beep,” went the machine.
I left a message and hung up.
My patient, Mr. G, had just been denied a medicine by his health insurer. It’s the same medication for the same condition that he had been taking last year.
I was leaving a message on his behalf.
You can be assured that if you hand an insurance card to the front desk employee at your doctor’s office, your doctor deals with health insurers every day. It’s the system we’ve come to expect for both the extreme and the routine in our medical care.
Most of us dislike it.
But, we’ve been taught we can’t afford it any other way. The cruel paradox—of course—is that the majority of us are being out-priced by the status quo.
Mr. G’s medicine was working fine. It’s the only one of its type that he has tolerated without side effects. The insurance company covered it last year. They changed their mind about it this year. And, until we accept the logic that entrusting third parties to pay for our health might be harmful to our health, they will be the ones who keep getting to decide.
I was told I could appeal the decision waged upon Mr. G by getting in touch with a “doctor” working for the insurance company.
If you read that again, it’s an unbelievably humorous statement.
Physicians, scientists, and researchers are routinely condemned by the most virtuous of stone throwers for having even the slightest lean toward a conflict of interest. Yet, having me appeal your insurance case to someone who works for the insurance company remains noticeably absent from their aim.