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Public Group active 4 years, 9 months ago ago

A group for survivors. Tell your stories and discuss your plans.

The politics of health care insurance (2 posts)

  • Profile picture of rick rick said 5 years, 8 months ago:

    “Politics makes strange bedfellows.”
    Charles Dudley Warner

    This week, the United States Supreme Court upheld the constitutionality of the Health Care Affordability Act. There are numerous reports on what this may mean for you individually in the future, but in my mind what has led us to this? Does anyone have examples of where their insurance has increased the burden of their cancer journey rather than decreased? Has not had insurance led to a delay in a cancer diagnosis or less care of a diagnosed cancer? Was a political overhaul necessary and were the key issues successfully addressed?

    This should be interesting.

  • Profile picture of rick rick said 5 years, 8 months ago:

    As a physician in a busy oncology practice, I’ve really seen things change over the past decade. And unfortunately they changed for the worse.

    As an office, we have done our best to insulate patients from the obstacles placed in the way of appropriate cancer care by those paying the bills for the care, usually large insurance companies and government programs, Medicare and Medicaid. But this is becoming increasingly difficult over time. We contact various insurance agencies multiple times per day on behalf of multiple patients for preauthorization for the various cancer treatments. This used to be only surgery and IV chemo and radiation. The list has now expanded to include regular prescription drugs, for things like nausea or pain, xrays and CT scans, small procedures and any myriad of other interventions. We are sometimes successful and sometimes not. If the insurance companies will pay for treatment, we’re good. If not, or if they decide slowly, we need to come up with a plan B and then go through the whole process again. I personally phone or write insurance companies regularly when the regular channels don’t work. the bureaucracy is ridiculous. And to make matters worse, when coverage is refused despite cited medical literature supporting the treatment, no payment will be rendered. I have a patient now paying $10,000 per month out of pocket for a salvage chemo agent because she has failed all others for her rare tumor and the insurance company wont pay for this agent. Interestingly, her son is a researcher for a major pharmaceutical company.

    I have also seen patients who have reported not seeking care earlier because the had no insurance and were afraid of the bills. I have seen patients who knew they should have come in earlier and when they saw me it was too late to cure. That breaks my heart. Our health care system will not turn away underinsured or uninsured patients for lack of payment. I have always made sure that I worked in such a network. But many other patients are not as fortunate.

    So clearly, I don’t feel we are in an optimal state. And as the medical community was unable to fix this problem itself, the politicians stepped into the leadership vaccuum. They passed a 2000 page tome, which few read and nobody fully understood. It was a politically crafted compromise taking into account the special interest groups. I dont think it will fix much. It will cause at least as many problems as it fixes. The costs are staggering and will pushed off to the state governments, which are already drowning in red ink. I’m hoping it is a step in the right direction, but honestly, I dont know what is in it. I’m putting my faith in the fact that someone in Washington is acting in patient’s best interest. But Washington appears to be less and less altruistic over the years.

    Bottom line, it is what it is, and I remain cautiously optimistic ( my natural state). When the roll out occurs, I’m hoping things improve.