Snapshot of the future? Snapshot of the future? - Talk of The Villages Florida

Snapshot of the future?

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Old 09-05-2013, 07:43 AM
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Default Snapshot of the future?

Man died when Anthem delayed coverage for surgery - for five months
http://www.indystar.com/article/2013...ry-five-months
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Old 09-05-2013, 08:12 AM
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Quote:
Originally Posted by Indydealmaker View Post
Man died when Anthem delayed coverage for surgery - for five months
http://www.indystar.com/article/2013...ry-five-months
No....it's a snapshot of what happens right now. While not often resulting in someone's death, insurance companies disagree with doctors decisions thousands of times a day (source: I was a pharmacist and it happened a number of times every day in my store alone). Many times, the insurance company is correct in saying that there is a much cheaper alternative treatment that has been proven to get the same results. Many times the doctor is correct in saying that the treatment he originally prescribed is correct. All the time, the patient is caught in the middle, most often with the pharmacist making multiple calls to both the insurance company and the doctor to find a drug that the insurance company will pay for and the doctor finds acceptable. I am making the assumption that when you speak of the future you are speaking of Obamacare but didn't mention it for fear this would quickly turn political and the moderators would ban it. But this is happening now and is not incorrect. The most expensive option is not always the best option. I am sure that you and many others have had the experience of taking a prescription to your drugstore and being told that your insurance doesn't cover it and the cash price will be $350.00, or the pharmacist can call the doctor and have him switch it to another drug that will do the same thing and you can get it for free on your insurance. I have never had someone tell me they want to pay the cash price. The same thing happened in this case. A number of cardiologists employed by the insurance company reviewed the case and determined that there was alternative therapy available for this case. Since a cause of death was not listed in the article you linked to, it looks like a jury will decide who was right. But right now, no one has enough information to make that claim or to imply that this will be happening to everyone in the future.
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Old 09-05-2013, 01:06 PM
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I don't know why you think this is the future. It is common now and has been common in the past as well, as Barry stated. I had a friend lose her foot because the insurance carrier refused to cover the doctor's recommended course of treatment about 15 years ago. Of course, amputation was much cheaper and guaranteed to work. Sadly, insurance is what it is and I doubt the fuure will be that much different.
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