Tuesday, November 15, 2011

Death Squads

I was schedule to begin a maintenance chemo plan yesterday, Monday, Nov. 14, 2011. It was postponed because the insurance company wanted to review the plan to see if they would pay for it. Today, the lady who is the case manager for the insurance administrator called and said my maintenance chemo plan was turned down for payment. She said I should wait until the Dr. reviews the decision and let him either appeal the decision or come up with a new plan that will meet with approval.

A year ago or so when the democrats pushed through a huge health plan a number of conservative leaders said if the administration of healthcare were turned over to the government we would have "death squads" who would be deciding who lived or died. Well guess what, they are in effect already in place in the private sector.

If I were in desperate straits health-wise I would be extremely upset. However, my prognosis for my condition is very good. There is a 95% chance of full recovery. However, because I had a recurrence of cancer I am also at increased risk for further recurrences. This maintenance program is aimed at reducing that risk.

I have a coworker and friend lying in a hospice in Jonesboro. Ten months ago he was the paragon of health until he started putting on about 2 lbs of weight per day. Within a two week period he went from healthy to deathly ill. They found a tumor had invaded his right kidney, was invading his liver and was in the venus cava area of his heart. It was judged to be inoperable and he was immediately sent home with a horrible diagnosis and no idea of any palliative  care that could be provided. He came home and immediately went to a hospice where he has lain since last May. The family Dr. was so upset with his condition that he contacted M.D. Anderson in Houston to see if they would take him and render a second opinion. The insurance company flat refused to pay. Could he have been saved? Who knows, in the meantime he lies in a bed in a comfortable setting waiting to die.

Seems like we owe ourselves more than just a one time shot. In my case, I'm not too upset. Something will probably be done because the insurance company also recommends maintenance therapy. However, we are betting my life on this. Suppose five years from now my cancer comes back and we find out that had I had this "gold standard" treatment it would not have come back. Then the death squad becomes that for real.

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