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.

A Private Sector Big Brother

The debate on health care has turned to fear creation. Let's not have a debate or conversation, lets just say no and scare the hell out of the people who have insurance and feel a little insecure. Let's lie and say their are death squads, lets say that government will ration care. Lets create a fearful atmosphere that chokes off debate and the intelligent discussion of issues.

Two weeks ago I was hospitalized with an A-fib episode. It took 2 1/2 days to get the heartbeat straightened out. A week and a half later, today Friday August 28, 2009 I received a letter saying that my hospitalization meets the nationally recognized precertification procedures and therefore is certified. Which means insurance will cover the hospitalization. What if it had been a severe anxiety attack and I was fearful for my life. Would it have been certified? Who knows what the recognized national certification procedures are, I sure don't.

An employee of Arkansas Northeastern College who works for me is undergoing chemo treatment for a stage four cancer. The intravenous dose knocks him on his ass. The pills have their own side effects. Last week he had a pain in his left foot, it is a stress fracture of a bone in his foot brought on by the treatment. The guy has a lot of mental anguish. He is in his mid-30's. He has a daughter 3 years old, his wife is pregnant and due in October. The cancer has spread to two locations and is considered stage 4 even though each site by itself is stage 1 so it is a confusing issue. If it is truly stage 4 the five year survival rate is only 5%. A tremendous amount of mental anxiety yet you wouldn't know it.

Tuesday he was diagnosed with a blood clot in his lower right leg from the treatments. It is kind of like the shit is piling on. His doctor prescribed blood thinners, only he has to inject them because the oral type interact with his chemo. So he has a prescription for injection thinner and it is expensive, $2000. When he shows up at the Wal*Mart pharmacy he is told insurance will not approve the meds. It turns out that they have another source they use for the expensive stuff. So he has to go back to the doctor and fortunately the doctor has enough samples to tide him over until the prescription can arrive from the insurance company's source. Let's add a little more aggravation and mental stress to a guy who is already dealing with a life and death possibility.

It makes me wonder how in good conscience these assholes propagating the fear statements that have been debunked can make those statements. Hell we don't need death squads, they already exist. The rich will rule the day, the special interests groups will give up just enough so the politicians can claim a victory of sorts, and the American public will continue to put up with inadequate health care that is continually subjected to squeezing in the name of profits not care. Go to hell private sector.