Quote:
Originally Posted by anothersta
I wasn't suggesting you weren't telling the truth. I'm questioning the MSM and BHO who keep harping on all of the waste in the healthcare field. Yet, you are saying it would be very difficult to have the waste as private insurance companies are micromanaging everything.
What I am suggesting is that maybe the US citizens are getting fed another made up story by this admin, when the situation may not be as bad as they are making out.
Because what I'm getting from you, with you being in the field, is that there are already checks and balances put into the system via the insurance companies to try to keep it minimal.
and that was the reference to my question.
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Thanks for clarifying that. Yes there are most definitely checks and balances put into the system. I understand the need on one hand, but on the other hand it frustrates the hell out of me to see them have so much say into a patients course of treatment.
To give you a personal example of why I get so pissed after what happened to me...
I'm the patient. My insurance company's fomulary dictated specific medications for my Crohn's disease. I took several on their fomulary and none of them succesfully put me into remission. In the meantime I get diverticulitis in the inflamed/damaged area. My doc fought with them over and over until they finally agreed.The one I did need is extremely expensive...in the thousands per infusion. Long story short. So much of my large intestine was destroyed in the process of waiting for their approval, I had to have half of it removed. In the long run it cost them a hell of a lot more money for the 5 times I was in the hospital in 8 months, each for a week at a time then the subsequent surgeries, post op care, etc...The cost for all of the surgeries, procedures, tests, etc... came out to close to half a million dollars. They could have saved hundreds of thousands if they weren't trying to micromanage and allow my physician to practice medicine and allow me the treatment I needed. This is from our private insurance.
Insurance companies need to police waste but many times they get it wrong and put the patient in a precarious position. I guess I see too much of this and get frustrated.
I wish I could go back 25 years when nursing was simple...we took care of patients, felt a sense of pride in doing patient care and were able to give our patients the time that they deserved.