Does anyone know a health insurance executive of integrity who is a person of conscience? I need to get their ear.
Today a patient of mine was denied insurance benefits, by United Health Care, for Non-Surgical Spinal Decompression (NSSD). The request was denied because of "a lack of high quality peer reviewed studies published in leading medical journals to support its use."
This did not come as a surprise. While NSSD has over 15 years of anecdotal data to support its safety and effectiveness, this is the standard of what I hear time and time again. When I spoke to the peer review doctor, Dr. Ayers, she told me that she had no authority to override the guidelines. I asked her if epidurals and surgery would be provided for a patient with this diagnosis and she said, "yes". I asked her is she was aware that neither of those options had the supportive literature for safety or effectiveness and she said, "yes". So when I asked her if this looked like a case of "the pot calling the kettle black", she agreed.
No person of conscience would allow people to be forced into a more dangerous, more expensive and less effective medical procedure. Only a corporation operating under the mandate that profits are the only thing that matters would behave that way.
Is it that the insurance companies want the cost of health care to go up?-- Would you rather have a percentage of a 500 million dollar a year industry or one trillion dollar a year industry? Or, is it that they want to scare people away from any treatment by only offering the most egregious option. I don't know, I do know that they constructively make it impossible to get an ear to listen to reason.
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