Barb's Daily Dose

No Virginia, Insurance Companies Aren't Santa

It was the best of times, it was the worst of times..... It was the Christmas season and I was at a holiday gathering at one of my husband's work friends. I had finished working a 12-hour shift in the Pediatric ICU.  I changed into something festive and was looking forward to a little break.

I didn't want to think about how much busier our unit would soon be after yet another local hospital shut down. You see, a huge insurance company had bought up a bunch of hospitals and was busy trying to make them more efficient.  After about 18 months, they stated in the press that the costs were too high, and they had to close more hospitals because there just weren’t enough funds to cover the cost of providing care. I thought I understood, I mean after all, MRIs, CAT scans and surgeries are expensive, but I wondered about the numbers of people paying their premiums and where all that money went.

WhiteGlove House Call Health

Aetna has added WhiteGlove House Call Health to its provider network in Dallas-Fort Worth. The company sends nurse practitioners and physicians out on house calls to patients who have minor medical issues, such as the flu, infections or skin rashes. The providers deliver a well-kit that includes foods, beverages and OTC remedies. They also can take laboratory tests and deliver prescriptions.

Please link to this site for more information.

Generic Swap Meet

Welcome to the Generic Swap Meet! 

Also known as health care in the United States. Guess what?  It doesn't matter where your doctor, nurse practitioner or PA went to school, or how much time they spent taking your health history or examining  you. Don't worry about those little details.  And the medication they prescribed? Oh, that's just a suggestion.  You see, they may be writing the prescription and you may be taking it to the pharmacy, but we all have to wait for the real "Decider" to figure out if it's in their best financial interest for you to take that medication.

Who Really Decides

Sorry, let me back up a bit.  You see, you may have your own health care provider, who has actually met you, examined you and spent some time with you, but often, the decision about what medication you will end up taking for your condition, well, that's up to someone else. 

Someone you've never met, who doesn't know much about you, except your social security number, your age and your diagnosis.  Oh, hold on, what they do know, is the least expensive medication approved for that diagnosis.  It doesn't matter if you've already tried the alternative and you had side effects, or it didn't work. That doesn't matter.  You see, it's better for the health of your insurance company not necessarily for your health.

Affordable Birth Control?

For years, I've tried my best to find ways to help patients, especially teens access birth control without breaking the bank. Women with insurance who had to pay $30 to $40 co-pays every month for contraception, while men picking up Viagra and Cialis had no co-pays or only $5.00. Give me a break!  And, there were insurance plans that didn't cover birth control unless it was being used to control heavy periods or for acne.  What? Luckily, many teens have those issues.  Actually, don't get me started.

For women, having access to contraception is integral to their health. Finally congress passed legislation that makes women's health more affordable. Here's a video:

What Is it Like to Treat the Homeless?

Today I was able to interview Dr. Seth Amerman.  Dr. Ammerman  is an inspirational guy who works with homeless and uninsured teens. He has been going out where these kids are through a novel and effective mobile van, which is part of the Lucile Packard Children's Hospital at Stanford.  This outreach is incredibly effective. 

Many of these teens have no options for health care. It's hard to earn their trust and they are notoriously hard to reach. Yet, if they are treated at the Packard Teen Van, more than 70% will come back, because the van comes back to them.

Pre-Existing Conditions

Yesterday I started a post on Medically Necessary formulas for babies and I realized that this is a much bigger issue with insurance companies.  

Pre-existing conditions 

What do we read on the policies: We do not cover Pre-existing conditions. Come on... I want to scream! Everyone I know has some sort of pre-existing condition. Don't ever let anyone know that you've ever sneezed, or had a cold, because, guess what, that's a pre-existing condition, and....sorry, you can't be covered with a regular policy, but we'll be happy to provide you with a special plan that covers emergencies. It's only $2,000 a month, with a $5,000 deductible. Sign here.