Tuesday, April 19, 2011

MS and the Insurance Bullies

Received this letter from a friend of mine that has been dealing with MS longer than I have

I am a Multiple Sclerosis patient. I was told I have to change Neurologist as He is no longer able to treat ms patients with Tysabri or Cellcept. The State of New York is making him do this. This is effecting over 300 ms patients directly as well as the good doctor.
Ecellus took this good doctor before the State board using ten of his patient files and a second opinion doctor (paid by Excellus) that said his treatments with Tysabri and Cellcept were not necessary. The State agreed and are making him stop treating this population of ms patients.
I am a Delphi salaried retiree that had all of my healthcare and benefits taken away through Bankruptcy court. I was being treated with another ms med where I would give myself a injection everyday (under this good doctor's care). When I lost my benefits, I started skipping daily doses trying to save some money by maybe only buying eight to ten months supply per year rather then twelve months. had been n this med for 11 years with very quiet ms symptoms and no major attacks. Well five months after my self "dose reductions", I had another major ms attack. I'd lost the use of my hands. Fortunately with two (usually only one Intravenous steriod treatment is needed) intravenous pulse therapies and almost 16 months later, I have regained enough to type this note.
I can tell you my Neurologist is the most competent Doctor I have ever met. He has more degrees then people have shingles on their roof. He developed the first non-invasive test for nerve function in the 70's. He is like Dr. House only square his abailties with the erascible personalty too. He truly is the reason I am not blind and messing myself in a nursing home along with most of the rest of this ms population.
The real reason Excellus took him before the board; The sum total cost of annual treatments to this population is just over $25 million dollars and that is why Excellus targeted this Doctor. This actual cost is only going to get exponentially more not allowing these treatments and altering them. Doing this will cause more disease activity and with other treatments are much worse side effects too.
I believe the State is allowing this insurance company to do this because of their political power and nothing else. The real culprit here is the Pharmaceuticals allowed to charge these ridiculous amounts for the medicines. Why isn't their more pressure on the pharmaceuticals by the insurance companies as well as the government? This is abuse of the system and the system needs to be fixed so it helps people not hurting them. That will be the real economic win too.
Thank you, MS Patient from Rochester, NY

from Todd,
I know this gentleman personally, and I don’t know that there is anything any of us could do to change this situation. I think being aware of what the bullies in State Government can do in the name of protecting us is criminal. The takeaway here is that in an era of a more caring health movement I think that the patient should have been considered first. Would it really have been that difficult to find these folks another infusion center before shutting this doctor down? Instead the government (insurance bullies are in the background) shut this doctor down and left the patients to fend for themselves. I don’t know who I get madder at the insurance companies or the government for letting themselves be manipulated.