Tuesday, April 01, 2014
Insurers Driving Insured Into Arms Of Drug Dealers? ... J. D. Longstreet
Insurers Driving Insured Into Arms Of Drug Dealers?
A Commentary by J. D. Longstreet
I know a man who suffers chronic pain. He also has an auto-immune disease which comes complete with its own myalgia (chronic pain). On top of that, the autoimmune disease has triggered fibro myalgia. So, let's just say he deals with a heck of a lot of pain every day, 24 hours a day.
For decades my friend has taken an opioid drug for pain relief. It does not take away the pain, but it does allow him to function. He has come to rely upon the relief that drug affords him.
He is also aware that he is most certainly physically addicted, even if he is not psychologically addicted, to the drug. But, in order to be able to function as a nominal human being, he must take the drug every day to be able to handle the pain.
Along comes Obamacare. His insurance company sends him the dreaded letter that as of December 31st of 2013, he would no longer have insurance.
Not being one to procrastinate he managed to re-insure with a nationally known insurance company.
However, so much has changed under the new Obamacare (so-called affordable Care Act) rules that he has been blindsided by many new rules and regulations that make if far more difficult for the insured to actually benefit from being insured.
If you haven't paid close attention to the drug formulary of your insurance policy, we suggest you do so, and not casually. Study it intensely. For even if you are healthy now, eventually you will become ill and you will require medications for treatment.
Today, the main function of a prescription formulary is to specify particular medications that are approved to be prescribed under a particular insurance policy. The development of prescription formularies is based on evaluations of efficacy, safety, and cost-effectiveness of drugs.
Understand, dear reader. Insurance companies are not in business to do you or me a favor. They are not in business to heal the sick no matter what their expensive PR firms may say. They are in business for one reason and one reason only: to make money.
Now, I'm a capitalist. So, I have no problem with a company, any company, making a profit. In fact I applaud it. But I draw the line when human pain and suffering is the result of a business decision.
My problem with all this is the point at which an insurance company's drug formularies and common sense clash.
For instance, my friend, under his new policy, must now have a "prior approval" to get the same drug he has been taking strictly by his doctor's direction and under his doctor's supervision, for decades. He told me it infuriates him and results in him feeling as if he were suspected of being a junkie.
He said the angrier he became the more tempted he was to forgo a prescription entirely and visit the neighborhood drug dealer who stocks the exact same drug and no prior approval and no prescription is required.
Well. that got me to thinking. Where my angry and frustrated friend was just blowing smoke and ranting, I have to wonder -- how many Americans are doing just exactly what my friend threatens to do?
In another case, an acquaintance told me of a situation in which he had been taking an old sulfa drug for decades. It is an old formula, very inexpensive, and very effective for his chronic problem. But, he said his new insurance company won't pay for it. They WILL, he said, pay for a far more expensive drug, that he doesn't need and doesn't want. So, he said, he ended up paying for the sulfa drug, out of pocket, in order to continue the extremely effective treatment it has rendered over the decades.
I, too, am frustrated and angry at where the insurance industry in America is headed. The bond of trust between the insurer and the insured is eroding at an alarming rate. The face of the insurance company is morphing into the face of Obamacare, which is to say -- into the face of government.
THAT is why the insurers are losing their customer's trust and respect. They have become just another bureaucratic branch of the strong central Leftist government of Obama.
In four years Obamacare has deconstructed the world's finest healthcare system and remade it into a healthcare system to rival any in the third world.
The tentacles of Obamacare have so entangled themselves into America's healthcare and insurance system that they can do longer be defined separately. They have, all three, become one and the same and hated by the very people they purport to serve.
So, what's to be done?
Repeal Obamacare -- completely. Rid this country of the cancer of Obamacare or the so-called Affordable Care Act. Don't make an attempt to repair it, as a group of Democrats (whose days in office are numbered as a result of their total support of Obamacare when it passed in the US Congress -- with not a single Republican vote) They are pathetic in their attempt to cover their collective derrières with their obviously insincere attempt to "fix" Obamacare. They are mostly from "red" states and every last one of them will, most likely, be in the unemployment line after this November's elections.
And they ought to be.
The damage they and their cohorts have done the people of America will take decades to repair and some of it will NEVER be fixed. Even after Obamacare is repealed the scars will remain.
The GOP's mantra of Repeal and Replace is pure Bovine Scatology ... plan and simple!
Look. We know the Democrats are hoping for a "repeal and replace" movement in Congress because they have the replacement already drawn up and ready to plop into the hopper in the Senate and the House. It is a Single Payer system much like that so hated in Great Britain today. Yeah, that's where some insured are extracting their own teeth with their pliers! Uh-huh! How great a system is that?
My point is: Obamacare is bad enough. It's replacement will be worse.
Let the marketplace recreate a uniquely American healthcare system while the government stays the heck out of it!
Two things: Being the bully that it is, the government WON'T Stay out of it, and so much damage has been done our healthcare system by Obamacare, I seriously doubt we will EVER be able to create a system that even approaches the quality of care and the efficiency of the original American Healthcare System BO. (BO = BEFORE OBAMACARE)
All of this is a part of the decline of America. A decline the Left wanted so much! Otherwise they would be left with egg on their faces. So, if America did not decline on it's own, which it did not, the Left made darn sure they would cause it to decline. I refer you to the Cloward-Piven plan for crashing America.
This nation must be free of Obamacare. It MUST be repealed -- completely! Repeal can't happen as long as the US Senate remains in the hands of Democrats. Only a veto proof Congress or a complete takeover of the US government (Senate, House, and Oval Office) by the GOP will result in repeal of Obamacare. We can begin the transition this November.
America deserves better than this -- MUCH better!
J. D. Longstreet