>> Pepto bismal is cheap, but we don't try treating a lung cancer with it just because of that.
> What? I'm sorry that is not a reasonable statement. I have no idea what point you are trying to make.
You stated that the insurance insisting on a non-related drug was step therapy, which is where one explores cheaper and less invasive treatments before exploring more expensive/invasive options. The point was step therapy does not include exploring treatment that there is no reasonable expectation will help.
> Again, without specifics I find that extremely difficult to believe.
I'm sorry. I'm not going to make my sister send me the drug names for a random internet discussion, and given the names of these things I unsurprisingly don't remember them. If you think I'm lying so be it, frankly I don't see how knowing the specific drugs involved would make that less likely.
FWIW it was a Parkinson's drug they wanted her to take, which might seem like it makes sense given the similarities between the diseases symptoms, but only if one doesn't understand the difference in cause and progression.
>> This should not be legal.
> It isn't which is why I'm having a difficult time believing your story.
The fact that you have a hard time believing that an insurance company might illegally deny a drug feels pretty shocking to me. The lawyer essentially agreed, it's probably not legal, but advised that fighting it would be extremely expensive and the best case outcome would be that she gets the drug, but it's more likely she runs out of money long before then. There are essentially no consequences when insurance companies do this, so of course they do. The worst case for them is they have to pay for the treatment eventually and most of the time it saves money.
> And yet that has nothing to do with the fact that healthcare is not free in Germany, and not single payer either, contrary to what 'radicals' like to claim.
I made no claim about Germany. I have no idea why you brought it up. I thought you were pointing out flaws in single payer systems, but now you tell me it isn't single payer?
>> I have a lot more say there than a private insurance company.
> Specifically, how so?
Voting, writing my senator/congressman, etc. Our government is broken in a lot of ways but are you really asserting we have zero influence? Because that's what I have with private companies.
>>The fact that you have a hard time believing that an insurance company might illegally deny a drug
No, I find it hard to believe, as you alluded to, Blue Cross were trying to get her on the equivalent of pepto for cancer. A Parkinson's drug likely has a correlation and is hardly pepto which is over the counter. Sounds like you acknowledge that even...
>>Voting, writing my senator/congressman, etc. Our government is broken in a lot of ways but are you really asserting we have zero influence? Because that's what I have with private companies.
You want to get an insurance company to respond quickly? Each State has an insurance commission with a phone line, email etc. I wish you the best of luck with Congress.
> What? I'm sorry that is not a reasonable statement. I have no idea what point you are trying to make.
You stated that the insurance insisting on a non-related drug was step therapy, which is where one explores cheaper and less invasive treatments before exploring more expensive/invasive options. The point was step therapy does not include exploring treatment that there is no reasonable expectation will help.
> Again, without specifics I find that extremely difficult to believe.
I'm sorry. I'm not going to make my sister send me the drug names for a random internet discussion, and given the names of these things I unsurprisingly don't remember them. If you think I'm lying so be it, frankly I don't see how knowing the specific drugs involved would make that less likely.
FWIW it was a Parkinson's drug they wanted her to take, which might seem like it makes sense given the similarities between the diseases symptoms, but only if one doesn't understand the difference in cause and progression.
>> This should not be legal.
> It isn't which is why I'm having a difficult time believing your story.
The fact that you have a hard time believing that an insurance company might illegally deny a drug feels pretty shocking to me. The lawyer essentially agreed, it's probably not legal, but advised that fighting it would be extremely expensive and the best case outcome would be that she gets the drug, but it's more likely she runs out of money long before then. There are essentially no consequences when insurance companies do this, so of course they do. The worst case for them is they have to pay for the treatment eventually and most of the time it saves money.
> And yet that has nothing to do with the fact that healthcare is not free in Germany, and not single payer either, contrary to what 'radicals' like to claim.
I made no claim about Germany. I have no idea why you brought it up. I thought you were pointing out flaws in single payer systems, but now you tell me it isn't single payer?
>> I have a lot more say there than a private insurance company.
> Specifically, how so?
Voting, writing my senator/congressman, etc. Our government is broken in a lot of ways but are you really asserting we have zero influence? Because that's what I have with private companies.