MEEKS: My insurance carrier is not my physician

October 9, 2013 

A few weeks ago, my physician wrote me a prescription for pain patches that he hoped would help in managing the pain from my arthritic knee flare-up. My insurance carrier refused to pay their part for the prescription because it has been determined by some standard that this illness should not be treated with those particular patches.

Since it was my knee that was flaring up, it occurred to me that the carrier would more than likely not have objected to a recommendation for a knee replacement.

Needless to say, I think that this is outrageous. In the first place, I don’t need to replace my knee because it has gotten much better. I wonder if the carrier realizes that I saved it thousands of dollars by being willing to seek alternatives to surgery, but I hardly think that is of any concern to the carrier.

I have many objections to the inhumane and wasteful system of caring for illness in our country. My biggest objections lie in the fact that pharmaceutical companies and insurance companies are practicing medicine by the ways in which they dictate what many physicians can and will do. I selected the doctor whom I want to have as a companion in my health care and wellness journey and that selection did not include the insurance carrier. Its job is to help to pay for the services that I receive from my selected provider. I do not want any medical advice from the insurer and especially not when that advice is based solely on a monetary concern.

The other group that needs to stay out of my treatment is the pharmaceutical companies. I despise seeing their representatives in my doctor’s office and hearing about their plans to bring meals for the office staff as a part of the sales pitch to make sure that their product ends up being prescribed. Along with this are the outrageous commercials on television about certain medicines that the companies want the general public to request from their doctors. It continues to be difficult for me to understand why this kind of advertising is permitted.

The physician is the one who has spent years training to practice medicine, and I would like for that job to be respected and trusted. When my physician writes a prescription, I do not want a third party having anything to say about whether or not it is appropriate.

Dr. Andrew Weil, the pioneer of integrative medicine, believes that our greatest mistake in this country was making our medical system into an industry. I agree with him. Though I do not wish to see physicians live and practice in a primitive style, the industry is destructive to everyone and simply is not working. Our costs continue to race forward in an unsustainable way, the level of care is often not what it could be and the providers have too much to do. Some of my medical practitioner friends often lament about the industry themselves and some of them have found other ways of earning a living because of its many negative challenges.

I realize that it is difficult to know what to do when one chooses to stand up against a system such as this, but we have to think about what is going on and seek to resist in every way that we can. Resistance has always been at the heart of major change. When things don’t work as they should to serve the overall common good, they need to be reconstructed. In the case of the medical industry, the first line of resistance is to work to stay well in the first place. We can send a powerful message to the pharmaceutical companies by simply not needing their products. We, the people, can insist that things change by speaking up and by our actions.

This column by Catherine Meeks, Ph.D., appears twice monthly. Meeks is also a contributing writer for the Huffington Post. Email her at kayma53@att.net.

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