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Hey, Americans! This is your periodic reminder that you have the worst healthcare in the developed world.
Today, my orthopaedist prescribed generic Celebrex for my bilateral hip arthritis. It's an inexpensive, well-tolerated antiinflammatory.
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Today, my orthopaedist prescribed generic Celebrex for my bilateral hip arthritis. It's an inexpensive, well-tolerated antiinflammatory.
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There's good reason to believe that it would help me, as my brother uses it to control his own hip arthritis. My chronic pain - which has its origins in the congenital defects that led to my arthritis - is so bad that I haven't slept through the night in more than a decade.
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We are fully insured. My wife is an exec at a blue-chip company and we pay $2k/month to insure our family through her employer - the top tier they offer.
The meds cost $40/month.
The insurer declined to cover it.
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The meds cost $40/month.
The insurer declined to cover it.
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They say that if I want them to cover this generic, commonly used, best-of-class, low-cost med, I must first spend months taking other meds - many with serious side-effects - and demonstrate that none are suitable.
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The fact that my orthopedist prescribed this medication is not sufficient. A bureaucrat at an insurer has decided to override the judgment of my specialist to save literally $5-10/month. We pay them $2,000/month and now we're paying $40/month for meds.
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This insurer - Cigna - already turned down the pain therapy my pain specialist - the top person in his field in the region and head of a major, prestigious university pain research center - recommended.
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Now they've turned down the low-cost meds that I have to take to manage the pain they won't pay to treat.
America, I grew up under Ontario's medicare, then spent 13 years in the UK on the NHS.
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America, I grew up under Ontario's medicare, then spent 13 years in the UK on the NHS.
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I often hear defenders of American health care speak of "choice" and "not having their care rationed." They speak of "not having bureaucrats interfere with the doctor-patient relationship."
I have never ever experienced those things in the UK or Canada.
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I have never ever experienced those things in the UK or Canada.
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But I experience it virtually every time I interact with a medical professional in this country, whether it's taking my daughter to a physio after a bone-break or seeing a top specialist for a lifelong, debilitating condition.
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This is the care that well-off people with top-tier insurance get in major cities. It is worse than the care I got in rural Central America when I had to be med-evaced on horseback while suffering from typhus.
It's a national scandal and an embarrassment.
It's a stain.
/eof
It's a national scandal and an embarrassment.
It's a stain.
/eof
My real name is Cory Doctorow. I really had this experience, really yesterday, and I really explained it in the real thread. Cigna will cover this only if I first spend several months on other NSAIDs, many with serious side effects (as I said in that thread).
What's more, each of these scrips has a co-pay, and each must be evaluated by the orthopedist, whose co-pay is nearly $100. That means that to get my $40/month generic Celebrex scrip covered, I would have to spend ~$550-650 to satisfy their bureaucratic requirements.
