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[IP] RE: insulin-pumpers-digest V3 #958

Snip>"Are there any medical doctors associated with these HMOs???  Don't 
know that most people on insulin pumps are also on humalog??

To All,
I am the father of a diabetic child as well as a physician. I have
experienced the frustration of being a health care consumer in trying to
get authorization for my newly diagnosed son to see an endocrinologist,
getting the insurance company to approve the pump as well as every other
blessed thing associated with state of the art diabetes care. To make
matters worse, I am a provider for this insurance company.
In general, authorizations are made by nurses, not physicians. It is the
primary responsibility of the company to say NO to everything. At that
point a large percentage of people accept the NO and go away, leaving
the company victorious. Forget about doing the right thing for the
patient. It's all about making money. Increasing premiums and deny care
is the equation for increasing profits.
We as patients and physicians must stay together and demand the care
that we are paying for. NEVER take No for an answer.
G-d bless all of you.
SHALOM <snip

Thank you for sharing this information about your experience.  One more 
confirmation of what most of us already know.

Now, what can we do to change this ineffective and inefficient method used 
by insurance companies.  The "DENIED" stamp mentality used by most 
insurance companies is ridiculous.  BUT where do we draw the line to keep 
our insurance frorm costing too much to afford?    Or shall it forever be 
that only the squeaky wheels get insurance coverage when they need it?

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