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Re: [IP] Now that is fast!

On 3 Mar 00, at 12:22, Holly Nelson wrote:

> I just found out yesterday that Taylor was approved for the insulin pump
> (after 6 long months of fighting), and talked to MiniMed today.  They are
> overnight FedExing the pump to us to be here tomorrow because we see the Dr.
> on Monday.  This could not have come at a better time as Taylor has a week
> off of school for spring break, and it will allow us to get used to the pump
> a little before he has to go back.  The only glitch in the whole plan is
> that BCBS placed restrictions on his approval and if he messes up once in
> the next two months they can decided to pull the pump.  They say this will
> see how compliant he is, I say that is a lot of pressure to place on a
> person.  Oh well I am still walking on clouds just to get the pump.
> Holly

They are just spouting hot air, unless they're bribing the doctor or 
something.  The insurance company has NO place in deciding if he is 
"compliant" or "messes up"... Make sure that the doctor isn't taking a 
kickback from BCBS to ensure "non-compliance".  Going on a pump takes 
several months to get basal rates adjusted, bolus ratios figured out and 
begin the education/familiarization process.  Once the pump is in your 
hands ATTACK!  Demand (in writing, with copies to you, your lawyer and 
maybe even the doctor) exactly what "messes up" means...  and if they won't 
cooperate call the insurance commissioner for your state and the medical 
board - because this sounds like the insurance company attempting to 
practice medicine without a license...  Just remember what you've read on 
the list - it can take a while to get all the multiple basal rates set up and 
every person is different - some people get by with one or two basal rates, 
but some of us require more.  Learning the carb/bolus ratios is also a 
process - I have seven basal rates and at least 4 ratios.  It takes time to 
fine tune all this and the only way it is done it by trial and error.  That's 
why the insurance company has no right (and if the doctor is in on the game 
it's out and out malpractice and medical fraud) to demand instant 
perfection.  You might mention that if the pump is pulled you will demand 
hospitalization every time his bg goes high or low.  It would only take one 
short stay in the hospital to exceed the cost of the pump... and then you'be 
be right back demanding improved care (a pump, of course) to limit future 

Insurance companies (and unfortunately by extension many of their people 
who have fallen for the soulless "clone-an-idiot" corporate mentality) have 
no values and morals.  They measure everything in dollars, so you have to 
remember to fight in terms they understand.  They would really rather have 
people die than provide adequate treatment - it's cheaper for them and 
improves their balance sheet and bottom line.  That's why you have to "fight 
dirty" because you are fighting what seems to be embodied greed, stupidity 
and maliciousness instead of looking for resolution of an issue with rational 
human beings... 

Rev. Randall Winchester
WD4HVA (email @ redacted)
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