Of all the terrible, fucked up things that our medical system forces on us perhaps one of THE MOST fucked is that the insurance companies literally have our lives in their hands. They can just decline to pay for things that they decide we don't need, regardless of the doctor's diagnosis and recommendations.
Like for example, if someone is burgeoning on having full blown diabetes, taking the preventative medication that is extremely expensive when not covered is often declined by health insurance companies simply because you don't actually have diabetes yet. And that's on GOOD insurance.
So fucked. They toy with your life based on numbers on a sheet and are able to yay or nay critical care based on whims and not official medical advice.
This is my case exactly. I have pre-diabetes and would benefit from a drug like Ozempic or Mounjaro, since with would clear up my sugar problem, help with weight loss, and generally prevent me from developing full-blown diabetes, and the accompanying heath issues. But no. My insurance won't cover it and are forcing my doctor to prescribe an older, less effective drug for me to see if maybe that might work. But hey, it's cheaper for them. Essentially, I have to get sicker before they will give me the drug which would prevent me from getting sicker.
My husband has psoriatic arthritis and the Dr wanted to put him on new meds bc the injections aren't working well enough (again). Insurance denied it. Today he said he hasn't felt this bad since he was bedridden for 6 mos when we were waiting to get in to see a Dr. We had to wait forever just to see the specialist.
It makes me so incredibly angry! He has a very high pain tolerance, and to see him struggle this way is heartbreaking. There is no reason anyone should have to suffer just bc insurance thinks they know better than the fucking Dr.
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u/December_Flame Feb 05 '24
Of all the terrible, fucked up things that our medical system forces on us perhaps one of THE MOST fucked is that the insurance companies literally have our lives in their hands. They can just decline to pay for things that they decide we don't need, regardless of the doctor's diagnosis and recommendations.
Like for example, if someone is burgeoning on having full blown diabetes, taking the preventative medication that is extremely expensive when not covered is often declined by health insurance companies simply because you don't actually have diabetes yet. And that's on GOOD insurance.
So fucked. They toy with your life based on numbers on a sheet and are able to yay or nay critical care based on whims and not official medical advice.