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Lizzie2
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Try this one on for size!
« on: Sep 7th, 2004, 6:55pm » |
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Yeah I know it's about migraine, but seriously...if insurance companies can do this, I'm scared!!!
Quote:Aetna creating new system for managing migraines
The insurer wants physicians and patients to discuss less costly ways of treating headaches.
By Robert Kazel, AMNews staff. Sept. 13, 2004.
In the latest effort by a major insurer to use disease management to stem the costs of treating a chronic condition, Aetna is reaching out to migraine patients and their doctors.
The Hartford, Conn.-based insurer this summer launched a migraine management program that distributes written materials on the causes and treatment of headaches to both patients and physicians, asking them to work together to identify pain triggers. Aetna says it spends about $70 million a year to treat migraines.
Aetna is encouraging doctors to consider less costly medication alternatives, particularly preventive drugs, and to think twice about ordering brain imaging tests, which Aetna says usually provide little useful information about headache causes.
Aetna invited into the new program 2,500 patients who, based on claims data, appeared to be failing to get chronic headaches treated effectively, said Mark Rubino, chief pharmacy officer at the health plan. This represents a small portion of the 80,000 members that Aetna believes get migraines regularly.
"The idea is, let's try to prevent the episode," Rubino said. "Let's try to get them to use medications [for acute attacks] as infrequently as possible."
Patients opting into Aetna's program are sent a headache diary in which symptoms, medication use, therapy response and side effects are to be recorded for three months.
Aetna spends $70 million a year on migraine treatment.
The program is the latest disease management initiative at Aetna, which also has programs for patients with asthma, coronary artery disease, congestive heart failure, diabetes, end-stage renal disease and lower back pain. Aetna and other major managed care firms have rolled out these programs to save money by pinpointing chronic users of health care services, supplying them with information on illnesses and in many cases offering regular contact with a specialized case manager by telephone. The migraine program does not now use case managers, Rubino said.
Aetna is hoping to save money over the long haul by paying for fewer brain scans and emergency visits and cutting the use of triptans -- drugs that treat acute migraine attacks and which can be relatively expensive.
Seymour Diamond, MD, director of the Diamond Headache Clinic in Chicago, said he likes elements of Aetna's programs, such as encouraging patients to keep a migraine diary. Tapping claims data to try to identify patients whose migraine treatment has apparently failed also is reasonable, he said. But Dr. Diamond said Aetna should go no further and not actually restrict the prescribing of triptans when needed.
"For most moderate and severe attacks, the triptans have been wonderful adjunctive drugs," he said. "They've been miracle drugs for these people."
Aetna might not find that doctors welcome efforts to teach them, or patients, about migraine drug options, said David Kudrow, MD, a neurologist with the California Medical Clinic for Headache in Santa Monica, Calif. "I'm a little bit put off that an insurance company might suggest I'm not making the right decisions for my patients," he said. "They're not doctors, and I don't like the idea that non-physicians are trying to make health care decisions. It's getting in between the doctor and the patient."
In addition to directly contacting patients, Aetna is sending their doctors utilization review reports that delineate patients' past care for headaches.
Some doctors are not prescribing preventive medicines for migraine patients, including beta blockers, antidepressants and anti-seizure drugs, when they might help, Rubino said. "They're not always effective, but it's something that should be considered," he said.
Aetna also is asking doctors to consider telling patients to try less costly, nonprescription drug alternatives such as aspirin, naproxen sodium, ibuprofen and combination products containing aspirin, acetaminophen and caffeine for treatment of acute migraine attacks. |
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IndianaJohn
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Re: Try this one on for size!
« Reply #1 on: Sep 7th, 2004, 7:22pm » |
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We should declare a war on the insurance companies. 
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Did my brains fall out or is this headache over?
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Lizzie2
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Re: Try this one on for size!
« Reply #2 on: Sep 7th, 2004, 7:28pm » |
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on Sep 7th, 2004, 7:22pm, IndianaJohn wrote:| We should declare a war on the insurance companies. |
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Seriously.......
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floridian
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Re: Try this one on for size!
« Reply #3 on: Sep 7th, 2004, 7:29pm » |
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Some of the ideas are good, but who is the big company doing this for?? Legally, their prime responsibility is to look out for the health of the investor's pocket book. Patient health comes second.
What the companies really need to invest in is some good software for tracking headaches. CHATS comes to mind. 
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vig
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Re: Try this one on for size!
« Reply #4 on: Sep 7th, 2004, 8:18pm » |
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Capitalism and Healthcare don't mix very well.
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never, Never, NEVER quit. -Winston Churchill
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Ueli
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Re: Try this one on for size!
« Reply #5 on: Sep 7th, 2004, 9:44pm » |
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Something I've wondered about for a long time:
With the Mob it is custom to cut off some fingers of people who don't pay up for their betting debts.
Do the members of this honorable companionship not need any health insurance or do they get special conditions or are they insured by fingerless people? 
PFNADs, Ueli 
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Gator
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Re: Try this one on for size!
« Reply #6 on: Sep 7th, 2004, 10:15pm » |
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I've posted it before Ueli, insurance is just legalized gambling. Betting whether or not a person will get sick or die or what not. As long as we are anteing up, the game goes along just fine. Let someone get sick or worse, let someone get a chonic illness and all bets are off. The big boys don't want to play no more and they try every trick in the book to get out of paying. This article is just one more example of how I was right.
Cluster Headache = Headache = take two aspirin and call me in the morning. Fuck That!!! Geez, I wish this illness had a different name!!!
Gator
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nancyc
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Re: Try this one on for size!
« Reply #7 on: Sep 7th, 2004, 10:21pm » |
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I would not like to see what i would do to the Doctor that told me to take two aspirin and call him in the morning for a ch...... nancyc
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cootie
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Re: Try this one on for size!
« Reply #8 on: Sep 7th, 2004, 10:39pm » |
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Brad's doctor said he was goin to state his condition under a new phrase to get his trex paid for better and get the max he could get....he stated he had intractable migraine !? He said they don't like mention of CH.......so he tried to take anouther route. A script for 4 boxes of the trex injections (2 in each box) was a grand total of $ 500.00 !!!! Insurence paid all but $ 30.00 this time and he got him a script for a YEAR this time too !! So even tho were limited to only so many a month (and he gets 2 to 4 or more attacks a day durein cycles tho) I will stock pile each month. But good grief.........would HATE to have my doc tell 'me' to try advil or asprin for migraines or Brad's ch cuz insruence co's are gonna try and make em go that route ! He'd need an entire bottle for himself after I tried to kill him Pam 
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Cause and Effect......"Cause is the effect concealed, Effect is the cause revealed"
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Lizzie2
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Re: Try this one on for size!
« Reply #9 on: Sep 7th, 2004, 10:40pm » |
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on Sep 7th, 2004, 10:21pm, nancyc wrote:| I would not like to see what i would do to the Doctor that told me to take two aspirin and call him in the morning for a ch...... nancyc |
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LOL ok my roommate does not have problems with headaches, although she gets tension headaches on occasion. She is a nursing student and an EMT, but otherwise has never had anything wrong with her. She can count on one hand the number of pills she's taken in her life, I think!
Anyhow, I sent her the link to this article. She said she had to read it twice in order to digest it. She said the last paragraph is what got her the most. She said, "if aspirin worked, why in hell would you be seeing the doctor in the first place?"
I said...yeah excuse me but I forgot to try the fucking tylenol sitting on my shelf. Silly me....
At least this kind of crap looks stupid to "normal" people too!!
Lizzie 
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Charlie
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Re: Try this one on for size!
« Reply #10 on: Sep 7th, 2004, 10:54pm » |
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The level of greed displayed here is criminal. They are reptilian in behavior. Not once do we see an iota of good will from this mob.
What's next, people like me with refractory seizures are supposed to spend time sittling under a pyramid to save them money? 
Where's Tony Soprano and Paulie Walnuts when you need them?
Charlie 
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| « Last Edit: Sep 7th, 2004, 10:55pm by Charlie » |
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Callico
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Re: Try this one on for size!
« Reply #11 on: Sep 8th, 2004, 12:08am » |
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Aetna also is asking doctors to consider telling patients to try less costly, nonprescription drug alternatives such as aspirin, naproxen sodium, ibuprofen and combination products containing aspirin, acetaminophen and caffeine for treatment of acute migraine attacks.
When I worked on a farm we called that fertilizer. Aspirin, acetaminophen and caffeine? Do they then have a clause exempting themselves from paying for bleeding ulcers and liver failure caused by excessive medication?
For one, and probably the first, time I agree with Dr Diamond. Track it, but then TREAT it.
jc
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"When He acts on the left, I cannot behold Him; He turns on the right I cannot see Him. But He knows the way that I take; when He has tried me I shall come forth as gold." Job23:9,10
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Lizzie2
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Re: Try this one on for size!
« Reply #12 on: Sep 8th, 2004, 12:10am » |
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Not only that, but there was a link at the bottom of that article to other related articles. The one at the top of the list was on young people overusing OTC meds to treat headaches and throwing themselves into rebound. So now, why in hell are they writing plans that state that patients need to try more OTC meds??? 
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floridian
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Re: Try this one on for size!
« Reply #13 on: Sep 8th, 2004, 12:32am » |
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on Sep 7th, 2004, 10:54pm, Charlie wrote:
Where's Tony Soprano and Paulie Walnuts when you need them?
Charlie
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Working for the pharmaceutical companies - dat's where da money is!!
And where's our government? Working for the pharmaceutical companies. That's where the war on terrorism is. Can't import meds from Canada - Al Qaeda might try to attack us that way.
Quote:
WASHINGTON (AP) - Tampering with prescription drugs imported from Canada could be a way for terrorists to launch an attack on Americans, acting U.S. Food and Drug Administration commissioner Lester Crawford said Wednesday.
http://cnews.canoe.ca/
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BobG
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Re: Try this one on for size!
« Reply #14 on: Sep 8th, 2004, 4:00am » |
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Quote:| Seymour Diamond, MD, director of the Diamond Headache Clinic in Chicago, said he likes elements of Aetna's programs, such as encouraging patients to keep a migraine diary |
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Hmmm.......that has been good advice since this site started. I wonder if Dr. Diamond learned it here.
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Lizzie2
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Re: Try this one on for size!
« Reply #15 on: Sep 8th, 2004, 3:16pm » |
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So...getting back to that Mob idea.
Does this mean I need to go to south philly, meet me a Rocky Balboa type and get some mob connections? teehee
So far...this is the only idea I'm coming up with!!
Lizzie
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marfanoidus
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Re: Try this one on for size!
« Reply #16 on: Sep 8th, 2004, 3:43pm » |
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This is waaay toooo loooonnnng. Sorry.
I too have said for years that all insurance is just gambling - and that is what it is.
Everything said in this thread about insurance companies seems right on - they are out to make a profit and stay afloat.
But I would submit to you all that insurance companies are not the sole culprit here.
The American Medical Association (AMA) is to be blamed even more. I am thoroughly convinced that far too large a percentage of what doctors prescribe, both in medicines and procedures, is a result of covering their ass and just general overkill.
Example: I also have Marfan Syndrome, and one night my chest was hurting to the point I figured I should go to the ER. No one there knew about Marfan, so I told them that I needed an ultrasound performed, as it is the best way to look for Marfan-related effects on the aorta.
Did they listen to me??? Hell no.
First, an x-ray. Well, they think they see something in it, but it will require another test to determine.
Test #2 - again, they think they see something, but it will require test#3 to be sure.
Test#3 was where they put the dye into you. After this test, they just came back and said they found nothing. But, they still want an ultrasound to be sure.
But the ultrasound technician wouldn't be in til morning, so they would need to admit me overnight for observation.
Oh yeah, and they had to do the blood test, chem 80, or something like that.
Finally, they did the ultrasound, and all was well. Of course, after all this, the doc said "You're low in magnesium and I've heard where that can cause mitral valva prolapse, which appears to be what you have".
Oh yeah, I was ready to strangle anything alive.
The bill for my 10 hours in the hospital was $3700. All to be told I needed to take some magnesium. Oh my god!
But I'm convinced they only did this because I had good insurance. When a doctor and hospital know they will get a certain percentage for their efforts, their efforts will quadruple, because even if you don't pay your portion, they still rake in the dough.
Doctors and hospitals are very much to blame for the excessive costs insurance companies must incur.
Oh yeah, and in this free country, we're not allowed to buy less-expensive prescriptions from Canada. Of course, we can smoke, drink, and eat bacon-cheeseburgers because we have the right to do those things. But the FDA (Food Drug Administration - read here: AMA patsy) says that getting drugs from another country where they don't have the same safety protocols would be to invite disaster on American health. We don't have that right, so sayeth the AMA.
So, we fortunate Americans are denied buying our medicines where we want and we are forced to pay patent-holder prices (can anyone say Imitrex???).
Insurance companies, all tolled, do some good for a lot of people. But there is no force on earth that can defeat the AMA and drug company lobbyists - when Hillary Clinton tried she was flattened in the contest.
just food for thought.
good luck to all,
walt
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Cerberus
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Re: Try this one on for size!
« Reply #17 on: Sep 8th, 2004, 7:13pm » |
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Aetna, listens to the diamondhead guy? May the powers that be have mercy on the sufferers...fuckin' money grubbin, good for nothing worthless POS doctor.
Quote:| Aetna also is asking doctors to consider telling patients to try less costly, nonprescription drug alternatives such as aspirin, naproxen sodium, ibuprofen and combination products containing aspirin, acetaminophen and caffeine for treatment of acute migraine attacks. |
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They REALLY don't get it do they? I'll be damned...
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I would rather face the end with terror than terror without end. - (Deitrich Sawatsky 194?)
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Cerberus
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Re: Try this one on for size!
« Reply #18 on: Sep 8th, 2004, 7:16pm » |
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Quote:| Oh yeah, and in this free country, we're not allowed to buy less-expensive prescriptions from Canada. |
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Apparently you can in Illinois now...at least thats what I've been hearing.
Ramon
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I would rather face the end with terror than terror without end. - (Deitrich Sawatsky 194?)
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eyes_afire
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Re: Try this one on for size!
« Reply #19 on: Sep 8th, 2004, 9:53pm » |
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Quote:| WASHINGTON (AP) - Tampering with prescription drugs imported from Canada could be a way for terrorists to launch an attack on Americans, acting U.S. Food and Drug Administration commissioner Lester Crawford said Wednesday. |
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LMAO
Lester Crawford... apparently another Washington braniac. Where do these geniuses come from? Do they really think we're that dumb? Where does our food come from? Where do we get beef? We import so many things from Canada, Central America, and Europe. Why would a terrorist go through the trouble of tampering with pharmaceuticals when there are so many other easier and better ways to kill? Besides, they'd have to kill alot of Canadiens first. 
Sorry Carrie, I'm on the political warpath. 
--- Steve
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marfanoidus
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Re: Try this one on for size!
« Reply #20 on: Sep 9th, 2004, 11:28am » |
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Here's a link to an article regarding Illinois' desire to purchase Canadian pharmaceuticals:
http://msnbc.msn.com/id/5138379/
And here's one where the FDA calls Canadian drugs 'dangerous' (which would explain why so many Canadians are dropping off every day, geez)
http://www.cbc.ca/stories/2003/10/01/Consumers/fda_drugs031001
Just go to Google and type "fda americans buy canadian drugs" as the search ctriteria. You'll be inundated with articles.
But for everyone you read, just remember, the FDA answer[color=Maroon][/color][/b]s to two Gods - the AMA and the American Drug Companies. Its so f'in
[b]UNAMERICAN!!!!
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Sometimes "What doesn't kill you" makes you wish it had.
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Melissa
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Re: Try this one on for size!
« Reply #21 on: Sep 9th, 2004, 11:55am » |
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Those of us in Wisconsin are allowed to have some of our prescriptions filled by a Canadian pharmacy online. Not only was it on our local news, but they even give a web address to do so right here: http://www.drugsavings.wi.gov/
go figure...
mel
p.s. here is an online e-petition to Congress and the FDA: http://drugsavings.wi.gov/register.asp?locid=2&linkid=14
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| « Last Edit: Sep 9th, 2004, 12:00pm by Melissa » |
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