Thursday, October 11, 2007

Over the last several months, I have had an alarming number of patients being denied medications by their insurance companies or third-party administrators. These medications include heart, blood pressure, diabetes and asthma medications just to name a few. I have had patients in the pharmacy with severe asthmatic attacks being told they had to mail away for the medications and will receive it in 2-4 weeks. In August, New York State announced it was going to sue one of the nation's largest pharmacy benefit managers, Express Scripts, Inc., for pocketing as much as $100 million dollars that should have gone to the state. According to an AM New York article, Attorney General Elliot Spitzer said, "They were simply committing fraud." In the July Daily News, Harvey Wachsman wrote an article titled Stop the HMOs Before They Kill Some More. In the article, he explains how HMOs are not held accountable for any decisions they make.

Mr. Wachsman states, "As it stands now, they can get away with what amounts to murder, avoiding any meaningful punishment even when they make egregious and callous decisions that cost people their lives." It seems to me that it is far more profitable for an insurance company to let a sick person die than to save their life. So, what are we to do? The laws seem to favor the insurance companies. We have to get the laws changed.

Filing complaints is part of the answer. If you feel you've been wronged, complain! File complaints with your benefit administrator at work. Write letters to your elected officials and file complaints with the New York State Department of Insurance. This mess we are in did not happen overnight and is not going to be fixed overnight but we better start working on it soon.

... hey, look at the greatest medical system in the western world ...
... losers ...

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