The state of New Jersey still allows healthcare providers to override orders from doctors. Despite lacking a medical degree, insurance companies can dictate to doctors what medications to use on patients first. The insurance companies actually have lists of medications for certain medical conditions (which for some reason usually are chronic pain conditions). These lists are generated based on profits and losses. They are based on financial reasons. They are based on closed-door deals the insurance companies have with different pharmaceutical companies. The one thing that is NEVER take into consideration when generating these lists is what is best for the the individual patients.
You might be thinking what’s the big deal. So a patient tries one or two medications first. Maybe those will work; maybe they won’t. However, think about the current healthcare insurance environment. People are shopping around for the best deals. That means people can be switching plans and companies on a yearly basis. Patients would have to prove EVERY TIME THEY CHANGE PLANS that they have already tried their new healthcare insurance’s approved medications and failed to receive relief from them. We all know the red tape and bureaucracy that exist in large companies. It can take weeks or months to finally get approval to fill a prescription that the patient has had for years. If it is a medication taken daily, the risk of withdrawal is not only a potential side effect of Step Therapy ( also known as Fail First), it is a given. Who will care for a patient going threw withdrawal? The Emergency Rooms. It is far more expensive to go to an Emergency Room that to simply be allowed to take a medication the doctor has been prescribing for months or years.
The other problem with this system is that it supersedes the doctor’s medical opinion with the healthcare company’s financial opinion. The doctor supposedly has years of training and continuing education to back up his or her recommendations. What does the insurance company have? A handshake and price cut from their preferred supplier.
There is currently a bill winding its way through the New Jersey Legislature. It was introduced on June 18th, 2012. Where is it now? It is lounging out with the Senate Budget and Appropriations Committee. It has not even been mentioned since January 6th of this year. How long does it take to provide needed relief to thousands of New Jersey citizens?
I challenge the elected officials of New Jersey to dare to do something great.
As an American citizen, I am disappointed in our federal government. There are no words descriptive enough to tell you just how disappointed I am. Congress was on the verge of greatness in December, but they wasted it. Instead of becoming legends in American politics, they took the cowards way out. They had the power, and still do, to make significant changes in this country for everyone – particularly those of us who depend on government “handouts” (and let’s face it, we all do in some form or other). Whether it be Medicaid, Medicare, Social Security, vital research done by the National Institute for Health or National Institute for Mental Health, all of us with chronic illnesses rely on the government to lead the way for making our lives better. Our elected leaders have the power to improve our lives through the bills they pass in Congress. They have the power to stimulate the economy and lighten the burden on those less fortunate. They have the power to improve healthcare for the disabled, the elderly, and children. They could do so much for this country, but they don’t. They refuse to work together. They cater to the lobbyists and big businesses. They lose sight of what their true purpose is in Washington, DC. I read somewhere that certain members of Congress have said they will oppose any bill that could make the President look good. The number of bills that have been passed (or even voted on) in the past 2 years is about half the normal number of bills Congress votes on. This is a disgrace! Our political culture is a reflection of the declining care we provide one another. It is a reflection of our society’s focus on the bottom line instead of helping people. Shame on you, Congress, for choosing a short-term bandaid solution over REAL change in our country. Shame on you for forgetting the real reason you were elected. Shame on you for letting America down. This type of politics can only lead to America’s ruin…