Yesterday I got a call from my brother who is awaiting surgery for a severe sinus condition, causing him to miss weeks of work and live with excruciating daily pain. This has been going on for over two months now. He was irate because his doctor told him that it would take 10-30 days to get pre-authorization approval from United Healthcare for the surgery, and they couldn’t schedule the $7,000 surgery until then. He had a choice, of course, to pay out-of-pocket, which isn’t going to happen. He couldn’t believe that insurance medical professionals have the final say over whether his surgery would be deemed appropriate to be paid for by the insurance carrier — so much for the patient/physician relationship reigning supreme or the big monthly premium payments getting you quick access to care.
The worst part of the wait, besides the pain and having to go on disability, is that he has been prescribed a potent antibiotic, Prednisone and Oxycodone for the pain. The only thing that seems to alleviate any of his symptoms is Oxycodone, which is addictive and can have serious side affects. Prednisone is no picnic drug either.
Inefficiencies and cost are closely related, especially in healthcare. They also are burdensome to people trying to manage their health, and who get caught in bureaucratic loopholes. The CAT Scan my brother had revealed that he would need surgery regardless of the drug treatment regimen. He’s been told his recovery time will be minimal and he’ll feel better quickly. In the meantime, he’s waiting on his couch in the dark for the phone to ring. I’m hoping it happens before he loses his mind.
