Tin foil hat time

I love Saturday mornings and C-SPAN. The absolute certainty that in any 10-minute period there will inevitably be a phone call from someone with a Southern accent ranting about Obama mind control, the evils of socialism, and the Democrats wanting to control every aspect of our lives is oddly comforting.

This morning, of course, they're talking about health care reform. And once again callers are focusing on "choice" and preventing bureaucrats from coming between them and their doctors. What choice? Unless you're one of the extremely fortunate few, i.e., independently wealthy and paying cash for everything, you're either dependent on what your insurance company tells you to do or or, if you're uninsured, keeping your fingers crossed you stay healthy. Anyone who thinks the insurers don't control what treatments you receive and when is living in a fantasy world.

I've gotten to witness that (again) this past year. In April 2007 I went for the annual physical, the one that included a full range of blood work (lipid levels, white and red cell counts, etc) and a chest x-ray. The radiologist spotted a possible aortic ectasia on the x-ray, so my primary care physician decided to do a cardiology consult, complete with echocardiogram. She had to give a reason for the echo, but said she could not use the aortic ectasia as the reason -- Blue Cross would not pay for it. She had to use either elevated cholesterol or high blood pressure. Or both. She went with the lipids.

Personally, I would have thought the aortic ectasia would be a damn good reason for further testing in and of itself, but my gold-plated insurance bean counters disagreed. And because my PCP put high cholesterol (for the record, mine usually runs right around 2o5, which is just barely over the line -- and I have a really good ratio of "good" to "bad") in the request, it colored the interactions with the cardiologist. He's busy worrying about clotting and blockages while I'm trying to get him to think about the semilunar valve and possible aortic regurgitation. In short, I've spent the last 18 months being treated for one thing while the other thing that does have the potential to kill me is being ignored. Thank you, Blue Cross.