Prescription for Profits

When it comes to health insurance companies, I am torn. On the one hand, I am grateful for the services they provide, and had it not been for the excellent healthcare coverage that I pay for through my employer, the outcome of my recent cancer surgery might have been very, very different.

I cannot imagine having to go through such a life-changing event like that and having to worry about how to pay for the treatment.

At the same time, I am absolutely incensed at the audacity of my health insurance provider to presume to know what’s best for my health and welfare as I continue to heal.

It is ludicrous, in my humble opinion as a cancer survivor, for my healthcare plan provider to presume they know better than my doctors what is the best care for me as I continue to heal.

Case in point: I am on a therapeutic dosage (.25 regular strength) of a prescription medication that is popularly advertised for recreational purposes. The insurance company will only pay for four pills a month. In a 30-day month, that means I would have to go ten days without the prescribed dosage. I offered to buy additional doses at cost, just to make sure the medication is continuous. The pharmacy said to come back after the first of the month.

What are these people thinking?
Certainly not about my best welfare.

They're thinking bottom line.

One of the post-operative phenomenona that cancer survivors go through is the “What-if” game: You cannot help but ask yourself, “What if” the original diagnosis was wrong? What if you really didn’t have the cancer…was the procedure really necessary?

Here’s another what-if: What if there was a drug you could have taken to keep from developing the cancer in the first place? Would you take it?

What if there was a drug to keep your kid from contracting cancer—would you administer it? What if the government told you you had to give that drug to your kid?

I share these two anecdotes with you to paint the backdrop for an issue that is raging in Austin, where Gov. Rick Perry has returned from the mountain top with tablets of stone mandating all 6th Grade girls be administered a vaccine against the virus that has been proven to cause cervical cancer. The Legislature worked until the wee-hours this morning on this, listening to a host of concerned leaders, doctors and citizens.

Protractors have multiple issues with the proposed law, including the delicate problem of unknowingly administering the vaccine to pregnant pre-teen girls.

I know—that’s a whole other horror story.

But it raises a valid question—when you mandate such ministrations, you apply a blanket ruling to a very personal, individualized situation: While vaccinating against cervical cancer sounds like a great idea on the whole, on an individual basis, it’s not necessarily the best course from one individual to another.

The primary problem physicians have with this scenario is that it obliterates implied consent—where an informed patient (or her parents) are able to make an intelligent decision on whether or not to accept an HPV Vaccination.

Here’s a telling point that should not be overlooked: According to Angleton State Representative Dennis Bonnen, who has led opposition to the Governor’s planned mandate, the only people who testified in support of imposing such vaccinations were medical doctors who’ve been professional advisors in the past for Merck Pharmaceutical, the drug company making the vaccine. Merck would charge $360 for the course of three inoculations.

That reveals what is perhaps the true crux of this issue: Who stands to gain if the Governor’s mandate moves forward? Would opposition to the proposal be as contentious were the mandate to also include a requirement for Merck to subsidize the cost of administering the vaccines?

That would not dull the sting of having state government dictate how you live your life. But removing the lucre-quotient might help clarify the ethical issues, and point to a more reasonable solution. In matters such as these, following the money trail often reveals who the real drivers are.