Many years ago, I saw a news report on a socialized health care system somewhere in Europe. The report discussed that, in this system, diseases are ranked by the potential success of treatments, and, the higher ranked your disease, the more likely and quicker you are to get treatment. Never mind that you might still be a contributing member of society, paying taxes, and taking care of a family. One shot showed the end of the list, and I remember the shock when I saw Crohn's disease near the bottom. Every time some politician discusses socialized health care, I remember that list.
Recently, I've gotten a preview of what my life might be like under socialized health care. For my latest Crohn's recurrence, my doctor @ UAB has prescribed Remicade, a biologic that is administered via IV infusion. When it works, it's a dream. When it doesn't, the side-effects, in rare cases fatal, can be a nightmare. The treatment is also outrageously expensive; infusions, done every 8 weeks, cost thousands of dollars. Due to the high cost of treatment, insurance companies, mine included, have developed detailed policies specifying under which conditions Remicade treatment will be covered.
After getting conflicting information from my insurance company customer service reps, I finally got a copy of their Remicade policy. They have strongly suggested I have my doctor apply for a predetermination, which he's done. Their decision could take up to 30 days.
So, here I sit, waiting for someone at my insurance company to second guess my doctor. (BTW, my doctor is an expert in Crohn's disease; that's why I travel two hours, one way, to see him.) This someone, who has never seen me, gets to decide if I'm sick enough to have Remicade. And, while I wait, the medicine I'm taking isn't stopping the disease; it is only suppressing the symptoms. If they don't pre-approve the drug, I won't be able to afford to take it.
I imagine this is something I'd have to get used to under socialized health care. Instead of faceless insurance company reps, my health care decisions will be made by government bureaucrats, who have never been known for speedy, rational decision making. And how long before those decisions will be based on factors other than medical necessity? Will someone decide that my after-treatment quality of life won't be good enough to justify treatment? Or will the fact that my disease can never be cured make me too big a liability?
In any case, I'm still waiting to hear from the insurance company. Maybe I'll get in a few infusions before someone gets elected and screws up the health care system more than it is already.