Daily Archives: June 21, 2007

Medicine and the Role of the Insurance Company

I continue to be astounded by insurance companies that consistently deny patients who are deserving the benefits due to them.

Yesterday, I saw a 39 year old individual who had been building bridges since age 18 and had sustained numerous accidents, had suffered multiple infections, fractures, and other serious injuries.

In 2004, he sustained fractures to the cervical spine and subsequently developed severe psoriasis over his entire dermis. An infection that occurred while draining a canal for rehabilitation purposes in 1997 led to his original psoriatic outbreak. There was no history of that disease on a genetic or other basis.

Following his cervical spine fracture, he developed a generalized outbreak of psoriasis which has become progressively more severe. Multiple therapies, including numerous topical applications, oral medications and a series of UV therapies failed to alleviate his symptoms.

I have considerable compassion for this type of patient who must incur massive expenses to attempt to find a cure, not supported by aid from the insurance carrier, WSIB , etc. Governments, unions, and other organizations extract premiums, voluntary or enforced on a continuing basis. These premiums appear to be utilized to benefit management primarily and unless the insured is sophisticated and retains proper legal counsel to pursue their rightful objectives, they are in many instances denied coverage.  

This patient requires therapy to the cervical and lumbar spine, in addition to the extensive psoriasis, a project not without cost and again, not supported by the insurer, which should be the case. The psoriasis can be attributed to either infections, stress, or presumably both. No one knows and if anyone has solutions, I would like to hear them.

At any rate, I have initiated a course of intensive Low Intensity Laser Therapy treatment for his problems and feel confident that he will be returned to the “land of the living” soon. He has not worked in about a year and wants to return as soon as possible. Without treatment this cannot happen!

This case once again illustrates one of my pet peeves i.e. the lack of support and treatment provided to the patient in order to obtain medical services to which they are be entitled. The government sustained by extensive lobbies and contributions from the insurance companies, does nothing to resolve these critical issues which adversely affect the lives of thousands of citizens. There is definitely a need for legislative change!