Eventually my surgeon was barred from treating MS patients by his insurance company.
A slightly different angle than what I was alluding to last night in my post about the possibility (despite the accepted treatment of venous occlusions as a known pathology with it's own code) of insurance companies in the future "tightening the belt" so to speak, until as such time that CCSVI gets it's OWN code, or is accepted to be treated industry-wide under the codes already in existence for IJV's.
One person answered that they were given what amounts to an ultimatum by their insurer, drugs, or procedure, but not both.
Now if I gather what you are saying, it was the Dr's own insurance (i.e. malpractice insurance, which is a huge factor in any office) put the kibbosh on him doing any more procedures?
That's yet another angle I had not considered.
Insurance companies are corporations. They aren't there for your health, my health, or any other health besides the bottom line. Think we all get that.
Insurance companies always work off what is best for the bottom line, and I offer for any given quarter
To have an onslaught of 50-100k operations for (estimated) 2-500,000 patients (assuming a certain % want to get treated, can find treatment, have insurance, and identifiable and treatable conditions), would put a serious cramp on the bottom line, and I understand the logic is, "well DMD's cost x dollars over lifetime". Yes, they do.
Spread out over a lifetime. Palatable. Plus insurance rarely if ever pays the going rate. Bigger the company, better their negotiating power to drive costs down via volume. (This is how Costco strongarms it's suppliers to get the best price).
So let's just go 50k, testing to treatment to follow up, for say half the MS'ers in America only. 250,000 x 50,000= 12.5 BILLION dollars of outlay in a very short period of time. And that's just a thumbnail with round numbers.
Let's say every person in the US with MS, and the count of 500,000 I think to be very outdated and low, but lets just bump the example above up to 75% of the 500,000 = 375,000x50k a pop= 18 billion, 750 million dollars.
That is a substantial, humongous outlay of money in a short period of time, with the presumption that say only 20-40% of those treated will discontinue their meds.
Now this may appear to be mere moaning and groaning and negativity, but for the rest of us in the real world, life is lived by the numbers game. Insurance doesn't lower my rates on my auto because they like me, think I'm cool, or in need, or anything else. I played the numbers game well, didn't have any accidents, or tickets, for x years, and the actuarials are pretty heartless and cruel if one has the opposite.
So, now my question is, besides the insurance company angle, which many will say, including me, "well my insurance covered it, no problem", at what point in the future will they do the simple math I did above and balance out their inclusion/exclusion criteria to effect the best condition for their corporation, OR, attempt to spread out those big numbers over the longest period possible, so the CEO doesn't get canned when the quarterlies (which most corps live and die for) show a substantial drop?
And at what point will insurers for malpractice step in and say, "no vein treatments for any MS patients or you lose coverage?".
Things to keep in mind in the times ahead, just because all seems cut and dried with the 50%+ stenosis treatment paradigm under established codes, doesn't predict the future, it's just a good guess.