The ultimate insurance company cost savings (Let the Patient Die)

The Heart Scan Blog ^ | September 29, 2010 | Dr. William Davis

[Future Useless Eater]

The ultimate insurance company cost savings

I had a very disturbing conversation with a physician who is employed by an insurance company last week.

I admitted a patient in the hospital for very clear-cut reasons. She is one of my few non-compliant patients, doing none of the strategies I advocate--no fish oil, no vitamin D, no correction of her substantial lipoprotein abnormalities, not even medication. Much of this was because of difficult finances, some of it is because she is from the generation (she is in her late 70s) that tends to ignore preventive health, some of it is because she is a kind of happy-go-lucky personality. So her disease has been progressive and, now, life-threatening, including an abdominal aneurysm near-bursting in size (well above the 5.5 cm cutoff). The patient is also a sweet, cuddly grandmother. I have a hard time bullying nice little old ladies.

While she was in the hospital, the social worker told me that her case was being reviewed by her insurer and would likely be denied. Their medical officer wanted to speak to me.

So the medical officer called me and started asking pointed questions. "Why did you do that test? You know that she's not been compliant. Are you sure you want to do that? I don't think that's a good idea." In other words, this was not just a review of the case. This was an opportunity for the insurance company to intervene in the actual care of the patient.

Then the kicker: "Have you considered not doing anything and . . . just letting nature take its course?"

At first, I was stunned. "You mean let the patient die?"

Expressed in such blatant terms, while he was trying to be diplomatic, made him back down. "Well, uh, no, but she is a high-risk patient."

Anyway, this was the first instance I've encountered in which the insurance company is not just in the business of reviewing a case, but actually trying to intervene during the hospital stay, to the point of making the ultimate healthcare cost savings: Letting the patient die.

Unfortunately, never having had an experience like this before, I did not think to record the conversation or take notes. I am wondering if this is an issue to be taken up by the Insurance Board . . . or is this a taste of things to come as the health insurers fall under increasing pressure with the legislative changes underway?

[Future Useless Eater]

This will be the tip of the iceberg as insurance companies are 'nudged' by ObamaCare to just let 'boomers' die

[Future Useless Eater]

Dr. William Davis

Plaque is the stuff of coronary heart disease. It is CONTROLLABLE, it is STOPPABLE, it is REVERSIBLE. But you must be equipped with the right information on diet, nutritional supplements, and hopefully the avoidance of medication. This is the blog that accompanies the Track Your Plaque program (www.trackyourplaque.com). Nothing here should be construed as medical advice, but only topics for further discussion with your doctor. I practice cardiology in Milwaukee, Wisconsin.

[ClearCase_guy]

THESE are the death panels.

I heard someone just the other day scoff at the "mythical death panels" but they are real. What is a myth is the image that the Left has built up in their own mind -- a "death panel" consists of some number of doctors and bureaucrats sitting at a long table, reviewing medical files and sorting them into Life and Death piles. That's a myth. That will never happen.

But what is already happening are financial decisions at insurance companies, with pressure applied at hospitals, about medical choices and payments that will (or will not) be made. It's quiet and it's deniable. But it's a death panel.

Not a myth. It's here. Right now.

[Haiku Guy]

Just wait until the power of the state is behind them. They won’t be asking, then...

[Future Useless Eater]

ping to death panels

[listenhillary]

It doesn’t look like she is serious about fending off death.

Do we go out of our way with non compliant patients who do nothing to help their situation? Do we force unwanted care on an individual?

Is there an inflexible play book that says that all efforts must be expended to prolong a life? Or do the patient and doctor get a say in the matter. I missed reading where the patients wants and needs were asked in this case.

If you don’t want insurers having input into the end of life process, fund it with your own money.

There are infinite ways to spend multi million dollars in care to buy time to prevent death for months/weeks/days. If we are going to use government power to make all insurers spend multi million dollars for end of life care, insurance will be priced out of reach or will simply go out of business.

Flame away.

[GailA]

WOW, Democrat Jokes That Seniors Should Be Denied
http://www.freerepublic.com/focus/f-news/2598612/posts

[ExTexasRedhead]

Letting boomers die was one of the intended designs of the DeathCare bill. Anyone over 55 not seeing that truth is a fool. Welcome to the next Holocaust. Never Again is here. Thank the Imam and all Democrats and bend over and kiss your rear goodbye. Repeal, immediate repeal, is the only cure. If not, We The People will be removing more Ruling Class politicians ASAP. That message better get transmitted to every elected politician very very loud and crystal clear.

[Vigilanteman]

What do you suppose would happen if these same standards were applied to people who voluntarily stuffed cocaine up their noses or gays who engaged in unprotected anal sex with multiple partners?

[BobP]

Letting boomers die was one of the intended designs of the DeathCare bill. Anyone over 55 not seeing that truth is a fool.

-------------------------------

Obama bamboozled millions... gave them the old 'okee doke.'

Bowing to foreign leaders, hanging out with terrorists and racists, pushing for amnesty for all illegal aliens in the country, nationalizing health insurance, nationalizing student loans, nationalizing two car companies, setting pay scales in companies not controlled by the government, regulating CO2 emissions, and on and on...

He is a menace to our nation and damn near everyone living here.

Time to end the experiment brought on by the piss-steam media and the Bush derangement crowd.

[Matchett-PI]

"If you don’t want insurers having input into the end of life process, fund it with your own money.There are infinite ways to spend multi million dollars in care to buy time to prevent death for months/weeks/days. If we are going to use government power to make all insurers spend multi million dollars for end of life care, insurance will be priced out of reach or will simply go out of business."

EXACTLY. BTTT

When one uses other people's money (taxpayers /the government) to fund his "healthcare", he is giving them the power to tell him how to live (or die).

Like it or lump it... it's true.

[listenhillary]

If you want a special rider on your insurance that covers unlimited end of life treatment, I’m sure there is an insurer that will sell it to you.

It might cost as much as a new car every year to pay for it.

[kalee]

Posted to my Facebook page

[dagogo redux]

I agree. I also think those who believe this woman should be saved from the deadly results of her purposeful non-compliance with medical recommendations by spending large sums of money should spend their own money on her.

The doctor could pay out of pocket for the tests and treatments for this cuddy free spirit, could he not?

Those Freepers here who think someone ought to pay for her care could pony up as well, maybe start a fund or charity to keep her alive a while longer.

Perhaps her family and friends could chip in the costs to repair her self
destruction.

It eludes me why this should be the financially responsibility of others who pay into her insurance plan, or the taxpayers.

And yes, the same goes for all the rest of us. If we are not responsible enough to do the heavy lifting to keep ourselves healthy, I have no idea why any of us should feel so entitled that we expect or demand others to sacrifice the fruits of their labors for us, especially those forced to do so involuntarily.

[dangerdoc]

Triple A surgery is not a benign intervention. There are some that would argue against surgery independent of the cost.

[Tax-chick]

I agree. Some people aren’t willing to do anything to prolong their own lives. They should be allowed to make that choice, in my opinion.

[SunkenCiv]

Thanks Future Useless Eater.

[Future Useless Eater]

A follow-up from the doctor...

September 30, 2010

Dr. William Davis said...

Although I was frustrated by this (very nice) woman's inability or unwillingness to follow a preventive effort, my primary concern here is the aggressive effort to intervene by the insurance doctor.

This is not the only instance of the clamp-down they have been exerting; we've been seeing it in many others ways. For instance, for most of the routine tests we run, including lab work, we have to get the okay of the insurer. Sounds fine, except my staff spends hours every day on the phone telling the insurance person things like "Their last HDL was 67," or nonsense that has nothing to do with justification of testing.

[dangerdoc]

I agree, this should be handled by a group of experts such as surgical grand rounds rather than by the insurer.

On the other hand, is a major surgery an appropriate choice if you have a woman of nearly 80 unwilling to do the simple things to manage her disease?

There is a significant chance of surgery killing her long before the AAA.

In this situation, she may be much better off with aggressive medical intervention and close follow up with a surgeon familiar with her case.