I once heard an Arab proverb that goes something like this:
Good health is a crown on the heads of healthy people that only sick people can see.
I am luckier than most people, I think, because my day-to-day work acts as a solemn reminder of the above principle. Many neurological diseases are curable, or at least treatable; some are not. When people receive a diagnosis of stroke, or Parkinson’s disease, or dementia, for the first time, I often wonder what goes on inside their minds. Do they simply accept their new reality? Are there any regrets that they did not take better care of their health before?
One thing for certain is that the old adage ‘prevention is better than cure’ remains relevant to this day. To that end, I wish there were more support for people trying to do the right thing and look after their health proactively. Specifically, I wish there were additional financial incentives to help people go for regular check ups, and to ‘reward’ them for getting a clean bill of health.
Right now, the healthcare system is very reactive.
We wait until someone becomes ill, then scramble money and resources to try to get them better. We pride ourselves at the ability to do so, but this seems to me like a losing battle. The cost of treating many illnesses is skyrocketing! Soon, whatever we pay in terms of taxes or insurance premiums may no longer be enough to cover the cost of our treatments. So, what then?
One surprising thing I’ve learned in the last few months is how difficult it is to deal with insurance companies. Many patients have shared their frustrations with me at the fact that their claims have been rejected for seemingly random reasons.
Recently, I had a lady who came in with transient global amnesia, a condition in which someone becomes acutely unable to recall certain facts about their life and surroundings. As a doctor seeing this person in the emergency room, it is plain as daylight that they need further workup and admission to the hospital for close monitoring. The idea is to look for other, more dangerous, conditions like stroke or epilepsy and to prevent them from getting worse. If, after doing all the necessary tests, they are found to ‘only’ have transient global amnesia (which is, by definition, temporary) then we can breathe a sigh of relief.
Unfortunately, this lady’s insurance claim got rejected because she did not receive any intravenous medications apart from IV normal saline. I am utterly perplexed by this simplistic way of looking at medicine! Who on earth came up with this ridiculous idea that only conditions requiring IV medications justify admittance to the hospital?
What annoys me most is the lack of transparency here.
I have no way of knowing whether the person doing the rejection is someone with no medical background whatsoever or is simply a doctor following simplistic algorithms with rules like ‘reject all claims where the patient was not given IV medications’. To me as the treating physician, someone who is actually on the ground, looking after patients, it is infuriating that they have to gamble on this when deciding whether or not to be admitted to hospital. In other words, they have no way of knowing whether their claim (which is medically valid, IMHO) will be rejected for one of these lame reasons.
Look, I get it! There are many instances where people fudge the truth, or outright lie, in order to get bogus treatments approved by insurance companies. I understand that businesses have to be financially sustainable. But the annoying thing is that these rejections feel like they came from someone with no medical training and no interest at all in understanding the issue.
Nobody deserves to be treated like this. And certainly, after paying their insurance premiums diligently, you can understand the anger and frustration when genuine claims like these get rejected by a faceless entity.
I guess this is my long-winded way of saying: please look after your health properly. Even something like dementia has been shown to be partly preventable by tackling a few risk factors like high blood pressure and cholesterol levels. These things are easy to do, they are relatively cheap, and yet they confer disproportionate benefits for the future.
All we need to do is start somewhere…
Imran Idris 