thoughts on insurance/doctors/medicine

first, i will try to give you the brief version of my story...

i am 29 now. when i was 18 i herniated a disc and was diagnosed with degenerative disc disease..for a couple years i was bounced around from various doctors. different neuros and chronic pain specialists. at any given time i was on percocet/vicodin/avinza(morphine sulphate)/actiq(fentanyl lozenges)/duragesic patches(fentanyl in a patch)/ms contin, and a variety of muscle relaxors.
in 2001 i ended up having a fusion done. they replaces L5S1 with a piece of bone from my hip, a cadaever bone, and a titanium cage. they went in through my belly to do this. i was in the hospital for 5 days.

for a couple years after that, i went through ups and downs with pain levels and pain spikes, various meds and side effects.


that is the background. now here is where my problems come in.
all of these medicines have side effects, some more severe than others. vicodin for example attacks your liver(not actually the vicodin or 'hydrocodone' but the loads of acetomenophin they put in it).. so after various drugs, therapues, epidurals, etc, i have been diagnosed with a 'failed back'...i was recomended for an artificial disc replacement. i was refered to the specialist to talk about it and set it in motion. this gives you more motion back there. thing is, in the US it is still 'experimental' according to my insurance company. it has only been approved for a year or two or something so they won't cover it...they have been doing it in europe for years....at the time we were talking about it, there were only a few hundred or a thousand people or something like that that had had the surgery but there were many success stories.
so, no surgery. now, my pain doc puts me on fentanyl patches but i get violent side effects. taken off that and put on avinva with the actiq as a breakthrough med...it was a lozenge. hands down, the BEST pain med i had had in my entire time of dealing with this....we're talking like 7-8 years....things are going well. i get a note from my insurance company telling me that they are pulling the entire class of narcotic analgesics off my plan...i have 2 more months...
so as you can guess, back to pain spikes, so, i get put on vicodin again. i am taking a LOT of vicodin....cut to quite some time later, i am getting blood work done....my liver functions come back abnormal. so, i get mote tests and ultra sounds cause they think liver cancer or hep c...clean on all counts.....turns out, it was the vicodin attacking my liver.
so now, no vicodin.

i go to the neurosurgen to talk about another fusion but he says that the success rate is not good. the chances of me coming out the same are much greater than me getting better. fine i say....i am an adult, i take the risk...doc says no.
must be against his moral code or something.....don't know why he mentioned it to me.

now i am back to the point where i am about rock bottom. i have medicines but they don't work...now i am starting to have 'other' problems.


so, the insurance company IMO, is causing my pain...i'm thinking A, it's cause it is expensive and don't want to pay for it and/or B, all the crap you hear on the news about those types of 'dangerous drugs' is causing them to crack down...
i just can't believe this is even possible.
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now, this is where some/most might not agree with me. i am sitting here with a disease and i can't get proper treatment for it..my father in law has limb girdle muscular distrophy and he can't get certain supplies and meds he needs cause insurance won't pay for it...he is almost wheelchair bound. now, i know mine is not severe as his BUT, it bother me when i see people like he and i that are born with a disease or develope it through no fault of our own...'accidents' maybe. then, we can't get proper treatments.
now, what else do i see. i see people who voluntarily smoke 2 packs a day for 35 years then get ling cancer, and the insurance pays for everything.
my wife is a pt and she works in a home where she has a lady that is in her 40's. she was an alcoholic and it tore her liver up and her throat...she can NOT eat food. it's like a tube or an iv. she chews food and spits it in a bag cause she likes the taste...nobody made her pick up the drink, but you can bet the insurance company is paying for everything.
there are many, many other instances of people getting their medical problems covered. problems they created themselves and probably millions of people out there that can not get treatment for an ailment they had no control over.
it's pretty saddening man..

While the medical establishment is far from perfect, the advances in life expectancy and the eradication of many diseases can clearly be linked to medicine so I am hesitant to paint the whole medical world with the same brush.

even though i can't get it cause insurance won't pay for it, i am a fan of modern medicine...i was more focusing on insurance companies paying for a 30 year smoker to get his cancer treatment, but i can't get surgery.

How much insurance shopping have you done?

I don't know if obtaining a new health carrier is a viable solution. Most of the time health insurance companies won't cover pre-existing conditions.

Many states have Insurance ombudsmen to deal with issues that might arise between patients and their insurance company. If there is no ombudsman, you still might be able to contact the governmental agency in your state that monitors your insurance company. Your doctor might have to go to bat for you on this one but occasionally, an insurance company will cede to the advice of the doctor on particular medications if it can be shown that there are no other viable alternatives.

Just a thought and my two cents