Things can go wrong after you get health insurance
The doctor-insurer interface is harsh, it wastes time & money
Insurers are often penny wise and pound foolish, including public programs
I review four scrapes from the first 2 weeks of the New Year.
- A girl (E) discharged from our hospital after surgery for a brain tumor (craniopharyngioma) was readmitted for avoidable dehydration. Surgery injured the pituitary and hypothalamus, leaving her dependent on replacement hormones. However, she ran out of an important hormone, ddAVP or desmopressin.
What happened? ddAVP was a nasal spray. Mother ran out before the month was up. The pharmacy told her that they could not give her any more medication for 6 days. Lack of medication caused excessively dilute urine, dehydration and an expensive hospitalization. MediCal (Medicaid) pays for only a 30-day supply. The pharmacy had three choices- 1. Give her some of this expensive medication and lose money (at least $100), 2. urge mother to call the child’s physician immediately (that might not have worked as mother met many different specialists while hospitalized and had no idea who was in charge). 3. throw up their hands and say “we’re sorry”. They choose #3.