Comments on: Just cutting and pasting, people http://blogs.philadelphiaweekly.com/trouble/2007/06/26/just-cutting-and-pasting-people/ A blog about mental health Fri, 20 Nov 2009 05:55:48 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Larry Parker http://blogs.philadelphiaweekly.com/trouble/2007/06/26/just-cutting-and-pasting-people/comment-page-1/#comment-2105 Larry Parker Thu, 28 Jun 2007 00:48:56 +0000 http://trouble.pwblogs.com/2007/06/26/just-cutting-and-pasting-people/#comment-2105 Without meaning to exonerate the "drug pushers" (and in full disclosure, I actually had a good friend at one point who was a pharma rep, albeit not for psychopharmalogical drugs), IMHO this is more an insurance industry problem than a Big Pharma problem. In my experience, and those of other mental health consumers I know, insurance companies are overjoyed to pay for prescriptions -- even those whose list cost (which, granted, the insurance companies don't pay) is frighteningly high. Yet they are penurious to a fault in refusing to pay for more than one therapy and psychiatry visit per month -- if they pay for that. Do the math. If more focused therapy and psychiatric monitoring, every two weeks instead of once a month, could help a consumer drop from, say, 5 or 6 medications to 2 or 3 (and let's say one of the three dropped is the most expensive medication), THE INSURANCE COMPANY WOULD PROBABLY SAVE MONEY, or at worst break even. (It's not like those infamous "usual and customary" rates for insurance companies don't apply for doc visits as well as prescriptions.) How self-defeating is that for the insurance company -- let alone the consumer?! Without meaning to exonerate the “drug pushers” (and in full disclosure, I actually had a good friend at one point who was a pharma rep, albeit not for psychopharmalogical drugs), IMHO this is more an insurance industry problem than a Big Pharma problem.

In my experience, and those of other mental health consumers I know, insurance companies are overjoyed to pay for prescriptions — even those whose list cost (which, granted, the insurance companies don’t pay) is frighteningly high.

Yet they are penurious to a fault in refusing to pay for more than one therapy and psychiatry visit per month — if they pay for that.

Do the math. If more focused therapy and psychiatric monitoring, every two weeks instead of once a month, could help a consumer drop from, say, 5 or 6 medications to 2 or 3 (and let’s say one of the three dropped is the most expensive medication), THE INSURANCE COMPANY WOULD PROBABLY SAVE MONEY, or at worst break even. (It’s not like those infamous “usual and customary” rates for insurance companies don’t apply for doc visits as well as prescriptions.)

How self-defeating is that for the insurance company — let alone the consumer?!

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