today at work I was baffled that an insurance company was denying precert for a bone marrow transplant as ” all the criteria” had not been met. It is easy to sit behind a desk and click criteria on your computer, but when did we lose compassion for our fellow human beings? And I got an email that I should have pended a case to the doctor yesterday and not approved it. It was a 2 yr old with a hematocrit of 4.7. This is such a game. We are just pending cases to justify physician adviser salaries. And yes I am totally aware my job should not exist. However I do believe these patients need an advocate who will stand up for their best interest.

the word “healthcare” is a misnomer

I admit I don’t have all the answers, but healthcare in this country is a farce. And I say that as someone who has worked for several years in managed care. To believe these large corporations care about anything but the bottom line is so wrong. It makes no sense that someone behind a mahogany desk decides if you need your ER visit or that chemo drug that could save your life. A price is being put on people’s lives, and we are all accepting it. I know some people say they are not for socialized medicine because it could lead to death boards/ conferences. Are physician advisers that different??