[Texas-T]

I think we all agree that there is problem when insurance companies can routinely deny treatments that are FDA approved and recommended by a reputable doctor. We can argue till we’re blue in the face over the solution, Jeff and I do this often as we support different political parties. The one thing that unites us though is that we want people to know that this is happening, to raise awareness so that it can be addressed. Regardless if it’s Oprah, GMA, Michael Moore, or politicians that take up the issue; if we get people talking hopefully some good will be found. Perhaps our focus should be awareness of the problem at this juncture. Once solutions are suggested by individuals, we can evaluate the pros and cons’s and better choose who to align ourselves with.

I had my ADR a year ago and I still cry when I think about how awful things were before the surgery, the hopelessness and the uncertainty caused by the insurance company. I was able to obtain coverage fairly quickly and sometimes this makes me feel guilty because there are so many people on this board who need the surgery just as much, if not more than I did, and they are forced to endure a truly screwed up process.

ADR will never become the standard of care in the US unless insurance companies start paying. Surgeons will not get the experience to perform the surgery and little advancement in the procedure will be made because people cannot afford the surgery or endure a fight with the insurance company. If ADR was covered by more insurance carriers who knows what advancements could be made; a surgeon might find newer and better ways to perform the surgery, they may even find ways to help individuals with more complicated cases or even failed ADR. The payment issue isn’t just about our individual cases; it’s about so much more.