[LBP]

Did you see the story on Oprah? I'm not asking in general to send pleas to her...like others have before. This time it's an invitation by her to discuss the craziness of health care. Yes death cases will get more time, but If there is a large group mobilized....back injuries have a HUGE impact on the productivity of the work force! The prevelence of our issue alone should give it notice. Esp since so many of us would not be applying for disability, taking so much time off from work, or not
working at all because of back problems!

Plus don't you think some of the horror stories out of Stenum might get their attn for a number of reasons: 1, US citizens are being preyed on to get treatment at an undesirable facility because they cant get their ins co to pay for the service in our own country 2, now these patients are having a difficult time even finding a dr to touch them after having problems from a foreign surgery!

Then contrast those experiences with those with huge successes from local surgeons as well as the other Germany locations. Then point out the hypocrasy it is that companies like BCBS could deny most of their insureds coverage but be forced to pay for a fed employee with BCBS. That is arbitrary and bad faith in my mind and should be an issue raised.

Plus the crazy issue how fusion is a "gold standard" yet it's never undergone rigorous clinical trials that ADR has, plus the stats on non fusion and secondary surgeries for fusion is pretty dam high.

As stated by Medicare in it's decision memo regarding ADR policy:

"Millions of Americans suffer from pain-related problems (Salovey, Seiber et al. 1992). Low back pain is a common condition, with sixty to eighty percent of U.S. adults afflicted at some time during their life (U.S. Preventive Services Task Force 1996).
***
In general, the social and economic impact of chronic pain is enormous (Salovey, Seiber et al. 1992).

***

Fundamental problems plague the study of spinal fusion, including the lack of definitive methods to confirm a solid fusion, a weak association between solid fusion and pain relief, and the placebo effect of surgery for pain relief.” For patients, improvement in short term pain and function from fusion is unacceptably variable, and long term results remain controversial. In spite of the many difficulties and ambiguities, the use of spinal fusion surgery in the United States is rapidly increasing (Deyo, Nachemson 2004). "


All of our issues are important to the Oprah discussion opened up by Michael Moore's new documentary. Mr. Moore's issue is that it's a profit driven industry and that's why insurers are constantly denying coverage claiming things are "investigational and experimental" in spite of what our treaters are saying are absolutely necessary. He points out that we would never consider it reasonable for the fire dept to turn on profit on saving lives...why should our health care turn on huge profits to CEO's? There's no insurance company looking out for our best interest medically protecting us....it's all political and economics...and that is what part of this Oprah discussion is about.

PLEASE DON'T BE DISCOURAGE BY PREVIOUS ATTEMPTS TO GET ADR IN THE SPOTLIGHT. MICHAEL MOORE MAY HAVE JUST DONE US A HUGE FAVOR BY OPENING THE DOOR TO A DISCUSSION ON OPRAH BECASUE THIS DOCUMENTARY WILL LIKELY BE A HOT TOPIC IN THE UPCOMING ELECTIONS.

The short term cost of the disc is one hinderance in getting coverage over fusion. I could have been approved a 2 level fusion but not an ADR? How is that not a financially motivated denial!! The only difference between the two surgies is a vascular surgeon and the cost of the discs. If a treater recommends this surgery based on age, life style, career, kind of injury, etc...shouldn't the insurance company be forced to cover the procedure. That's the point.

When Mr. Moore was on Oprah, she specifically asked people to send comments after seeing his documentary (which is supposed to come out later this month). She had one of her "ah ha" moments about socializing medicine and want's to hear others comments and also experiences with the heath care system.