Happy birthday, dear Levi. Sarah's husband is 31 years old today, and he is here spending the weekend with Sarah and with us. They were last able to be together while Sarah was still in the hospital and barely able to hold his hand. Now they have plans for dinner out for Levi's favorite meal - Japanese food! (One of Levi's grandmothers is Japanese)
As you may recall, Sarah will have a personal, point-of-care device to measure her PT/INR from a drop of blood much like someone with diabetes monitors his or her blood sugar. This is the test of the coagulation status or thinning of her blood that is crucial to the adjustment of her Coumadin dose. This device (a piece of "durable medical equipment") is covered by our private insurance plan. I obtained a letter of necessity (actually, I wrote the letter) signed by her cardiologist and submitted it about three weeks ago. A few days later I confirmed that the device had been authorized and should arrive in a few days. As of yesterday, no word about the device.
So here is the pathway through which this process must unfold... Sarah's private insurance company (CIGNA) contracts with another company (Care Centrics) which reviews the letter of medical necessity and decides whether a purchase should be authorized. If authorized, Care Centrics then contacts another company (Alere Home Care Systems) which actually procures the device from another company (the vendor). Alere Home Care also contracts with yet another company (are you keeping count?) that will provide the in-home training in the use of the device. Needless to say, once this process is launched, it can be a challenge for the patient to track down the bottleneck if the delivery of the product or service has been delayed. I count five companies (not counting the company that manufacturers the device that Sarah will use) involved in this seemingly simple process. That would seem to mean five CEO's, five sets of owners or shareholders, five profit margins to be assured, five sets of vice presidents, five marketing departments, five human resources departments, five corporate headquarters (none of which is within 500 miles of our home), and a partridge in a pear tree. And some think that our extraordinary national health care costs can be addressed in a multi-payer model.
Only five more days of IV antibiotics! One more dressing change, three more IV bag changes, hopefully the loss of the heavy satchel that Sarah hates to carry around. We will worry for a time about her having no antibiotics in her blood stream, about the loss of that probably false sense of safety. But the new reality, the new normal looms ever closer.
As you may recall, Sarah will have a personal, point-of-care device to measure her PT/INR from a drop of blood much like someone with diabetes monitors his or her blood sugar. This is the test of the coagulation status or thinning of her blood that is crucial to the adjustment of her Coumadin dose. This device (a piece of "durable medical equipment") is covered by our private insurance plan. I obtained a letter of necessity (actually, I wrote the letter) signed by her cardiologist and submitted it about three weeks ago. A few days later I confirmed that the device had been authorized and should arrive in a few days. As of yesterday, no word about the device.
So here is the pathway through which this process must unfold... Sarah's private insurance company (CIGNA) contracts with another company (Care Centrics) which reviews the letter of medical necessity and decides whether a purchase should be authorized. If authorized, Care Centrics then contacts another company (Alere Home Care Systems) which actually procures the device from another company (the vendor). Alere Home Care also contracts with yet another company (are you keeping count?) that will provide the in-home training in the use of the device. Needless to say, once this process is launched, it can be a challenge for the patient to track down the bottleneck if the delivery of the product or service has been delayed. I count five companies (not counting the company that manufacturers the device that Sarah will use) involved in this seemingly simple process. That would seem to mean five CEO's, five sets of owners or shareholders, five profit margins to be assured, five sets of vice presidents, five marketing departments, five human resources departments, five corporate headquarters (none of which is within 500 miles of our home), and a partridge in a pear tree. And some think that our extraordinary national health care costs can be addressed in a multi-payer model.
Only five more days of IV antibiotics! One more dressing change, three more IV bag changes, hopefully the loss of the heavy satchel that Sarah hates to carry around. We will worry for a time about her having no antibiotics in her blood stream, about the loss of that probably false sense of safety. But the new reality, the new normal looms ever closer.
Hallelujah on the end of IV antibiotics. May that transition proceed smoothly.
ReplyDeleteReally remarkable how complex the acquisition of that blood testing device was. Glad you have it though. Back in the day we had to take Danny in every few months for a blood draw. He was pretty good about it, but once the phlebotomists cried.