Jennifer Esposito is just one of the ever-growing list of celebrities diagnosed with celiac and/or living a gluten-free lifestyle. Diagnosed with celiac in 2009 after an apparently long struggle with the illness, she has become a vocal advocate for celiac awareness. She has a blog and has started a foundation -- called the JW Foundation-- to fund research, advocacy and awareness. And apparently she was recently effectively fired for having the disease.
Showing posts with label Costs. Show all posts
Showing posts with label Costs. Show all posts
Saturday, October 27, 2012
Monday, April 19, 2010
F&*K*#&$!!!
Damn you people on the train, with your germs and your sneezing and your failure to cover your mouth! Ok, so maybe its not the best idea to lick the poles on the metro (my toddler, not me). Lesson learned. Thank you. Again, my household has been struck down.
For the first day, I thought it was allergies. Really, really bad allergies. But no. Is it just me or do celiacs get sick all the time? I guess it makes sense, right? Compromised immune system and all? I actually thought that once you were on the diet and no longer testing positive, you were "normal". This does not seem to be the case. I think, in the last three months, I've been sick--with a cold, flu, etc.--at least three times. That's a LOT! And I'm not a good sick person. I'm whiny, pathetic, irritable, cranky. (When I'm sick!)
The icing on the cake is that, while food is increasingly labelled gluten-free, medication is not. Apparently, there are proprietary issues; pharmaceutical companies have resisted any attempts to require allergen labeling because they fear that their super-secret formulas will be stolen. Somehow. From the indication that it has wheat in it. Because the presence of wheat is clearly the missing link. Anyway. Suffice it to say, it can be tricky to determine whether a medication has gluten in it.
Take Zyrtec, for example (I thought I had allergies). Google it. Some sites say "zyrtec has gluten." Others claim that calls to the company have assured them that the medication is safe. Still others suggest that some dosages are fine, while others are dangerous. Calls to the company--typically the go-to measure of last resort--were, frankly, no more helpful. I got transferred around.
I don't have a great suggestion here. I'm worn down. Really, I don't understand the logic behind not mandating the drug companies label the presence of common allergens. I'm sure I'm overly cynical, but I have a fair certainty that effective lobbying has played a role. What can you do to fight that?
Meanwhile, it's late. I'm sick. I need to go to bed.
For the first day, I thought it was allergies. Really, really bad allergies. But no. Is it just me or do celiacs get sick all the time? I guess it makes sense, right? Compromised immune system and all? I actually thought that once you were on the diet and no longer testing positive, you were "normal". This does not seem to be the case. I think, in the last three months, I've been sick--with a cold, flu, etc.--at least three times. That's a LOT! And I'm not a good sick person. I'm whiny, pathetic, irritable, cranky. (When I'm sick!)
The icing on the cake is that, while food is increasingly labelled gluten-free, medication is not. Apparently, there are proprietary issues; pharmaceutical companies have resisted any attempts to require allergen labeling because they fear that their super-secret formulas will be stolen. Somehow. From the indication that it has wheat in it. Because the presence of wheat is clearly the missing link. Anyway. Suffice it to say, it can be tricky to determine whether a medication has gluten in it.
Take Zyrtec, for example (I thought I had allergies). Google it. Some sites say "zyrtec has gluten." Others claim that calls to the company have assured them that the medication is safe. Still others suggest that some dosages are fine, while others are dangerous. Calls to the company--typically the go-to measure of last resort--were, frankly, no more helpful. I got transferred around.
I don't have a great suggestion here. I'm worn down. Really, I don't understand the logic behind not mandating the drug companies label the presence of common allergens. I'm sure I'm overly cynical, but I have a fair certainty that effective lobbying has played a role. What can you do to fight that?
Meanwhile, it's late. I'm sick. I need to go to bed.
Wednesday, April 7, 2010
Think Twice About The Tea Parties
The health care bill has passed. For that matter, the health care bill passed, was effectively castrated, and passed again. There are uproars and...tea parties. The ironically named "tea parties" (for who can imagine something so completely counter to the conservative, polite discourse that occurs at most tea parties?) are being held in protest.
To what? Well, to be honest, I am not entirely sure. Taxes increasing to pay for it? (Do they all live in DC where you really do have taxation without representation?) Illegal immigrants with no current coverage will suddenly have access to doctors, thus decreasing the availability of those doctors for citizens? (No, seriously, I heard that one. The lack of basic humanity that must exist to say something so egregious with a straight face...) I do, however, know one thing for certain: there are at least 1 out of approximately every 133 people in the U.S. who should be thanking whatever higher power they believe in that this health care reform has passed. That's right, celiacs. I'm talking to you.
Health insurance companies used to be able to refuse to cover pre-existing conditions if an insured had allowed their previous insurance to lapse for any significant amount of time. Now, there is a provision in the law that disallows insurance companies from refusing coverage for pre-existing conditions.
Celiac disease "presents" with a myriad of symptoms and its impact--if untreated--can be catastrophic on several systems. Anything from gas to severe depression can be clinically linked to celiac. It has been shown to lead to other autoimmune diseases and even cancers. Make no mistake, it is a serious disease. And it has been gaining in prevalence and diagnosis. Presumably, health insurance companies are becoming aware of its far reaching tentacles.
Now imagine--under the old health insurance regime--that you lose your job and your insurance. Your cobra coverage expires. Six months later, you get a new job and--thankfully--new insurance. You fill out the paperwork, noting the existence of celiac. To the extent you think about it, you think that your celiac is being treated as much as is possible by your adherence to a gluten-free diet. But wait. You're having some difficulty dealing with the financial stress of being out of a job for so long. You want to see a doctor for depression, but your coverage is denied: depression is a symptom of celiac, a pre-existing condition. Your back is hurting. You want to get chiropractic treatment, but your coverage is denied: back pain is a symptom of celiac, your pre-existing condition. You break your arm and the doctors discover you have osteoporosis. Coverage for the treatment is denied: brittle bones are a side-effect of celiac, the condition that has effectively eliminated any security you may have felt from having insurance.
This concern, which I became aware of when my husband recently switched jobs, no longer exists. While the above are all hypothetical--I am as yet unaware of any real instance where someone was denied coverage for a celiac disease related incident--it is not difficult to imagine that the industry that denied insurance to a fat baby would make those not-so-attenuated arguments.
So. For all of you celiacs out there...avoid the Tea Parties. I don't think they can accommodate a gluten-free diet.
To what? Well, to be honest, I am not entirely sure. Taxes increasing to pay for it? (Do they all live in DC where you really do have taxation without representation?) Illegal immigrants with no current coverage will suddenly have access to doctors, thus decreasing the availability of those doctors for citizens? (No, seriously, I heard that one. The lack of basic humanity that must exist to say something so egregious with a straight face...) I do, however, know one thing for certain: there are at least 1 out of approximately every 133 people in the U.S. who should be thanking whatever higher power they believe in that this health care reform has passed. That's right, celiacs. I'm talking to you.
Health insurance companies used to be able to refuse to cover pre-existing conditions if an insured had allowed their previous insurance to lapse for any significant amount of time. Now, there is a provision in the law that disallows insurance companies from refusing coverage for pre-existing conditions.
Celiac disease "presents" with a myriad of symptoms and its impact--if untreated--can be catastrophic on several systems. Anything from gas to severe depression can be clinically linked to celiac. It has been shown to lead to other autoimmune diseases and even cancers. Make no mistake, it is a serious disease. And it has been gaining in prevalence and diagnosis. Presumably, health insurance companies are becoming aware of its far reaching tentacles.
Now imagine--under the old health insurance regime--that you lose your job and your insurance. Your cobra coverage expires. Six months later, you get a new job and--thankfully--new insurance. You fill out the paperwork, noting the existence of celiac. To the extent you think about it, you think that your celiac is being treated as much as is possible by your adherence to a gluten-free diet. But wait. You're having some difficulty dealing with the financial stress of being out of a job for so long. You want to see a doctor for depression, but your coverage is denied: depression is a symptom of celiac, a pre-existing condition. Your back is hurting. You want to get chiropractic treatment, but your coverage is denied: back pain is a symptom of celiac, your pre-existing condition. You break your arm and the doctors discover you have osteoporosis. Coverage for the treatment is denied: brittle bones are a side-effect of celiac, the condition that has effectively eliminated any security you may have felt from having insurance.
This concern, which I became aware of when my husband recently switched jobs, no longer exists. While the above are all hypothetical--I am as yet unaware of any real instance where someone was denied coverage for a celiac disease related incident--it is not difficult to imagine that the industry that denied insurance to a fat baby would make those not-so-attenuated arguments.
So. For all of you celiacs out there...avoid the Tea Parties. I don't think they can accommodate a gluten-free diet.
Tuesday, October 6, 2009
The Economic Benefits of a Celiac Diagnosis
I got a medical bill yesterday. You know those notices you get from your insurance company that say how much the doctor's office charged for a service, how much you paid, and how much they are willing to pay? Before I was diagnosed with celiac, I used to get at least one a week. I was going to the doctor so often, I was convinced that they had a little note on the chart saying: "This one's crazy--disregard all complaints." I had gotten to that crisis point that apparently happens frequently for celiacs--my system was essentially shutting down. In many ways, my life and health have improved exponentially following the diagnosis, yet I have health issues that remain because it took so long to find out what was wrong. So I continue to get those medical bills. Luckily, as I've said here before, I have pretty great health insurance.
Just based on my own experiences, I could have told you that undiagnosed celiac causes an enormous economic burden both for individuals and for the health insurance industry. However, you do not have to take my word for it; the Journal of Insurance Medicine published a study back in March discussing this very phenomenon. Dr. Peter Green of the Celiac Disease Center at Columbia University joined forces with CIGNA HealthCare and, using anonymous data collected from 1999 through 2003, compared more than 10 million managed care patients in the U.S. They divided patients into four sub-groups: (1) newly diagnosed with celiac disease, (2) one symptom of celiac disease but no official diagnosis, (3) two symptoms of celiac disease but no official diagnosis, and (4) three celiac disease symptoms but no official diagnosis. After analyzing the medical resources utilized by each of the four groups, including amount and cost, they found that, after the first few months following diagnosis, the first group had consistently lower resource use and overall costs than the other groups.
Clearly, the study is not perfect. But how could this not make sense? Before diagnosis, those suffering with untreated celiac are sick. The list of symptoms is ridiculous. You have migraines, stomach problems (to put it mildly), extreme fatigue, skin issues, mental health problems. It goes on and on. Of course you are going to see the doctor, if you can. And the longer you go with untreated celiac, the sicker you become. It is an autoimmune disease; eventually it will wear your body out. It has been associated with other autoimmune diseases, cancer, osteoperosis, chronic fatigue. When you get to the point of other illness involvement, the medical costs are not going to go down. And those costs are pervasive.
The conclusion of this study was that early diagnosis would be economically beneficial to the health insurance industry. Yes! An important point! The blood test that ultimately was responsible for my diagnosis cost them about $100 versus the many, many thousands that they had put out previously just looking for what was wrong. But I would take it a step further. Early diagnosis is economically beneficial to just about everyone. Besides the pure health costs, imagine the work time that would not be lost for pointless medical tests, unnecessary hospital stays, care for family members who cannot be cared for by the patient. When you get right down to it, considering that an estimated 1 in 133 people have celiac but only a tiny percentage of those are currently diagnosed, the costs of performing the test on everyone are probably lower than the costs associated with undiagnosed celiac. (That might be an exaggeration. I clearly have not done those calculations.)
While health care is on everyone's minds, its a great time to suggest that your loved ones get tested. A simple blood test might save more than your friend's life... it might just save everyone a ton of cash.
Just based on my own experiences, I could have told you that undiagnosed celiac causes an enormous economic burden both for individuals and for the health insurance industry. However, you do not have to take my word for it; the Journal of Insurance Medicine published a study back in March discussing this very phenomenon. Dr. Peter Green of the Celiac Disease Center at Columbia University joined forces with CIGNA HealthCare and, using anonymous data collected from 1999 through 2003, compared more than 10 million managed care patients in the U.S. They divided patients into four sub-groups: (1) newly diagnosed with celiac disease, (2) one symptom of celiac disease but no official diagnosis, (3) two symptoms of celiac disease but no official diagnosis, and (4) three celiac disease symptoms but no official diagnosis. After analyzing the medical resources utilized by each of the four groups, including amount and cost, they found that, after the first few months following diagnosis, the first group had consistently lower resource use and overall costs than the other groups.
Clearly, the study is not perfect. But how could this not make sense? Before diagnosis, those suffering with untreated celiac are sick. The list of symptoms is ridiculous. You have migraines, stomach problems (to put it mildly), extreme fatigue, skin issues, mental health problems. It goes on and on. Of course you are going to see the doctor, if you can. And the longer you go with untreated celiac, the sicker you become. It is an autoimmune disease; eventually it will wear your body out. It has been associated with other autoimmune diseases, cancer, osteoperosis, chronic fatigue. When you get to the point of other illness involvement, the medical costs are not going to go down. And those costs are pervasive.
The conclusion of this study was that early diagnosis would be economically beneficial to the health insurance industry. Yes! An important point! The blood test that ultimately was responsible for my diagnosis cost them about $100 versus the many, many thousands that they had put out previously just looking for what was wrong. But I would take it a step further. Early diagnosis is economically beneficial to just about everyone. Besides the pure health costs, imagine the work time that would not be lost for pointless medical tests, unnecessary hospital stays, care for family members who cannot be cared for by the patient. When you get right down to it, considering that an estimated 1 in 133 people have celiac but only a tiny percentage of those are currently diagnosed, the costs of performing the test on everyone are probably lower than the costs associated with undiagnosed celiac. (That might be an exaggeration. I clearly have not done those calculations.)
While health care is on everyone's minds, its a great time to suggest that your loved ones get tested. A simple blood test might save more than your friend's life... it might just save everyone a ton of cash.
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