Who decides my health?

Yesterday, I received a letter from my health insurance provider regarding the future of one of my prescriptions.  Now I know health care in general is a touchy subject and there are a lot of opinions and controversy out there. I’m not trying to make an argument for or against universal health care or for other legislative matters. But I am questioning the validity of a letter that states “Please don’t think we’re giving you any specific advice about which drugs you should take.”

You see, for the third time in as many years, my insurance company has decided to change the coverage of my asthma inhaler.  I use my inhaler maybe six times a year because I have a mild form and I can by and large control it through lifestyle choices. You won’t catch me running a marathon or doing yard work on a hot, humid day.  But when I need my inhaler, wow, do I need it.

The inhaler I received last month when I filled my prescription will last me until it expires sometime in 2013.  Then I’ll have to get a new medicine or pay full price out-of-pocket to continue with the same type.  My co-pay was in the double digits and without insurance coverage it will hit three easily. The insurance provider suggested two alternatives, although one of them is in the highest co-pay category, the other is cheaper. But, according to them, they are not giving me any specific advice about which medicine I should take.

The insurance company also made decisions about how I should take my medicine.  I have another prescription for a 150mg dose of a medicine that comes in a 50 mg, 100 mg and 200 mg tablet.  My doctor wrote my prescription for three 50 mg tablets.  The insurance company decided I should get 45 100 mg tablets and have to cut fifteen of them in half to get my proper dose.  It’s inconvenient, but more worrisome to me is that when I cut the pills myself, I see the powdery residue piling up on the cutting surface and the blade.  Some of the pills split unevenly or a chunk cracks off the side.  It’s important to keep an even level of this drug in my system, but because of what I see while splitting the pills and feel in my body, I know I do not receive a consistent dose day after day.

Look, I’m grateful to have insurance but I wish they wouldn’t lie. They make a lot of decisions regarding my health, controlling certain aspects without having ever seen or spoken to me.  The same cannot be said of my doctor or even my own judgement.  I wish they’d let those who know me best decide what’s best.