Re: F, etc.

On Wed, 03 Oct 2007 22:43:23 GMT, "cllmd" <cllmd@xxxxxxxxxxx> wrote:


"Puddin' Man" <puddingDOTman@xxxxxxxxx> wrote in message
news:nla5g3trctqtbul1s4sifh0ivfi949oag1@xxxxxxxxxx

On Sun, 30 Sep 2007 18:00:09 GMT, "cllmd" <cllmd@xxxxxxxxxxx> wrote:


...

At this point, odd as it has been,
i want them to keep this hell-hole of an insurance company.

I understand how you feel (I'd likely feel the same my po' self), and
I ain't gonna defend *any* healthcare ins. co's, but ...

A box of 30 of the suckers is $1400 ($2200 brand) and i use 4 bxs a
month. The pharmaceutical company that makes the suckers, Cephlon, has
labelled them for cancer pain only so they can charge that extra
percentage
that a "cancer only" med can get away with.

Near $47 per sucker? For generic??? "Gott Im Himmel!!!"

Actiq is just a fentanyl formulation. Fent has been around for quite
some time.
*******************************************************
I can't figger why they cost so much (maybe someone can explain?).
The exorbitant cost has got to be 80% of your headache. If they
were reasonably priced, you'd likely not hear a sqeak (let alone >> a holler) from United Gut&Filet.

Whelp, doubt the actual ingrediants and such are the cost, nor the research
that is part of every med's price.

Check.

My belief is that Cephlon keeps the label as "for cancer pain only" because
they can multiply any price a good 70 times if it is specialized for
anything "cancer." (The education field does the same...anything marketed
"for classroom use only" can bear a humongo price tag. It can be the exact
same item you take off a WalMart shelf for $8. If it is being sold for
classroom use, put that price times 10.

Well, you may be right. But, I gotta wonder ...

Is Cephlon cutting their own (and the patient's) throats (with over-
pricing)?

If you had pancreatic cancer, would you -still- have had to
go into arbitration? Aren't cancer patients being denied
Actiq (by their ins. co's) due to the exorbitant cost? These
question based on the assumption that the ins. co's care neither
a fig nor a fart about the source of a patient's pain iffen it's
gonna cost 'em a bundle.

If the suckers were put out simply for pain use, i'd guess the price to be
around $10 a sucker....still a lot, but more likely the market reality.

Sounds reasonable.

Pud, i canNOT tell you how...amazing...the last couple of days have been.
I've helped folks with stuff in the flesh world, have rarely been on the
'puter, had the neighbor girl over for several hours yesterday....it's been
a taste of my pre-January life again. It's still not the pre-pain life i
had, but it's been a life that my heart can rejoice upon. My brain hid the
memory of this life from me in the last few months...smart of it.

I've been a person again for a few days.

WOW!!!!!!!!

Well, to hell with the Actiq price issue. Rejoice!

The cleaners are here, and want to dust this area...off i go! But,
golly.....

I'm damned glad you won, and I'm damned glad you feel "right" again.
May they (United FlushCare) never hassle you again!

Pax,
Puddin'



My best guess is that Anthem healthcare (or whatever they call 'em
on the W. coast) would be even worse. UHC *used* to have a good rep.

I'd been warned by a few folks as to what to expect from them. Their
warnings have proven true, every single one of them. Either they are the
worst run business i've seen, or they are as ruthless as they try to be.
I
dunno which is true.

As near as I can tell, **all** the hc ins. providers are moving in
the same direction: higher premiums coupled with lower coverage
and iced with increased hair-splitting. Bears keeping in mind.

In any event, you shouldn't have to suffer this particular headache
for at least the next couple months. Congrats.

Wellness,
Puddin'



On Thu, 27 Sep 2007 16:58:21 -0700, "cllmd" <cllmd@xxxxxxxxxxx> wrote:

Just rec'd the ppwk from United In Hell Until They Rot and I See It From
Heaven And Laugh Myself Assless saying congrats, the state decided in
your
favor, so here is our ass....until 12/31/07.

I figure, okay, that's cuz the school district only has a year policy.
They'll re-up it when it comes time to get the med in January.

Yes, as you will ask, then i called them

They are only acknowledging the overturn until 12/31. I cannot use the
state info for the year '08. I have to go through the entire FUCKING
process again. I scared one customer service rep away and ended up with
a
supervisor who wanted to transfer me away, too. I threatened her with
legal
action. No, i did not curse at any time....i know that's grounds for
terminating the call....i was a killer customer service rep for several
years.

she said they "might" want to use the state ppwk when they begin the
appeals
process this time (which cannot begin until Jan 1) and "maybe" that will
circumvent the double denial, but since it's a "label" issue, she doubts
it.

FUCKFUCKGUCKGUVKDFHJIQ4\ -9` PI]J65Q
3Odfeokdjfn5y3o]ERG -DAF0=8;/SOLDEJIKGIU5 M, 09EOFRDLFG

i was so happy. i'd spoken with a rep this afternoon, before rec'g the
"we
bend over" letter this afternoon. she gave me a reference number and
told
me that, yes, i can get the med right away...today if i wanted. Called
the
pharmacy, they can have it tomorrow. Called the doc, need to call in
the
a.m. and get into his day clinic cuz he's on-call. It was all lining up
so
i was going to post tomorrow and tell you i was posting with the sucker
firmly planted under my tongue or between my gum and cheek.

and they've sucked every ounce of joy and relief out of the situation.
am
i
grateful for the med? yes, of course. but i was taking down my pants,
finally being given the tush, and once again, it's me getting screwed.

I think i have a case for cruelty, pain & suffering if they don't allow
the
med during the first appeal. i expect them to deny it right off the
bat
in
January, as usual....that's a system thing....a computer automatic thing
that a person has to go in and change. But if they pull an actual
denial
of
that request....Then i'm going to have to get ugly.

Had to KY myself for 9 months now....they'd better grease up, and i DARE
THEM to deny me in January past the initial thing.

F...no, i won't use that anymore. I've got some praying to do....

Thanks for the ears, guys....Lavon

"Mit der Dummheit kaempfen Goetter selbst vergebens!"
-Friedrich Schiller
.