On 2/4/2014 2:20 PM, Shadow wrote:
On Tue, 04 Feb 2014 10:35:58 -0500, Peter wrote:

I'd rather have an insurance company be unable to pay for the med
(or the patient) rather than a bureaucrat in Washington denying
permission for the med.


As someone who falls squarely into the category of "Washington
bureaucrat" for the final 14 years of my military medical career, I
very strongly resent the implication of your statement.

There is no such thing as an "insurance company that is unable to pay
for medicine". When they say that, they mean it might affect how
much cocaine they can buy at the next office party. Which is why I
always say, if there is ever a possibility of a public health plan,
choose that. Only private health insurance will limit what a doctor
prescribes. []'s


Well... as far as the military heath system is concerned... not
completely so. The doc may prescribe what he/she feels is best, but
whether or not the patient has easy and economical access to the med is
a much more complicated issue.

Military pharmacies have formularies of what they keep in inventory to
dispense and what they don't. The military MD can prescribe a med not
on the pharmacy formulary list and try to make a case to the pharmacy
for a special purchase for that patient. If successful, the drug will
be obtained and dispensed without cost to the patient. If unsuccessful,
and the doc still feels that specific drug is a "must have", he/she can
write a prescription, provide it to the patient, and the patient might
be able to fill it at minimal cost at the military mail order pharmacy
if it is on their formulary. If not, the patient will have to fill it
at a civilian pharmacy and there's a complicated chart to determine the
Tricare (the DoD's health insurance program) copay for a 30 day or less
supply.

So, at least considering the military's health plan, the doc can
prescribe ad lib, but that doesn't mean that the patient gets it for
free before leaving the building. Many times yes, sometimes no.