I phoned the insurance company this morning, as instructed, for news on my application for ‘prior approval’ for surgery.
The lady in customer services checked my file on the computer, and said… “We need 5 working days to process your application.”
I replied that the application was submitted by fax last Wednesday morning (marked URGENT) and that this was now Day 5.
I was asked to hold the line.
After a long wait while she contacted the claims department, I was told… “Sorry, there’s no update on your application.”
I, again, explained that the surgery is due to take place this Friday, that the surgeon is booked, the hospital bed is booked, the flights are booked, the hotel is booked and that I’m due to travel to Nottingham in less than 48 hours time!
A long silence ensued.
Finally, the reply came… “You could try phoning again, this afternoon.”
“When you need us, we’re there” Grrrrrr!
With thanks to Grannymar for keeping me smiling…
SENIOR HEALTH CARE SOLUTION
So you’re a senior citizen and the government says no health care or pension for you, what do you do?
Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot 2 MPs and 2 Senior Government Officials.
Of course, this means you will be sent to prison where you will get 3 meals a day, a roof over your head, and all the health care you need! New teeth, no problem. Need glasses, great. New hip, knees, kidney, lungs, heart? All covered.
And who will be paying for all of this? The same government that just told you that you are too old for health care. Plus, because you are a prisoner, you don’t have to pay any income taxes anymore.
IS THIS A GREAT COUNTRY OR WHAT?!
The VHI pride themselves on being there when you need them. I’m due to undergo revision surgery in the UK next Friday. The arrangements have been made, flights and hotel are booked but if the pen pushers in the VHI don’t get their act together, it will all be cancelled. Facing surgery is never an easy task but when you have to fight to get insurance cover for it, it can be soul destroying. Surely it’s not right that a health insurance company can hold you to ransom like this?
People associate VHI Healthcare with excellent hospital cover. I’ve been insured with them since childhood and with my medical history, it’s fair to say that I’ve given them a good run for their money. With medical costs soaring, holding private health cover should offer peace of mind. However, should you find yourself in a position where you require treatment that is not available in Ireland, be warned! There is no guarantee of insurance cover.
No matter what level of insurance you hold, you will be made to grovel for treatment abroad by a process called ‘prior approval’ and if you fail to tick all the right boxes, cover will be refused. What really bugs me about this process is that it interferes with patient autonomy and the doctor-patient relationship. The VHI make the decisions.
The VHI state in their terms and conditions that “VHI Healthcare does not provide cover if a member travels abroad specifically to get treatment. However, in exceptional circumstances and subject to prior approval and satisfaction in full of specific criteria, we will pay up to the plan amounts outlined in the Table of Benefits.”
I was first sent ‘abroad’ for surgery in 2007 as treatment options in Ireland, had run out. The VHI subjected me to the process of prior approval and despite meeting all the specific criteria, my application for funding was turned down. This caused untold stress at a time when I was facing major surgery. The funding was subsequently granted on appeal and the operation went ahead as planned, in Nottingham.
I was referred back to the UK last year to undergo further radical surgery. Again, the VHI insisted on prior approval and again my referring consultant was asked to complete an in-depth questionnaire and supply academic evidence to support the proposed surgery. On this occasion, funding was sanctioned on the first attempt but the VHI kept me on tender hooks right up to the week of surgery.
Two weeks ago, I travelled back to Nottingham for a consultation with the surgeon who last operated on my head. I was referred back to him with a post-operative complication which has failed to respond to treatment in Ireland. The surgeon advised that some revision surgery is required. On contacting the VHI on my return, I was informed that prior approval must be sought for any surgery outside Ireland.
I have spent the last 2 weeks trying to get the revision surgery ‘approved’ in time. If it has to be cancelled, I will have to wait another month for surgery. On phoning the VHI last Friday, I was informed that I would be notified by post of their decision. When I reiterated that the matter is urgent, I was asked to phone again on Tuesday. That’s two days before I’m due to travel to the UK and there is no guarantee that my application will be approved.
“When you need us, we’re there”
Well, I need the VHI now so where the hell are they?
Do you know someone who is about to undergo treatment for cancer? One of the worst and most feared side effects of chemotherapy, is losing all your hair. Partial or total hair loss can have a devastating effect on how people feel about themselves. On looking for suitable headwear, women often find that they are disappointed with the range of hats and scarves available. Last year, a friend asked me if I could recommend somewhere to buy some stylish headwear for a friend undergoing cancer treatment. I just wish I’d known about Feelgood Scarves sooner…
“One of the shocks of losing your hair temporarily to chemotherapy is not the sudden, rather French gamine look you acquire, but that your newly-bald head is a) unexpectedly soft and fuzzy and b) apt to feel cold. A wig will provide instant coiffed perfection for the outside world; at home, a soft but-not-too-hot hat or scarf will no doubt be the more useful and comfortable.
Catherine O’Sullivan, having mastered her own crash course through chemotherapy two years ago, recognised a gap in the Irish market and has started an online business selling five different styles of snazzy headgear for women that help to avoid the pirate-in-distress look. Made in a selection of soft, washable, cheering and good-looking fabrics (including velour, velvet, cotton, chambray and viscose), the scarves arrive artfully packaged in tissue paper, which makes them a great gift for a friend or loved one going through the various sorts of hair-raising ordeals. Now someone needs to figure out how to compensate for missing eyebrows. See feelgoodscarves.com Prices range from €25 to €39.”
Credit: Patsey Murphy, Editor, THE IRISH TIMES magazine.
The jury is still out. I’ve been back to Nottingham to receive the verdict on my head. The day went pretty much as expected and depending on how you look at it, the news overall was good.
Monday was a long and tiring day, not helped by the biting wind and frequent showers of sleet in Nottingham. I’d an early start to catch the morning flight and arrived into the city centre in time for a late breakfast. Once revived, I headed to the local library to avail of the internet facilities and the warmth. Shopping is not an attractive option when your mind is otherwise focussed. I made my way to the hospital with plenty of time to spare and the surgeon saw me exactly on time for my appointment. We were off to a good start.
Having looked at my recent CT scan on computer, the doc was pleased to find that there hasn’t been any significant deterioration since the last scan. He examined my head endoscopically and using local anaesthetic, did some ‘house’ work on the previous operation site near the base of my brain. Using an endoscopic camera, he was able to give me a guided tour of the inside of my head by projecting the images onto a screen. It was amazing to finally get to see the small area of bone that has caused so much trouble in recent months.
In layman’s terms, the surface of this inflamed bone looked like white paint which has blistered in the sunshine while the rest of my internal anatomy, was pink and glistening. At this point, the surgeon informed me that the exposed bone will require further intricate surgery. He proposes to line the bone with a mucosal ‘flap’ graft which will provide the blood supply needed to promote healing. My airway will be internally splinted for about 10 days to prevent adhesions. Last summer’s radical surgery in fact included a similar graft repair to another area of exposed bone and the surgeon showed me how well this area has now healed. This was exactly the sort of the reassurance I needed. I left the hospital armed with a bevy of syringes and plastic tubes together with strict instructions to flush out my head daily using a sterile solution. Having navigated through airport security without being arrested for the strange contents of my bag, I arrived home totally exhausted. I’m still exhausted two days later.
I now know exactly what needs to be done and how it will be done. While this is good news, I’m still struggling with the reality of having to face going back to Nottingham for further surgery. The operation will be a minor one compared to previous surgeries but even so, I still find myself deliberating over it. I’ve been instructed to ring the surgeon within the next few days to discuss a date for surgery.
Did you realise that at least 50 per cent of antibiotic use in Irish hospitals is inappropriate? One of the foremost concerns in modern medicine is antibiotic resistance. Antibiotics are the first line of defence against many infections but overusing or misusing them can cause more harm than good.
The HSE Health Protection Surveillance Centre (HPSC) has published an updated set of expert guidelines, to promote rational antibiotic prescribing in Irish hospitals. The recommendations range from the relevant structures and personnel that should be in place in all hospitals, to specific interventions that should be considered once essential structures are in place. The guidelines, if adhered to, will save money in the long run.
The Guidelines for Antimicrobial Stewardship in Hospitals in Ireland aim to cut antibiotic resistance and improve patient safety. They represent huge savings as the costs associated with people being infected with a resistant bug, can be enormous. Antibiotic stewardship, which implies quality prescribing, is distinguished from antibiotic control, which implies limiting use. The primary rationale for antibiotic stewardship is the prevention or reduction of antibiotic resistance.
The guidelines recommend the appointment of teams of clinical microbiologists, infectious disease consultants and antimicrobial pharmacists in every acute hospital across the country. Approximately 20 hospitals already have antibiotic pharmacists in place and these hospitals have seen the biggest reductions in antibiotic use. This scheme has the potential to make a real difference in the fight against hospital infections. I welcome it with open arms.