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Carolyn, I was diagnosed in 1996 and achalasia was listed with NORD back then.

This isn't something that's all that " recent " .

Also, it seems that current research is showing similar success rates for

dilation vs myotomy, so balloon dilation as the recommended course of treatment

isn't really all that out-of-date, particularly given the cost savings and

reduced nosocomial infections related to dilation vs surgery.

Insurance companies are in the business of staying in business... they're not

going to back a more expensive procedure when it's not significantly more

beneficial than the less expensive alternative.

My insurance company requires a referral from my primary care provider if I want

to see a specialist -- this keeps their cost down, as I will only be able to see

a higher-cost specialist if my PCP deems it medically necessary. My insurance

company does not, however, require a referral to see a chiropractor, even though

he's a " specialist " .

That's because the insurance company has learned that MDs are less inclined to

refer to a chiro (many see them as pseudo-doctors, even though they are licensed

healthcare providers who completed medical school), and because patients who get

chiro-adjustments for back/neck pain cost them less money than patients who see

PCPs, orthopedic specialists, and neurology specialists for back/neck pain (all

of those MDs are inclined to want prescription drugs, physical therapy, surgery,

etc. -- all of which cost way more than a couple of chiro appts.). The

insurance company SAVES MONEY while still giving decent treatment by allowing

chiropractic care, just like it saves money by doing dilations rather than

surgery.

Dilation doesn't work for everyone, but neither does myotomy. Keep an open

mind, folks.

Debbi in Michigan

formerly known as Pepto-Deb

>

> Just to let you know, in medical terms..

>

>

> The medical field and insurance company has a coding system.  Each disease or

disorder or etc has a code and there is also a dictionary description and

recommended course of treatment of each disease.

>

> Many and I really mean most had a description that state ... " balloon dilation

is the recommend course of action for treatment "

>

>

> They were so out of date... from the early 1980's that it is scary.  Most

often if your insurance company says it will NOT cover surgery... myotomy and

fundoplication, it means they are not current to today's standards of usual and

customary.

>

>

> Additionally, Achalasia only very recent, became prominent enough to make the

National Organization of Rare Disorders Database. http://www.rarediseases.org/

>

> At this site you can see the various diseases that occur more often than

achalasia... It is still rare enough that there is not current funding or

studies for it...

>

>

> Carolyn

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Deb -- You are right: insurance companies are in business to make money. NOT to

make sure you get the best care. If they can make you " settle " for a procedure

with a five year life, at one fifth the cost = Bingo. In five years, you are

likely not to BE their client any more, and someone else will have to pay for

the next one, and the one after that. And almost for certain sure they won't be

around when you need the esophagectomy. . . . As late as ten years ago they

were denying heart transplants as " experimental " -- of course, if you're willing

to get a lawyer, and sue, they give in. But with luck, you'll be dead before

that. My SIL died while waiting for an Insurance Company to reverse on a bone

marrow transplant decision. Good business practice. Lousy medicine. And five

little boys lost their mother.

Whether or not the two procedures are even roughly equal is up for debate:

http://www.sages.org/publication/id/ACHALASIA/

/WV

> >

> > Just to let you know, in medical terms..

> >

> >

> > The medical field and insurance company has a coding system.  Each disease

or disorder or etc has a code and there is also a dictionary description and

recommended course of treatment of each disease.

> >

> > Many and I really mean most had a description that state ... " balloon

dilation is the recommend course of action for treatment "

> >

> >

> > They were so out of date... from the early 1980's that it is scary.  Most

often if your insurance company says it will NOT cover surgery... myotomy and

fundoplication, it means they are not current to today's standards of usual and

customary.

> >

> >

> > Additionally, Achalasia only very recent, became prominent enough to make

the National Organization of Rare Disorders Database.

http://www.rarediseases.org/

> >

> > At this site you can see the various diseases that occur more often than

achalasia... It is still rare enough that there is not current funding or

studies for it...

> >

> >

> > Carolyn

>

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Guest guest

I was sick with A since 1988, was not treated until 2010 with surgery.  That

being said, when I did get them to do the right tests and surgery, it was ME

that informed them of what I wanted and why....I gave them all the medical terms

and success rates etc....This helped my case for surgery and with an experienced

doctor....otherwise I would have been SOL.  

 

When you get to the point that you can no longer keep food down, you learn to be

persistent and use terms that doctors understand....like this is an emergency or

I will starve to death....usually works :)

 

Good luck to all. 

 

Julee ( from Oregon)

________________________________

From: bigbrillohead <imahockeymom@...>

achalasia

Sent: Monday, June 4, 2012 11:04 AM

Subject: Re: rarity of achalasia..

 

Carolyn, I was diagnosed in 1996 and achalasia was listed with NORD back then.

This isn't something that's all that " recent " .

Also, it seems that current research is showing similar success rates for

dilation vs myotomy, so balloon dilation as the recommended course of treatment

isn't really all that out-of-date, particularly given the cost savings and

reduced nosocomial infections related to dilation vs surgery.

Insurance companies are in the business of staying in business... they're not

going to back a more expensive procedure when it's not significantly more

beneficial than the less expensive alternative.

My insurance company requires a referral from my primary care provider if I want

to see a specialist -- this keeps their cost down, as I will only be able to see

a higher-cost specialist if my PCP deems it medically necessary. My insurance

company does not, however, require a referral to see a chiropractor, even though

he's a " specialist " .

That's because the insurance company has learned that MDs are less inclined to

refer to a chiro (many see them as pseudo-doctors, even though they are licensed

healthcare providers who completed medical school), and because patients who get

chiro-adjustments for back/neck pain cost them less money than patients who see

PCPs, orthopedic specialists, and neurology specialists for back/neck pain (all

of those MDs are inclined to want prescription drugs, physical therapy, surgery,

etc. -- all of which cost way more than a couple of chiro appts.). The

insurance company SAVES MONEY while still giving decent treatment by allowing

chiropractic care, just like it saves money by doing dilations rather than

surgery.

Dilation doesn't work for everyone, but neither does myotomy. Keep an open

mind, folks.

Debbi in Michigan

formerly known as Pepto-Deb

>

> Just to let you know, in medical terms..

>

>

> The medical field and insurance company has a coding system.  Each disease

or disorder or etc has a code and there is also a dictionary description and

recommended course of treatment of each disease.

>

> Many and I really mean most had a description that state ... " balloon dilation

is the recommend course of action for treatment "

>

>

> They were so out of date... from the early 1980's that it is scary.  Most

often if your insurance company says it will NOT cover surgery... myotomy and

fundoplication, it means they are not current to today's standards of usual and

customary.

>

>

> Additionally, Achalasia only very recent, became prominent enough to make the

National Organization of Rare Disorders Database. http://www.rarediseases.org/

>

> At this site you can see the various diseases that occur more often than

achalasia... It is still rare enough that there is not current funding or

studies for it...

>

>

> Carolyn

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