161–170 of 273 posts
'don't buy anthem products, period, for any reason"
These days I am screening potential employers with who they use for their medical insurance plan. There's absolutely no way I'm ever going with United Healthcare Group ever again.
Alternatively, try a low histamine diet. Many people who have been told they need surgery to correct "deviated septum" or need cpap have found their problems go away. Edit: to downvoters - why the closed mind?
The few matches for low-histamine diet and apnea come from what I would consider fringe and untrustworth research, often suggesting a low-histamine diet helps a large number of medical issues, but not pointing to study giving numbers, describing the severity of the apnea, and other things I would expect.
I was able to find papers which studied the effect of anti-histamine drugs on obstructive sleep apnea, like https://journals.sagepub.com/doi/abs/10.2500/ajra.2013.27.39... for when people also have allergic rhinitis. "adding [anti-histimines] to this treatment did not show improved effects compared with placebo treatment". I presume people taking anti-histamines would have a lower amount of histamines in their body, so if there were a correlation it would have been seen. (Alternatively, it says that a low-histamine diet is not effective for CPAP when suffering from allergic rhinitis.)
It is apparently quite hard to identify what "low-histamine diet" means. In "Low-histamine diets: is the exclusion of foods justified by their histamine content?" at https://www.mdpi.com/2072-6643/13/5/1395 , which specifically concerns "the symptomatology of histamine intolerance", notes the "great heterogenicity in the type of foods that are advised against for histamine intolerant individuals. Excluded foods were, in most cases, different depending on the considered diet. Only fermented foods were unanimously excluded."
> The design of a low-histamine diet is challenging due to different handicaps. One of these is the lack of consensus on the histamine level below which a food is said to be considered low in histamine. Thus, variable histamine levels in food ranging between 5–50 mg/kg have been pointed out as potential thresholds, while other authors are much more demanding and consider foods with low histamine concentrations to be those that contain amounts below 1 mg/kg [ 12 ,26 –28 ]. Moreover, there is no specific regulation for the food industry to declare the occurrence or absence of histamine in food labelling, which could help histamine intolerant individuals to make suitable and informed choices.
> Overall, providing dietary recommendations and guidelines in the frame of a low-histamine diet is difficult for healthcare professionals.
If it's difficult for healthcare professionals to even determine what is low-histamine - and that's for people who are specifically histamine intolerance - and no studies to back up your suggestion ... why should anyone think your proposal has merit?
There is a long history of using the "why the closed mind?" argument to sell snake oil treatments, so I would not advise using argument and instead point to supporting evidence.
I've worked on the claims management process flow for payer like Anthem before. It's probably obvious, but this story hints at some serious deficiencies in the backend processes. One way to look at it is that this Byzantine process helps Anthem by trapping valid claims in a black hole of bureaucracy. That way they don't need to pay, right? It's not quite that simple. It's true that incentives are not usually aligned,…
> They may be the third-party administrator charging back to an employer, can you please elaborate on this? does this mean that some companies (employers) directly see and pay their employees medical stuff on their books? > Ultimately for Anthem, this claim cost them a lot more to handle than if they had just paid out in the first place ... well, of course, but the whole middleman game costs the US many many many ser…
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I've dealt with this many times as a South Asian person and it is very possible they still do actually want money. Most people will not ask in a straightforward manner for money and when you offer to pay them, they act all offended. This is a stupid game that I have no idea how it started where they will pretend to not want the money but will still very obviously want it. This has stumped me, being mildly autistic, f…
It's their culture of saving face. The solution is extremely simple. You tell the person "I was told I had to pay this to release my package but I don't know who or where I pay" while waving the cash around cluelessly. The person will 100% then offer to take it and "handle it from there" under the stupid guise of plausibility.
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You really need a professional to configure the CPAP, otherwise it can mess up your lungs (too much airflow) or make your sleep apnea worse (not enough airflow). That's why these are considered a prescription--the prescription is the settings on the machine.
Not at all. You can figure out how to configure one yourself with a few hours reading on /r/CPAP or watching YouTube. Source: myself after trying to acquire one and get it configured for months through a similar bureaucratic nightmare as the article.
I'm the US with health insurance but I bet it'll be more expensive to go the legit way.
You can now understand why the UK is holding on the its NHS with white knuckles despite the Conservative push to dissolve it by stealth.
I'd rather go the other way and not require a prescription for a breathing machine. They're not habit forming and you won't OD on breathing.
There was probably some argument for requiring a prescription when someone needed to adjust the pressure, but now that the machines do that themselves, they should probably just be available at Wal-Mart next to the reading glasses.
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Is step 3 to eliminate the FDA? The idea of letting randos modify and sell medical devices is terrifying.
A CPAP is a simple device. It is a fan that generates constant air pressure, with a heater and a bit of water to humidify the air. The idea that the law prevents me from pulling defective foam out of a device I own is terrifying.
You can't go modifying some types of medical devices and then sell them to _others_ without going through some sort regulatory process. Simple as that.
Now, Kaiser is FAR from perfect - they have their share of problems.
But....this sort of nightmare is not one of them. With Kaiser, doctors are free to prescribe whatever they think is medically necessary, and if they prescribe it, it's covered, guaranteed. There's no separate claims department.
Obviously there are some exceptions, like if it's an emergency and you need to get care outside of Kaiser and then submit a claim.
But, the vast majority of the time it just works.
Now, sometimes we aren't happy with what Kaiser offers. So then we go outside of Kaiser and pay out-of-pocket.
Our friends sometimes tell us we're crazy when we do that. We just spent $1200 out-of-pocket to see a specialist because Kaiser didn't want to refer us. What they don't realize, though, is that we saved $3000/year by choosing Kaiser over the next cheapest health insurance provider from our employer. So we're still coming out ahead.
And most importantly, we have the peace of mind knowing that any time we end up in a Kaiser hospital, we'll never once see a bill.
I think we really need more integrated systems like Kaiser. Imagine if there was actually competition in that space, where you could choose between competing hospital systems that came with complete integrated coverage, no middle man.