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Leann Schaff/Neck Surgery Patient

Published On: Nov 13 2013 11:17:43 AM CST

"It started last spring when I saw Dr Beck and he made the diagnosis of the two-level fusion that needed to be done.  We had to have the insurance company ok the surgery.  It took them a long time to get back.  When they finally did, they said no, there was no medical reason this surgery needed to be done.  That floored me.  I couldn't understand why they would say that.  I asked Dr. Beck the reason they had given and the reason was because he hadn't done an MRI on me. Well, I can't have an MRI because I have a metal clip in my brain from an injury from many years ago. So, he's done everything he can without the MRI to diagnose what was there.  I couldn't understand, if they had read the chart, they would know why there couldn't be an MRI. "

"Anger was probably the number one emotion that I felt because I couldn't understand how they could say that it wasn't medically necessary, when my doctor, who has read the scans and has talked to me and knows what is going on, says that it is necessary.  How could they say it's not?"

"I had to have surgery 4 or 5 years ago and Dr. Beck had to do a fusion on my neck.  It's been great since then.  I have had no more headaches.  I have had no more pain.  The stiffness and pain in my shoulders is totally gone.  I can only imagine that this would be just as good an outcome.”

“My understanding is that, if the insurance company won't pay for the two-level fusion, then if I wanted to pay cash for the second level, I could do that, but I don't have the money to be able to do that.  So, I will have to have the first-level fusion done now, then in six months to a year, have the second level fusion done."

What are your thoughts about the Affordable Care Act?

"I don't think it's good. It's looking pretty bleak right now.  Everything seems to keep going up.  In the last year the premiums on our insurance have gone up dramatically and our coverage has dropped considerably, so you are not getting the best of what you could be getting."

What do you think will happen when the Affordable Care Act takes effect?

"That won't be good at all because it will be a larger entity making the rules for the physicians.  The physicians won't have a whole lot of say in how to run their practice themselves and they are the ones who know what they are doing.  The larger business doesn't know what each individual doctor does exactly."

"It makes me sad that the government is running things more than the individuals now."