Dec 27, 2009

A good link to comparison of House & Senate Health Reform bills

Here's a good Q&A analysis of differences between the House and Senate bills as passed. Easy To read, from Kaiser Family Foundation.

Dec 6, 2009

Medco, Federal Employees Health Plan, and Vitamin D

Here's a great little piece of "evidence based medicine" courtesy of my Federal employee health plan (GEHA) and Medco, its designated pharmacy benefits manager. Just received in the mail a notice that Medco will not pay for any vitamins, even those available only by prescription. That includes my Vitamin D, which I am directed to take at doses of 50,000 IU every two weeks for the rest of my life. Without it, I don't seem to be able to keep my Vitamin D levels in the territory of normal. Why that is nobody knows, but my family has witnessed the rapid improvement in my post-hip-replacement pain (after two years of getting weaker and weaker post surgery) following the initiation of an anti-Rickets therapy of high-dose Vitamin D. So, in its wisdom, GEHA/MEDCO has said that Vitamins are out as covered drugs.
Now, Rx Vitamin D isn't very expensive. I can buy 12 capsules (3 month supply) at Costco for about $15. So, forcing me to pay for it isn't going to make any difference in my adherence to the therapy. But, it's a perfect example of how little subtletly there is in insurance coverage. Here's one medical technology (vitamin d) that's both cheap and effective (see my previous Vitamin D post for links to the strong evidence that keeps emerging. Needless to say, the blunt instrument that is coverage policy discourages its use.