I got a diagnosis once in Tucson for bi polar. The whole thing was odd to me because we talked for about 15 minutes and she gave me this diagnosis with in the first 5 minutes of talking and a prescription for risperdol. I got to admit I was in a whirlwind...had moved to a new city had some visions and dreams of what it would mean and I was getting some of that and then also having some unsettling things happen...for instance the job I had secured before my move fell though so I was in a new city and unemployed!!!...I was frantic and also excited. She assured me about how many people who think out side the box are bipolar. Any way I don't have a lot of the classic symptoms how ever I do understand that I have had alot of the high and then so many things have discouraged me and I developed low self esteem or hardships while still trying to hold onto my ambitions and dreams. One of the things she told me was that with this diagnosis I was okay for life to get treatment.

I wasn't going to take the medication but decided to try it. And I did feel a difference in some ways. Also I had just interviewed for a position with a green building consultant and felt it went great. In fact I was pretty sure it was leading to a job offer. A day after this diagnosis and beginning the prescription I read an email from the consultant and he wrote that he had hired an administrative assistant and I gotta say I got into a wierd state ( like I felt embarrassed or humiliated that this thing that I thought was happening wasn't) because I was almost sure that I had the job! Maybe it was the rispidal or maybe I would have reread it anyway... but I got over my feeling and reread the email. I hadn't caught that he wanted to bring me on as an associate and had filled the administrative assistance position with someone else. I was much happier. However I wondered about the bipolar...like perhaps it was the bipolar that made me not realize what had happened. And that the risperdal kept me more level headed enough to reread the email??

Anyway turned out that I started to have some very weird sensations ... went back to the clinic and spoke with someone else ... she told me about the hazards of risperdal and was also shocked that someone diagnosised me in about 5 minutes.

What is it about PTSD? Is it that treatment for PTSD could take a more than a few years of therapy. Or is it that by nature of the name it shows that the disorder is caused by a trauma and they don't like that cause of the cause and effect; doesn't sit well with the pathology of the individual approach?

You know that my diagnosis was changed from PTSD as per above. My insurance was only going to cover 30 visits for the year. That is not even once a week all year.

PTSD covers so many different types of traumas. I am not sure what it is about PTSD and the insurance. I am not sure what it is about the insurance and mental health with regards to treating traumas. Now, I have case worker that insurance company talking to my therapist.

Don't get me started on insurance companies. Years ago, I worked in a medical insurance claims adjustment office. These were the people who processed insurance claims for payment. Many claims were denied for what I thought were invalid reasons.

My job was, among other things, to enter information in the computer that would generate the checks. They were printed in our home office in another state, reviewed yet again, signed if approved, and then fed-exed to us to be sent out. Each morning I was given a dollar amount that I could not exceed for that day's checks. Our office was convinced this number was generated in a dart game or by roulette wheel or something. We had file box after file box of processed claims awaiting payment and had to decide which to pay. Some days only one got paid.

I was young. I took this stuff very much to heart. Since I answered the phones, I had talked to some of the people. They weren't just "insureds". I still remember some of their names and heartbreaking stories.

Naively, I thought I'd stumbled upon a scam. My older coworkers assured me we were working for one of the better companies.

The medical insurance industry was mind-boggling to me, a confusing array of companies. I joked it was so full of middle-men that no one could claim full responsibility for anything. I thought the whole industry was highly unethical.

It's only gotten worse since then. Way worse. I won't bore anyone with my family's tales of insurance woes.

My husband is self-employed. Medical insurance is expensive. In 2009, he was really ill and ended up having a pituitary tumor removed. The medical bills piled up. Since we met our huge family deductible, we all ran out and took care of every medical need we could think of. I said, "Well, our medical insurance finally paid off!"

My husband crunched the numbers. He's on the receiving end of medical insurance, so he knows how little is actually paid out. He decided it made more sense for us to drop our medical insurance in favor of joining a sort of co-op group that shares medical expenses. It means we are cash patients. My husband has negotiated with our doctors and pharmacy for discounts.

The best part? We can do whatever the hell we want. No insurance company is telling us what our doctor can or can't prescribe, what tests we can or can't have, what treatments we are or aren't eligible for. There are no hoops to jump through. We aren't spending hours on the phone trying to get stuff paid or trying to rectify mistakes the insurance company made.

Our doctors and pharmacy love us because they don't have to get on the phone and verify coverage, fill out ridiculous forms, and come up with creative ways to get paid for their work. I hadn't realized what a strain all of this was on anyone until we put it behind us.

We pay what we used to pay in premiums to ourselves and stick it in an account for medical expenses. I realize this isn't an option for everyone, but it's great if you're self-employed. It's been the only option for some young friends of ours who can't afford medical insurance.

The whole system is horribly flawed. It's terrible how insurance companies have, out of greed, determined standard of care. Everyone has ended up losing out, patients and health care providers -- everyone but the insurance companies.

Haha. I said not to get me started...

StehtFest, that company you worked for sounds like a for-profit "death panel" if I ever heard of one!

And a "medical co-op"?? Why, that sounds downright communist!

Check this out: http://www.huffingtonpost.com/2009/10/21/insurance-companies-rape-_n_328708.html -

...But just try to organize a FREE social support group for rape victims prematurely terminated from treatment. I dare you!

Insurance companies....
Of course, y'all could come take a look at how we do things over here in Israel. :-)

My husband had open heart surgery 3 years ago for a heart condition he didn't even know existed. He went for a routine stress test and flunked. Time from identification of blocked arteries to surgery? 2 weeks. The cost to us? 0. Time spent filling out claim forms? 0 The time spent fighting/negotiating to get promised coverage? 0. The time spent trying to argue down the hospital bills for what isn't covered by insurance? 0.

I am fortunate that I work for the state and have very good insurance. It covers everything - including my therapy and I don't pay a dime. I did read an article though about women with PTSD and RR-PTSD being refused coverage by insurance companies based on a pre-existing condition. The article highlighted that if the patient disclosed they were once raped, the company would also deny the insurance application. And this does worry me about diagnosing.
The bipolar diagnosis seems to be really sexy lately too. That has a huge stigma attached.
Overall, when I read the article in its entirety, I just felt like, well there is the man again, profit profit profit.

The new health care law prohibits the use of pre-existing conditions..

Yes, for children...and for adults after 2014. Which means that Tonya still had to endure a year of untreated pain so she'll be covered this November. I am so stoked about the new prohibition on denying care, though, as well as FINALLY making it illegal to drop someone's coverage if they get sick...or if a coworker gets sick...

Now, I wonder if it changes anything about DSM diagnoses and denial of care?

Well, I'm glad to see there's still plenty of lively discussion/debate in this group.
Whenever I read anything about the health-care system in the US I always thank all the gods for the NHS. Although in view of the current Conservative spending cuts, I am also very worried about the way this will affect health/social care services (and not just from the viewpoint of me finding another job!)
I'm currently doing some part-time volunteering for my local Labour Party office, and following the news quite closely about everything that's happening.

I think a lot of people in the UK are still quite unaware of the difficulties that many ordinary Americans face in getting treatment and dealing with the insurance system - it's very worrying to me that current government is trying to push the UK towards that system, just as the US is finally trying to reform its own.

And Matt, I hope that the changes mean that Tonya will be able to get treatment sooner rather than later?

We hope. It's part of the game here that she has to endure more than year of pain without treatment before she'll be eligible for care. Hey, did you know that here in America, people try to scare us away from a system like yours by warning us that YOU guys "ration care"? Seriously!

oh man! we do not ration care, what we do is called 'distributive justice'!!! But, having seen how you guys need labels, diagnoses (DSMIV!!!!) and not to mention a degree in Maths to understand the insurance systems in order to even begin to approach your health care system, I am so grateful for the NHS too.
Don't worry phoenix, I am sure the current coalition will not do anything very much to the system we have here! (but good for you for your volunteering role)

My favorite moment of last years health care debate was when some group ran an advert saying that Stephen Hawkings would have been left without care if he had to use NHS. Apparently the people who made the advert didn't realize that Stephen Hawkings was British and had received all his care from .... NHS.

Yes, that was a classic moment. My next favorite was the Tea-party sign that said--and I an NOT making this up--"Don't steal from Medicaid to support socialized health care!" See it here: http://i584.photobucket.com/albums/ss288/MoronsWithSigns/uhohsocializedmedicine.jpg .

In America, he'd have to change his diagnosis to "Major Depressive Disorder" to qualify for 30 sessions of treatment. That is, unless being wheelchair-bound is considered a pre-existing condition. But the more likely scenario is that Hawking simply wouldn't be eligible for any insurance anywhere in the United States!

It's a good thing we don't ration health care like those socialist Brits do! ;)


Okay, now who can bring this back around to the original topic of the DSM and diagnosis for money and poweR?