Impatient Voices

I want to tell you about what happened during the insurance payers' panel at the DiabetesMine Innovation Summit back in November. I've been meaning to write this up for some time now.

TL;DR version: some patients stood up and yelled at some insurance executives and then I had to share a plane ride home with one of them.
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We were asked to politely write any questions on a post-it. A post-it.

We listened as each of the five panelists representing insurance companies (payers) gave their perspective.

You've got to understand, they lamented, it's REALLY hard for your insurance company to figure out how to decide treatment coverage for large diverse patient populations and still be competitive.

Many of the patients in the room were shifting uncomfortably in our seats. At least everyone at my table was. We were having a hard time hearing how hard it is for the big insurers.

Corinna Cornejo, with whom I've worked on committees and shared countless phone calls - whom I have always found to be savvy, smart, diplomatic - leaned across the table.

"I kind of want to stand up and say 'I don't give a $h1t about your balance sheet'."

"You should," I mouthed off. "I'll stand up with you."

And then...she did.

The air seemed sucked out of the room for me. $h1t.

That was my cue. I jumped to my feet and started talking, my feet ever comfortable on rickety old soapboxes. I spoke about access. Asked where the payer stood when pharmacy benefit management companies (like Express Scripts International and CVS Caremark) change 780,000 patients' medications (via formulary exclusions) without consulting their doctors or the patients affected. Without letting them know how they can discuss it with their insurance provider or how they might advocate to continue their therapy. I asked why they couldn't take a patient-centered approach to explaining those changes to their customers. I spoke about how hard it was to find a phone number or a website or an appeal form when all we want as patients is the opportunity to discuss our needs, our therapy, or our medical history with the people high above us making decisions that affect our very lives.

"Where is the letter with every denial or change in service that tells me whom I can call at your company or how to file an appeal? Where is the patient access to YOU the insurance company? Patients in this room represent the top 1%, most activated, most engaged patients," I explained. "If I can't navigate this system to fight for what I need, how can the average patient?"

Apparently, no matter how fluorescent you make a post-it pad, the act of scribbling out my question with a sharpie on it is just not as satisfying as the opportunity to use my voice.

Though the Sweetly was noticeably absent.

Soon after, it was time to break for lunch.