Lyme disease is highly political in nature. Insurance companies and plan administrators aggressively red-flag patients with a Lyme diagnosis and harass the doctors who treat them. According to a significant number of doctors and other Lyme-disease patients, First Health plan administrators are one of the worst offenders. I have documentation on the practices of other insurance companies and plan administrators as well that support widespread discriminatory practices. Doctors cannot afford to carry the burden of these unreimbursed claims. They cannot afford the office staff to meet the escalating demands for paperwork on each and every patient to intentionally delay reimbursement, yet this is becoming the common practice.
This travesty is being duplicated throughout the whole Lyme community. Lyme disease patients are suffering needless permanent disability and unnecessary loss of jobs because of inadequate treatment limited by insurance companies and plan administrators. This lack of treatment is guaranteed to produce a disabling result. Lifetime disability is more expensive than recommended treatment protocols. The job loss among formerly highly technical, highly productive employees can only be detrimental to the companies involved and to society as a whole. These bad-faith insurance companies and plan administrators are routinely making medical decisions based on proven cost containment policies and not the medical needs of the patient. Increasing numbers of judgments are being won against these insurance companies and plan administrators for "practicing medicine without a license." ERISA-funded plans particularly are being held liable for the "inherent conflicts of interest" behind these financially motivated medical decisions. (Refer to the Internet at www.lymenet.org for details on Lyme disease as well as unethical and discriminatory insurance company and plan administrator practices. This web site also presents specific legal cases and decisions involving these practices.)
We are the fastest growing patient population next to AIDs, and suffer from discrimination in treatment second only to AIDs, primarily because we do not die like AIDs patients. Insurance companies feel they will be on the hook longer for us. Note: Lyme disease is considered an infectious disease, but can be transmitted from one human being to another only through pregnancy. Lyme disease is also the most underreported disease. It is estimated that for every one case diagnosed, ten more go undiagnosed. Doctors are fearful of giving a diagnosis of Lyme disease because of the political climate and discriminatory policies that exist, even though each case must be reported to the Centers for Disease Control and the Texas Department of Health. (Note: It is very probable that many more MRG employees either currently have Lyme disease and do not know it or will be diagnosed with Lyme disease in the near future as more doctors become educated on this ever-increasing epidemic.) The problem of Lyme-disease discrimination must be addressed so the employees affected can return to a full-functioning status. The lack of appropriate treatment only adds to an employer's overall costs.
