[ping] Nicky

I'm copying a I made last night, and you may be the only one who can answer
it. It is about Travel Insurance in England. Finding the UK Forum has
opened my eyes to many things between our two countries. Protocol is a real
biggie isn't it? For my understanding, I understand the GP, yet that is not
the same as our PCP/GP equiv, then a consultant, and on to a neuro. For me,
I would go from my GP/PCP to my neuro. Who is the consultant in-between,
and in specific cases, I can tell they are two different people. Some
patients have been advised not to give their consultant's name because
protocol was not being followed to the (i and t), and he could get into a
lot of trouble if she did not follow his leadership (1st step is thymectomy,
and she doesn't want to get one, though required)

I find some of explanations on things British hard to understand sometimes
with the short, clipped answers (unlike Chris' nice detailed ones , and is
why I am asking you guys here. But when it comes to things medical, there
is no holding back in their replies. One guy just returned after four
months after non-MG surgery, and was thankful for being alive, and for his
neuro, and his leadership of the OR team.

Thanks Nicky, and if you need to take this privately (not sure why after all
the junk that can go on around here, and I'm needing some help)

Hugs across the pond, and land as well,
Billie

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I never heard about Travel Insurance, approval, denial, until finding the
UK MG Forum. I was just curious about it, and how it works for you. If I
were living in England, I would not be eligible for Travel Insurance. Way
far from it. You should see the MG control of those who are still being
denied it, even with such better control than they've ever had. I'm growing
to *dislike* [a very mild term] this disease more and more everyday. It
literally snaps the life away from you unless you are young, and very lucky.
So far, I've been neither.

I understand the reason for denial because of the high chance of one having
a crisis in another country. Emergency surgery costs would be astronomical,
and the risk of death very high without high-cost pretreatments, and special
surgical teams (such is for me even for the
colonoscopy and endoscope I am going to need soon - I have to carry an
emergency drug treatment card to prevent instant death if given the wrong
drug, and MG being rare, 20:100,000 doctors are not generally aware of
them).

With our insurance coverage as it is, individualized, I just found this
interesting, especially affecting my fellow myasthenics in England. I have
GREAT admiration for your myasthenics in England for the hard work they
individually put into their cause, 1:10,000). Wish I could afford to go to
Edinburgh for treatment. ;-) I'm starting to look for MG treatment
hospitals in the US. Not heard of any yet, not even through the foundation.

Billie

On Sat, 9 Jun 2007 17:26:28 -0500, "Billie" <mynewsaccount@swbell.net>
wrote:

>I'm copying a I made last night, and you may be the only one who can answer
>it. It is about Travel Insurance in England. Finding the UK Forum has
>opened my eyes to many things between our two countries. Protocol is a real
>biggie isn't it? For my understanding, I understand the GP, yet that is not
>the same as our PCP/GP equiv, then a consultant, and on to a neuro. For me,
>I would go from my GP/PCP to my neuro. Who is the consultant in-between,
>and in specific cases, I can tell they are two different people.

Billie, I'm not really the best person to answer this question,
because you learn this kind of stuff as you go along, and so far I
haven't had to go very far... you might get a better answer by posting
on the asd.uk forum, I'm thinking particularly about a nice guy called
Andy Hall who posts there.

However, I'll have a go! On protocol; our basic family doctor is the
GP, General Practitioner. You go to them for all ailments; if he/she
can't cope, then they'll refer you up the tree. It's not generally
possible to go directly to a specialist; even private specialists
usually require a GP's referral. GPs get funded by a reasonably large
salary, which they use to pay for all ancillary services, like nurses
and administrators; they get performance bonuses for patients meeting
various targets. As a well-controlled diabetic, I'm worth about an
extra £1000 p.a. to my GP; he'd rather not transfer my care anywhere!
Generally GPs cluster together into practices, size dependent on
population density, roughly. As a patient, you get allocated to your
nearest practice; it's possible to move freely between doctors within
a practice, but requires a fair bit of bureaucracy to change
practices.

Further up the tree, most specialists are attached in some way to a
hospital. For instance, the local hospital's diabetic clinic sees all
T1s and out of control T2s, but OK T2s are seen by the GP. The clinic
has a number of endocrinologists, who also spend some time consulting
on non-diabetic clinics in the hospital itself. Hospital clinics are
likely to be multi-disciplinary - the Ear, Nose and Throat one my
eldest spends too much time in is headed up by the top-notch surgeon;
under him are a couple of trainee surgeons; a GP with a ENT
specialism; and a bunch of nurses at various grades and specialisms.
Most consultants also seem to have a private practice alongside the
NHS one. I don't know how their funding works - but the local top
paediatrician lives in my village, in the lord of the manor house

Travel insurance seems to be something where people have problems in
waves. Thank goodness I've never had any - I've been with the same
insurance firm for several years, predating both diabetes and the
heart attack I had a couple of years previously. They've never
quibbled about any holiday I wanted to do, and have never loaded my
premiums at all. It sounds a whole other kettle of fish if you're
looking for an insurance just following a diagnosis - even T2s on
metformin seem to have been given a hard time recently. Like anything,
if you shop around there seems to be better deals. Life insurance
seems to be the same kind of deal - although I'm told that annuities,
which people with private retirement funds have to invest when they
retire, do better deals for diabetics. I'm hoping that's the case!

Now, I'm still not sure I've answered your questions - I'm sure I'm
too close to the system to see what might be puzzling looking in from
the outside. So please ask away - although, as I said at the
beginning, I really don't know too much! (Although I'm becoming much
more au fait with diabetic research funding, as I get involved there.)

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.5% BMI 25