Newsgroups: alt.med.cfs
Date:         Sat, 19 Dec 1992 13:42:25 PST
              <CFS-L@NIHLIST.BITNET>
From:         John Setel O'Donnell <jod@EQUATOR.COM>

This is a re-post of a message from sci.med concerning Sigal and his
role in causing Lyme suffering.
- - -

In article <17483@pitt.UUCP> km@cs.pitt.edu (Ken Mitchum) writes:
>In article <1992Nov9.014815.6935@ns1.cc.lehigh.edu> mcg2@ns1.cc.lehigh.edu
 (Marc Gabriel) writes:
>|
>|Sigal has absolutely no credibility with Lyme folks.  Many believe that he is
>|in bed with the insurance companies, telling them what they want to hear
>                                                   ^^^^ ^^^^ ^^^^ ^^ ^^^^
>This is a curious criticism coming from the "Lyme folks", many who
>seem to only accept what they want to hear. Depends on whose ox
>is being gored?
>
> -km

Once again, what seems to me an astounding lack of empathy for suffering
is on display.

Suggesting that billion-dollar insurance companies are equal in power
to the few Lyme patients healthy enough to do activism is outrageous,
IMHO.  I find this implied in the above.  Others might notice this
more clearly if we substituted African-Americans and whites in
discussing "whose ox is being gored"; however, the power relationship
is more equal there than in Lymies vs. insurance companies.

Sigal's case, mentioned above, is a case study in betrayal.  I do not
know the man; unlike some of the other "leading Lyme clinicians", I
have not had the pleasure of being treated by him.  I do, however,
personally find his papers despicable, deceptive, and a menace to
public health.  Also, I know of his involvement in a recent situation
which may be illustrative.

Insurance companies around the country have been redlining late-stage
Lyme therapy.  "Redlining", a term first used to describe bankers'
policies regarding mortgages for certain neighborhoods and
populations, has become a fashionable technique for insurance
companies to save money recently.  AIDS in particular has been the
topic of numerous court challenges to companies' redlining.  Lyme is a
disease of concern to the insurance companies because serious
treatment of it can be extremely expensive -- my own runs to well over
$100K -- and because, in the charming words of one insurance industry
executive, it is not a "self-limiting condition."  (It kills people,
thus ending the need for therapy, infrequently, primarily children and
the elderly.  And for many, it never goes away.)

Some Lyme patients (PWL?) in New Jersey got together to try to enlist
the support of the state, which has the responsibility of regulating
insurers, in preventing Lyme redlining.  Many of them were (and are) being
denied access to therapies which would vastly improve the quality of
their lives, even if they did not permanently cure them.  They managed
to push through legislation requiring the state health department to
promulgate minimum treatment coverage requirements, hoping and expecting
that they would work with the health department in selecting a panel
of clinicians in the state who'd been dealing with Lyme and knew what
was of value.

Unfortunately, the process was diverted by the insurers' obtaining the
appointment of Sigal as the person who set the treatment
standards.  Sigal's treatment coverage standards were below those
in use by nearly all New Jersey insurers.  His involvement has
drastically increased Lyme redlining in New Jersey, and the precedent
is being picked up by insurance companies operating in other states.
His recommendations are lower than those found in many current research
publications on the subject, and drastically lower than the more
informally published recommendations of many of the front-line
clinicians.

Sigal actions are responsible for a substantial increase in
suffering.  In a single stroke, he has both increased the likelihood
that patients seeking treatment early will be undertreated, opening
them to relapse and late Lyme; and he has curtailed the therapies
for late Lyme, relegating thousands to disability and suffering.

However, he has personally saved insurance companies nationwide a lot
of bucks, so maybe he really has done us all a public service that we
just don't understand yet.  Kind of like Reagan did for people living
in public housing.
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