Posted by Carl Plaskett on April 25, 2002 at 08:22:13:
In Reply to: Maze Selection Criteria posted by Dan Moyer on April 25, 2002 at 00:40:24:
Dan: This is a very interesting question which has no clear-cut answer, since the medical community is really poorly informed about afib and potential cures. The treatment protocol most physicians have learned (with the help of drug/equipment companies) is either treat with drugs or implant a variety of pacemakers. Both of these do nothing to "cure" the cause, they just treat the symptoms, with varying success.
This may explain why such rapid advances are being made with ablation techniques, which have great promise; but we don't know the long-term (several years) sucess rate associated with these really new techniques. We only know that flutter ablations DON'T cure afib, and the older PV cryoablations have higher surgery risks than the maze.I think more doctors are "coming around"(albeit slowly), in part because of the undeniable success of so many "mazers". Some doctors in HMOs may be influenced by the fact that this is an expensive procedure, and if the doctor has a contract with an HMO to provide "care" at a specific average $ amount per patient,per year, this could impact his relationship with the HMO and even his pocketbook.
It seems to me, that the insurance companies are more open to the maze than most doctors, because IF a doctor/provider in their respective plans recommends the maze, the patient usually gets it IF it is done at one of their "network provider hospitals". Different carriers have different procedures/policies about referrals outside of their network. The bigger the carrier, the more likely they are to have such a center under contract in another part of the country.
I am not the only poster on this site who was insured by an Aetna HMO, and I had no choice of where to go, as I searched their web site to try to find a "smaller", less "factory-like" facility than the Cleveland Clinic, Aetna's choice, which is how I perceived the CC to be from my vantage point in Florida. BOY, was I WRONG! As Bob McKee has just posted below, I could not have been happier with the care/kindness/professionalism of all I encountered there-thanks to my insurance carrier, Aetna, which incidentally picked up ALMOST ALL of the costs, including transportation/hotel for my wife and I during our stay. They didn't pay my $15 co-pay for seeing a "specialist"!
I believe most carriers would pay for the maze if it could be performed by one of their "provider" surgeons or hospitals under contract with them. The "bean counters" at insurance companies recognize that the long-term care of many afibbers is going to be very expensive, and the side effects of the associated drugs are likely to add to the treatment costs over time.
Educating the doctors seems to be the answer, which is one of the reasons several of us have been wanting to have a "Mazer Reunion" of sorts in conjunction with a meeting of medical providers (probably cardiologists)who are in need of the knowledge that people (LOTS OF THEM) are being cured of this dreadful affliction.