King Canute and the tide--and insurance companies:a tale with modern relevance
Robert Lacy, in his book "Great Tales fromm English History", states "King Canute, who ruled the English from 1016 until 1035 and who tried to turn back the waves, has gone down in folklore as the very model of arrogance, stupidity, and wishful thinking. " According to a contemporary history written by the country clergyman Henry of Huntington entitled "History of the English", it seems the good king sat his throne along the seashore in a a vain attempt to turn back the waves. "Let the world know", cried Canute, as he retreated from his throne and contemplated his wet feet, "that the power of the king is empty and worthless!"As luck (or fate?) would have it, I had just read this account the day before I received a notice from an insurance carrier denying payment for SLIT (sublingual immunotherapy), because "it remains experimental." And as luck (or fate?) would have it, this was also the same day I received the latest article from the JACI (Journal of Allergy and Clinical Immunology), with updated ARIA assessments on the experimental evidence for immunotherapy for SCIT and SLIT. The recent evidence for SLIT is AS GOOD OR EVEN POSSIBLY BETTER THAN SCIT--check it out:
Condition: SCIT SLIT
clinical efficacy: rhinitis Ib Ia
clinical efficacy: asthma Ia Ia
clinical efficacy: childhood
rhinitis Ib Ia
dev of new sensitivities Ib IIa
long-term effect Ib IIa
prevention of asthma IIb IIb
The only logical position, from the modern evidence, is that an insurance carrier should either pay for BOTH forms of therapy, or NEITHER. Paying for SCIT and NOT SLIT is illogical. But then again, who said insurance decisions were logically based?
And it's THIS kind of "stuff" that makes me gratified I named the site "The Angry Allergist" instead of various more tepid suggestions such as "Allergy Commentary", "The Compleat Allergist" or some other drivel.
Now where does King Canute figure in on this, you ask? Well, the metaphor should be obvious. With the tidal wave of recent articles on SLIT, it is equally as "hopeless" for insurance carriers to continue to deny coverage for SLIT as it was for King Canute to try to turn back the tide.
My message to insurance companies: get over it. SLIT works.
Insurance aquiescence to SLIT's effectiveness will happen, and its inevitable. The real question is not "if" but "when" insurance companies will begin to cover SLIT more fully. They are, in my opinion already "getting their feet wet", like good King Canute...
Posted on Sunday, April 15, 2007 at 01:40PM
by
George F Kroker MD FACAAI
in Sublingual Immunotherapy (SLIT)
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George F Kroker MD FACAAI
in Sublingual Immunotherapy (SLIT)
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