quarterly update--and winning a healthcare battle

I had my CT scan on Monday and oncology appointment yesterday. This time I scheduled the scan and appointment back-to-back so that I didn't have to resist temptation: reading the CT scan report before my appointment (see my previous post). Dr. Villaruz said my scan looks stable. The 8mm nodule is still there, but she thinks it might be scar tissue and isn't concerned about it. Although my lungs don't look "normal," the cloudy webbing that draped my lungs in 2022 is much less visible now. There is always some anxiety before these appointments, but they are getting easier for us as I have stabilized. Stable is good. 

In other news, Penn State employees don't know it, but we won a major behind-the-scenes healthcare battle this week. As a faculty senator, I'm serving on the Faculty Benefits Committee for the first time. (Faculty Benefits is a misnomer: we discuss benefits, including health insurance, for all PSU employees, not just faculty.) I have zero scholarly expertise in benefits, but I have way more personal experience with the healthcare and insurance systems than I ever wanted. 

HR has discussed with our committee (and the Healthcare Advisory Council) a proposed change to the 2025 Highmark insurance plan: requiring prior authorization (PA) for all outpatient advanced imaging (CT scans, MRIs, PET scans). This policy would apply even to people like me who get routine scans as part of our treatment plan. 

I consulted a professor with expertise in health insurance; he helped me strategize about how to approach this issue with HR. Another senator and I, along with a few others, fought hard against this proposed change. PA often leads to delayed or interrupted care, abandoned treatment, and adverse health outcomes. This recent New York Times op-ed describes some horrific cases. Then there is the added stress, anxiety, and lost productivity from dealing with bureaucratic hurdles in addition to the health problem itself. In many cases, PA also increases healthcare costs, in part because providers have to hire staff whose only job is to deal with PA. (See this American Medical Association physician survey.)

This was a hill I was ready to die on. Thankfully, it didn’t come to that! HR wrote this week to say that they will not require prior authorization for outpatient advanced imaging. This is a huge win for the physical and mental well-being of PSU faculty and staff.

***

The College of Education faculty senators jokingly refer to ourselves as the “centaurs” (senators - centaurs, get it?). On a whim, I entered the following prompt in ChatGPT: create an image of a centaur defeating an enemy that is labeled “prior authorization.” Apparently, the free ChatGPT version doesn't create images (lame!), so here is what I got. (I can't get the font size to look right - sorry).

“I can't directly create images, but I can certainly help you envision it! Imagine a powerful centaur, half-human and half-horse, wielding a sword or a spear, charging forward with determination. The centaur represents overcoming obstacles with strength and agility.

In the background, you see a formidable foe labeled 'Prior Authorization,' depicted perhaps as a monstrous creature or a daunting fortress. It symbolizes the bureaucratic hurdles and delays often encountered in healthcare, where prior authorization processes can be time-consuming and frustrating.

The centaur, with a determined expression, is depicted striking down or breaking through the barrier labeled 'Prior Authorization,' symbolizing the triumph over bureaucracy and the ability to navigate challenges to achieve success. The image conveys the idea of perseverance and determination in overcoming obstacles in the healthcare system.”

Spot on.

A friend/colleague with paid ChatGPT surprised me by producing the image:

 Despite several attempts, she could not get ChatGPT to understand what a centaur is.