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April, 2021

Discrimination by health insurance companies - Part II

he patient of our story was diagnosed by Dr. Coucke as having an immunity deficiency and pituitary insufficiency. At the time that CZ suddenly started to make things difficult, the patient had been under treatment with the doctor for three years.

Patient of our story was initially reimbursed for everything

During which time the treatments and medications were all reimbursed. Dr. Coucke told the patient of our story that it was mainly the CZ that went after each of his patients and took away their medication. This again despite blood tests that proved his diagnoses. He advised the patient who was deathly ill when treatment began, to take precautions, because of his insurance with the CZ. But where do you go when you are not taken seriously by any doctor in the Netherlands? Just because you were diagnosed by Dr. Coucke.

Dr. Coucke referred the patient to the immunology department in Maastricht. After a long wait for an appointment, the patient was received there and physically examined. At first, this doctor was accommodating, because she also saw the immunity deficiency in the blood test she had taken. She told the patient that she couldn’t give her the medications before following the patient for a year to see the occurrence of the infections. Before that because of regulations in the Netherlands she couldn’t start prescribing the medications. So she told the patient that she thought Dr. Coucke was doing a good job and sent the patient back to him. She did guarantee that when Dr. Coucke could no longer prescribe the medications she would take over the treatment.

A year later the patient was back with this doctor because the patient was in danger of losing the medications. The doctor had evidently googled Dr. Coucke in that interim. She withdrew all her help and refused to treat the patient with the very needed medications.

Insurer CZ now reports to this patient

The CZ had meanwhile reported to the patient and asked to see all the lab results. They wanted to hand these over to their medical specialist for a thorough investigation into the legitimacy of the diagnoses. The verdict was that the Human Growth Hormone was no longer reimbursed. This was despite the fact that the same insurer had been reimbursing the medication for more than three years. Although the ITT test and Glucagon test clearly showed that not enough Human Growth Hormone was being produced by the pituitary gland. The second opinion that was done by a professor of endocrinology was also completely ignored.

According to the insurer, Norditropin (the human growth hormone) was no longer on the medication list for reimbursement for this condition. While it was simply reimbursed all that time before, and according to our research it is still on the list of reimbursed medications for this condition at the 'Zorginstituut'. The patient objects to the decision, but the insurer CZ reacts extremely negatively to it, see https://www.medicijnkosten.nl/zoeken?trefwoord=norditropin.

The patient knows that the insurer is lumping everyone who has been prescribed Human Growth Hormone by Dr. Coucke together. Patients with CFS were also given the hormone, but this patient has pituitary insufficiency and a completely different story. In that case, the need to get this medication is absolutely proven.

The gamma globulin, however, were still reimbursed for a year after lengthy examinations by CZ medical specialists. The blood tests and all hospital admissions did indicate that this medication had been prescribed correctly. They again would reconsider the agreement for another year.

Patient is then discriminated against by other doctors as well, once they see that the diagnosis was made by dr. Coucke

The patient of course knows that this is because of Dr. Coucke's reputation. And went for the third opinion for the pituitary insufficiency to Drs. van Battum internist-endocrinologist at the Zuyderland Hospital. The Patient took the blood tests with him and also those of the second opinion doctor in Belgium. This second opinion doctor also recommended to the patient the Norditropin (in a lower dosage) and similarly all other hormones.

Upon reading the name Dr. Coucke, the patient was scolded by Drs. van Battum. Why had the patient been so stupid to go to such a doctor and was immediately not taken seriously by this doctor? He even wrote in the patient's medical report that he had no confidence whatsoever that a correct diagnosis had been made here. In his eyes and writing he saw Dr. Coucke more than unreliable. But blood tests, all the physical burdens and the improvement through medications speak for themselves, that is what we think! The Patient walked out of the consulting room and felt truly discriminated by this doctor. The Patient needed to fight to be able to remove this doctor's very negative notes in the medical record.

Then the patient was referred by the GP to an Endocrinological specialist team in Rotterdam, who called the GP before the patient came in at all. They called because the diagnosis had been made by Dr. Coucke, the patient had to be willing to taper off the Hydrocortisone. If the patient was unwilling that team refused to see our patient.

A few months earlier the patient has been rushed to the hospital in an ambulance three different times because of an Addison Crisis. These crises occur due to low Cortisol levels, these facts were not taken into account by this team at all. The last crisis was so severe that the patient almost didn't come out of the Addison coma. This team of specialized doctors didn't say a word about it and the patient felt very unsafe because of this. The Patient was again discriminated in advance and not taken seriously, certainly not from the severity of the symptoms. The Patient did not even bother to travel to Rotterdam to be seen by this team.

One year later, the gamma globulin are either not reimbursed anymore

A year later CZ announced that they would no longer reimburse the gamma globulins. So CZ withheld two life preserving medications from the patient: growth hormone and gamma globulin. In the meantime, the patient had been referred by Dr Coucke to a leading professor of immunology in Antwerp and was on the waiting list. The Patient wrote a letter to the CZ that they were not allowed to simply stop life-saving medication. Because it could be expected that all the life-threatening infections would occur again.

In the letter to CZ, the patient tells about the impending third opinion examination by the immunology professor. Could CZ perhaps not continue to reimburse the medication until this professor came up with a new diagnosis? But no, CZ did not want to think along with the patient in any way. But why had they approved the gamma globulins the year before, after reviewing all the blood tests, and all those years before that? Now suddenly it was not Evidenced Based? And again blood does not lie! The correct tests to make the diagnoses had been performed, in the exact right way, this is Evidenced Based diagnostic work according to X-Codex.

Patient becomes ill within two weeks

The patient becomes ill within two weeks after stopping the gamma globulins! Had severe asthma attacks every morning, muscles and joints that inflame. Many bladder and skin infections develop, a pressing forehead, dense sinuses, weakened muscles and an unheard-of fatigue falls over the patient. Fever continued to come on and off and finally a renal pelvic inflammation with very high fever developed. Patients regained life was crumbling more by the day, which in our opinion is extremely irresponsible.

A renewed immunological investigation is being accelerated

Meanwhile, the second opinion examination by the professor of immunology was started on an accelerated basis, as the patient became increasingly ill. After ten weeks of thorough examination and many rounds of antibiotics later, it appears that the patient indeed has an immunity deficiency. Dr. Coucke had made an absolutely correct diagnosis in this patient. The Patient is diagnosed with humoral immunity deficiency in the classes IGG/IGG2 and IGM. The professor mentions in the letter that urgent administration of gamma globulins is required. This is in connection with the many life-threatening (sepsis) infections that the patient had and will go through again without these life-saving medications.

How can an insurer like CZ refuse life-saving medications to a patient with an immunity deficiency and a pituitary insufficiency, which have been proven with the right tests via blood tests? Doing this only on unjustified discriminatory grounds of the RIZIV (National Institute for Disease and Disability Insurance) that witch hunts a doctor.

The RIZIV does this because this doctor treats thousands of deathly ill people out of the box with great success and gives their lives back. But in the limited vision of the RIZIV wrongly gives medications such as human growth hormone and hydrocortisone. This is given to patients who have been suffering from a severe form of CFS for years but get their life back with these medications. Because this treatment is not mentioned in the books, this doctor who saves lives has already been suspended twice! Also has to pay back more than 800,000 worth of medications to the RIZIV. Do the RIZIV and the insurers want the people rather sick than healthy? Does all the recovered patients mean nothing to them?

Dr. Coucke can diagnose correctly!

The most unjust in the case of this patient is that the diagnosis of pituitary insufficiency twice (also in a second opinion) was made correctly, also by Dr. Coucke! Now in a second opinion also the immunity deficiency was correctly diagnosed by Dr. Coucke. This patient doesn’t have CFS and therefore was not "wrongly” given growth hormone or gamma globulins. But the medications are indeed urgently needed to preserve patients life.

So lives are literally being played with by this health insurer CZ by withholding life-saving medications that are simply on the reimbursement list. These medications are withheld for the sole reason of an unjustified bad reputation of the prescribing doctor. If CZ had acted correctly, the life-saving medication would have been reimbursed until the immunology professor had made a new diagnosis.

Now the patient has had to suffer for months and the patient's immunity has been impermissible, unnecessarily and very dangerously weakened in corona time. This patient's immunity is also specifically deficient in the IGG2 subclass. This is the class that primarily regulates defenses in lungs, throat, nose, sinuses etc. The crucial areas where Corona initially harbors and thus this patient had no immunity to this at all. Health insurer CZ was aware of this, but despite this they thought it was right not to pay for the medication.

Patient has been living in quarantine for a year now

The patient has therefore been living in quarantine for a year now and will not be released for some time. It takes a long time for levels to return to normal after restarting the gamma globulins. Should Patient get COVID-19 the outcome is not good from that. All this unnecessary physical decline and the many infections were extremely hard on the patient. Who felt awfully targeted by the insurance company CZ and has still so many hard times because of that. The gamma globulins cost about 4200 euros per month, not something you can cough up by yourself as a patient.

X-Codex believes that patients should not be the victims of insurances when a doctor is discredited. Especially since it looks more like a 'witch hunt' than that there are really wrong treatments performed by this Dr. Coucke. Our opinion is that when a doctor thinks out of the box and treats a patient successfully, these doctors are better off being applauded than blocked by regulations and pigeonholing critics. If a doctor is really wrong in treating patients, make sure that the insurer forces the client to get a second opinion. Warn the client about the treatment, but at least keep paying. It is our human right and certainly with the right insurance with a free choice policy that the concerned patients of this story have, to be able to make these choices themselves!!! The health insurance companies are unjustly trampling the human right to self-determination of their clients, a very bad thing we think!

Why are very expensive experimental treatments allowed in terminally ill patients?

We wonder how many expensive experimental treatments are performed on patients, for example, in the case of cancer? In these cases, experimental treatment suddenly becomes permissible because if you do nothing the patient dies. It is also necessary to accurately determine how many patients die in hospitals from actual gross negligence and incompetence of doctors. These situations are all covered up to avoid liability in lawsuits!

How many people die just as a result of these experimental treatments is never charted. The body is totally destroyed by heavy chemotherapy and has no chance to fight the cancer itself. Even worse are the people who die after cancer treatment, who are cancer free, but the body is destroyed by the treatments. Or that the cancer comes back again and again because the immunity and the body has no resistance against malignant cell division. That in oncology in the hospitals hardly anything is done with healthy food and immune strengthening therapy in the treatment of cancer, is almost unbelievable.

Then here is a doctor who gives nothing more than hydrocortisone and human growth hormone to serious ill people who have no life left. But are just short of terminal, and that doctor is hounded and reviled. It seems to be a repeat of the witch hunts in the Middle Ages up to 1800. But now this doctor's patients are also unfairly victimized by these witch hunts, together with this doctor. Meanwhile, this doctor makes his patients better, in contrast to many thousands of other doctors, who only apply band-aids in the form of medications imposed by Big Pharma.

Big pharma rules the medical world

The whole system is broken, doctors are under great pressure from Big Pharma to prescribe their drugs. They are offered so much to do this, they are bribed and played with. Big Pharma then continues to drive up their prices so that insurers feel compelled to deprive patients of the necessary medication for the sake of profit. Big Pharma rules and plunders the sick. There will be much more to read about this in our category 'Big Pharma Big Bullshit'.

X-Codex condemns this injustice to patients

X-Codex this a great injustice and condemns it deeply! An even greater injustice is the fact that insurers and a RIZIV are lumping everything together. Suddenly, according to these short-sighted people thinking in boxes, Dr. Coucke with years of studies and work experience no longer knows how to make a correct diagnosis. But what we understand is that his diagnoses in so many second opinions were found to be correct! Patients of this doctor are thus unjustly hounded, their progress in their disease and complaints taken away and hampered. But even creating life-threatening danger as with this patient of our story, anything goes at once. Why is all this allowed?

From the doctor in question, Dr. Coucke, we learned that many patients in the Netherlands have had their medications taken away unfairly by various insurers, but especially by the CZ. For financial gain, they make victims of these patients, who are already so sick. X-Codex is not agreeing in any way with this and will always fight against this kind of injustice!

If you have a similar story, please let us know and mail your story to our editorial team, we find this a disturbing matter especially since it affects our human right to good health.