Wessely Says: Even if XMRV Causes ME, "There's Nothing We're Going to Do About it"

[Hip]

I find it hard to follow your reasoning. The links provided indicate, and you seem to accept, that there is an overall desire by certain companies in the disability insurance industry to make CFS/ME a non-disease, or at best, a psychiatric condition.

Now, for every single scientific publication that comes out that indicates that CFS/ME is in fact a physical disease (and there are hundreds of such studies, the XMRV being one of them, albeit a major one), are you going to ask for proof of the insurance industry's antagonism in each case?

 

[Dolphin]

I find it hard to follow your reasoning. The links provided indicate, and you seem to accept, that there is an overall desire by certain companies in the disability insurance industry to make CFS/ME a non-disease, or at best, a psychiatric condition.

Now, for every single scientific publication that comes out that indicates that CFS/ME is in fact a physical disease (and there are hundreds of such studies, the XMRV being one of them, albeit a major one), are you going to ask for proof of the insurance industry's antagonism in each case?

It looks like we are going to have to agree to disagree.
If ME turns out to be reasonably treatable with XMRV drugs, I think the disability insurance companies won't necessarily be unhappy.

 

[Hip]

It looks like we are going to have to agree to disagree.
If ME turns out to be reasonably treatable with XMRV drugs, I think the disability insurance companies won't necessarily be unhappy.

I see what you are getting at.

Thing is:
(1) It may be a decade or two before effective treatment for XMRV is available (I certainly hope that it is not that long, but who knows), and as was said above, "they are thinking only short-term".

(2) Maybe XMRV will turn out to be non-treable? But its presence in CFS patients will still help prove CFS is real, which is bad for these companies.

(3) Also, these companies have for may years avoided long-term disability payouts on the basis that CFS is officially considered psychiatric. If XMRV overturns that view, would these insurance companies be liable for decades of missed back payments to the CFS patients they snubbed? I am not sure of the law in this area (does anyone have info on this area?), but I would guess that there certainly are going to be lots of snubbed CFS patients who will try to sue them.

 

[Knackered]

I see what you are getting at.

Thing is:
(1) It may be a decade or two before effective treatment for XMRV is available (I certainly hope that it is not that long, but who knows), and as was said above, "they are thinking only short-term".

Not likely, from what I've been reading currently available ART has potential to work against XMRV, for more spesific treatment there only needs to be a slight modification of pre-existing drugs. There are also drugs on the shelf that didn't woth for HIV that could work for XMRV.

(2) Maybe XMRV will turn out to be non-treable? But its presence in CFS patients will still help prove CFS is real, which is bad for these companies.

As I've said above, currently available drugs are shown to inhibit XMRV in vitro and in theory should work in vivo too.

http://www.forums.aboutmecfs.org/showthread.php?4079-Summary-Drugs-tested-against-XMRV-to-date-(in-vitro)&p=63397#post63397

 

[Hip]

Not likely, from what I've been reading currently available ART has potential to work against XMRV, for more spesific treatment there only needs to be a slight modification of pre-existing drugs. There are also drugs on the shelf that didn't woth for HIV that could work for XMRV.

In which case, as tomk hinted earlier (but I was slow on the uptake), it may be that in this XMRV circumstance, the objectives of the Wessely School are no longer aligned to the objectives of Unum.

 

[justinreilly]

If Simon Wessely were to suddenly experience pangs of conscience, and withdraw from his leading position in making the medical profession think that a serious disease like myalgic encephalomyelitis is "All in the Mind" just for the purposes of saving money for insurance companies like Unum and Swiss Re, do you not think that these wealthy and apparently unscrupulous insurance companies would not appoint some other malleable expert or professor to perform this twisting of facts? Unum Group Named Second Worst Insurance Company In US.

Instead of just focusing on Wessely and his network of acolyte colleagues, it would be good to also start boycotting these insurance companies. We would have to find out which high street insurance companies use Unum and Swiss Re insurance products. For example the large UK company Aviva (formerly Norwich Union), who do a lot of automobile insurance, uses Unum products (but we need to check these facts before going ahead).

With the latest CDC figures showing that 2% of the population now have chronic fatigue syndrome, once CFS patients, their families, and their friends start boycotting these insurance companies, that will show that the CFS community is not as frail and easy to push around as these megalomaniac insurance companies think.

Great idea!

 

[fred]

Do US insurance schemes pay out for HIV related illness?

In the UK, private insurance (whether it be for treatment as an alternative to the NHS or for income replacement or a lump sum disability payment) specifically excludes HIV and so, I assume, UK terms and conditions would be amended to exclude XMRV too, if/when causation is proven. If this is the case, then XMRV is not bad news for UK insurers: they will simply have moved from excluding ME on the basis of it being a psychiatric diagnosis to excluding it on the basis of it being a retrovirus.

 

[justinreilly]

Short-Term Profits are What Matters to Insurers

In which case, as tomk hinted earlier (but I was slow on the uptake), it may be that in this XMRV circumstance, the objectives of the Wessely School are no longer aligned to the objectives of Unum.

This is a good possibility. Wessely is not going to just start saying XMRV is a cause of ME since that would mean he would be drummed out of medicine for his crimes.

Insurers, and most public corps, generally operate on a this-financial-quarter-only mentality. Look at the big investment banks in the US. The CEOs knew what they were doing and they knew that to get monster bonuses they had to take outrageous long term risks in order to get astronomical short term profit which determines their bonuses. Then they can move on with a great severence package with all the shareholders holding the bag. Shareholders are myopic too. If this quarter's profits are not up they are going to be very angry at management. So Management just gives them what they want.

Also, the 'market for corporate control' ensures that the focus of directors and management is always on current profitability. If the corp doesn't pursue maximum current profitability, the share price will sag. The share price in a world of perfect knowledge would equal future profits (reduced to current value), but human knowledge and rationality is limited so it usually reflects current profits more than it should. If the share price sags, a corporate raider can come in, buy a controlling interest, fire directors and officers, install his own and direct them to pursue maximum current profit. This raises the share price and the raider sells pocketing a profit. The mere threat of this possibility keeps the focus on current profitability.

People own insurers because they have great cash flow from premiums. But if they have to pay out a lot of claims this obviously eats up the cash flow so they focus a lot of attention on avoiding current payouts.

Directors won't interfere because corporate law mandates that corporations pursue the maximum possible profit (to the exclusion of all other considerations). This is a major reason why corps act sociopathicly. Directors have a very limited amount of time to review management decisions and if they make a decision against management that ends up costing the corporation money, they will be held personally liable via a shareholder derivative suit. So the board generally rubberstamps.

In the wake of Enron and WorldCom, directors are burdened with the responsibility not to simply take everything presented to them by officers at face value. This has had a salutory effect on corporate governance, but only a very modest one.

So even if proper treatment is only a few years away, an unscrupulous insurer would continue to sponsor 'thought influencers' (PR shills) like Wessely, Sharpe and White to create confusion so the insurer can say the science is unsettled and thus can continue to deny claims.

 

[Robin]

Do US insurance schemes pay out for HIV related illness?

In the UK, private insurance (whether it be for treatment as an alternative to the NHS or for income replacement or a lump sum disability payment) specifically excludes HIV and so, I assume, UK terms and conditions would be amended to exclude XMRV too, if/when causation is proven. If this is the case, then XMRV is not bad news for UK insurers: they will simply have moved from excluding ME on the basis of it being a psychiatric diagnosis to excluding it on the basis of it being a retrovirus.

Yes, US insurers cover HIV testing and treatment. But, there's a few caveats. If you acquire HIV when you're uninsured, and then later you try to purchase an individual plan you'll probably either be denied coverage or be offered unaffordable coverage. But if you have insurance and then get HIV then coverage varies by plan -- they can't drop you for having it. Some of this will change under Obama-care; they will subsidize high risk pools and eliminate the 6 month coverage-wait for pre existing conditions (I think).

It's interesting that UK private insurers don't have a dog in the XMRV fight. Big pharma could benefit by selling treatment, and the governments could potentially benefit if people get well enough to get off disability. US private insurers and NHS will end up footing the bill. Raltegravir is not cheap!

 

[Knackered]

It's interesting that UK private insurers don't have a dog in the XMRV fight. Big pharma could benefit by selling treatment, and the governments could potentially benefit if people get well enough to get off disability. US private insurers and NHS will end up footing the bill. Raltegravir is not cheap!

For people such as myself who want to return to work, the government will save money by prescribing antiretrovirals.
Let's say Ralitegravir costs 650 a month.

The cost of being on benefits is say:

Housing Benefit: 350
Council Tax: 70
Incapacity benefit: 360
DLA (Mobility): 200

That's 980 a month vs 650 on the antiretrovirals.

 

[Snow Leopard]

^ Plus the productivity benefits of working...

 

[Hope123]

Yes, US insurers cover HIV testing and treatment. But, there's a few caveats. If you acquire HIV when you're uninsured, and then later you try to purchase an individual plan you'll probably either be denied coverage or be offered unaffordable coverage. But if you have insurance and then get HIV then coverage varies by plan -- they can't drop you for having it. Some of this will change under Obama-care; they will subsidize high risk pools and eliminate the 6 month coverage-wait for pre existing conditions (I think).

It's interesting that UK private insurers don't have a dog in the XMRV fight. Big pharma could benefit by selling treatment, and the governments could potentially benefit if people get well enough to get off disability. US private insurers and NHS will end up footing the bill. Raltegravir is not cheap!

I think some of the prior posts were talking about private disability insurance and not health insurance which are two different things.

Also, many of us do not have private health insurance but have Medicare/ Medicaid so US public insurance will also need to pay.

Also, if we work we pay taxes so it would be to at least US gov't interests to get us, especially the younger ones, well.