The State of Connecticut vs. Dr. Charles Ray Jones - A Hangin' In Hartford Written by Rick Vassar April 17, 2007
Lyme Disease Doctor Risks Career to Treat Chronically Ill Kids
You hand in your ticket, to go see the geek, who walks up to you, when he hears you speak, Says `How does it feel to be such a freak', you say `impossible' as he hands you a bone. And something is happening and you don't know what it is, do you Mister Jones... Bob Dylan - "Ballad of the Thin Man"
Dr. Charles Ray Jones is a physician in Connecticut. He treats kids. Sick kids. Really sick kids. These kids have chronic Lyme disease. The Lyme bug, transmitted by tick bite, is quite treatable if it's caught and diagnosed quickly, and can be cleared up with a relatively short course of oral antibiotics.
If the bug sets up shop in the body, though, the resulting maladies can be quite severe. Rheumatoid arthritis, cardiovascular problems, migraines, and diminishing cognitive ability are just a few of this disease's debilitating results. The problem with Lyme disease is that these symptoms have varying forms of severity, and this makes it hard to diagnose and difficult to treat.
The good news - Lyme disease will rarely kill you. The bad news - treating a Lyme patient can go on for years, and can be very expensive.
In my experience, there are two things health insurers really hate:
1. Diseases that go on indefinitely 2. Diseases that are expensive to treat
Since Lyme disease fits into both categories, it's not surprising that health insurers are reluctant to pay for ongoing treatment. It just doesn't fit their vision of the bottom line. This is where it gets interesting.
The Case of Dr. Charles Ray Jones
Dr. Jones has been advocating aggressive treatment of chronic Lyme disease for years. He has treated thousands of kids with great success. One day, he receives a call from a parent who ostensibly wants antibiotics for their child due to the effects of Lyme. Dr. Jones allegedly prescribes antibiotics over the phone. Well, it turns out that the child was central to a custody battle, and it appears Dr. Jones got caught up in this. A complaint was made to the medical board, and Dr. Jones has spent the past few years defending himself.
Late last year, the Infectious Disease Society of America (IDSA), stated in no uncertain terms that long term chronic Lyme does not exist, meaning that in their opinion, Dr. Jones is practicing voodoo medicine and he must be stopped at all costs.
Dr. Jones is 77 years old. He really doesn't need this. He could just walk away. In fact, the State of Connecticut told him just that: retire, give up your license, and we will drop the charges. Dr. Jones has decided to fight, for the kids, incurring the wrath of his licensing state and the loss of his reputation. He goes back before the board this Thursday, April 19, 2007.
The Infectious Disease Society of American (IDSA)
The State of Connecticut intends to call Dr. Eugene Shapiro of the Yale University School of Medicine. Dr. Shapiro helped shape the research that led the IDSA to say unequivocally that chronic Lyme disease does not exist.
They say the science is good. They say their guidelines are voluntary. They also state that members of the panel who wrote the guidelines have ties to Lyme product producers who will benefit from the findings. Some even have ties to Baxter vaccines, a pharmaceutical company developing a Lyme vaccine. It seems a Lyme vaccine is more valuable to the manufacturer when the effects of the disease are short term and can be cured in a majority of patients.
Connecticut Attorney General Richard Blumenthal thinks the IDSA's science is good. He also believes that the science is incomplete, and that the IDSA may have held back the science that did not enhance its conclusion. If so, Blumenthal contends, the IDSA may have violated state antitrust laws.
The reason?
Although the guidelines are voluntary, health insurers are using the IDSA's findings in their evidence of insurance to deny an ailment categorized as chronic Lyme disease. If the IDSA held back information that challenges their findings, patients in Connecticut have limited access to covered treatments, and that could be an antitrust violation.
The Big Picture
So then there's Dr. Jones. He tells the IDSA they are wrong. He continues to treat patients with chronic Lyme disease. Nobody really cares all that much, except his patients, who see him as their last hope. Then these patients submit their bills to their insurance company. Sorry, they're told, it's not covered. Why?
Well, it's not a disease.
So the patient sues. And the insurers gets ticked (no pun intended), and very conveniently, someone comes forward with a complaint, and the licensing authority comes in with its full force of law. Why do you think most doctors won't treat chronic Lyme disease?
They're afraid. They're afraid of losing everything, like Dr. Jones.
And if you think this is an isolated incident, think again. Dr. Zackrison in Virginia, Dr. Jemsek in North Carolina, among others, have been intimidated and threatened in incidents similar to Dr. Jones. An innocuous complaint turns into a career threatening event. Many more doctors turn away patients at the door because they can't afford the risk.
The IDSA says that they are concerned that a long course of antibiotics may be counterproductive to the healing process. They believe their findings are protecting the patient from needless long-term therapy. They do this by telling folks that the illness doesn't exist long term and recovery from the short term effects of Lyme disease can be cleared up with a mild and short course of antibiotics.
I have two questions for the IDSA:
1. If Lyme disease is so easy to clear up, why in the world would we need a vaccine? 2. If chronic Lyme disease does not exist, what the heck do all these people have? They're pretty good at telling us what it isn't. I'm guessing if you diagnose another cause, the health insurers would be obligated to pay for treatment for a seriously ill patient who won't die. And that's not good.
There is a coordinated effort to control the outflow of funds from the insurers, using the medical community to fight for the greater good of the bottom line. Dr. Jones is merely collateral damage. It's good business. It's bad medicine.
And don't believe for a minute that this strategy is reserved for this one chronic illness. Your illness may be next. In fact, if I had to make a prediction as to a disease that is being primed for this, the answer to me is obvious: autism.
Email this * Subscribe to this feed Rick Vassar CPCU, ARM, AIS, ARM-P writes primarily on the insurance industry. His book Hide! Here Comes the Insurance Guy uses humor to explain insurance strategies in language everyone can understand
Posted by FightFireWithWater (Member # 5781) on :
Thanks for this informative write-up, Rick.
Let us hope that with enough people shining light on this case, it will amount to an attempted hanging only.
Posted by Lymetoo (Member # 743) on :
Wow! Great article!
I pray that this man is NOT hung or even slashed with a wet noodle. We desperately need him....FOR THE CHILDREN!
Posted by bpeck (Member # 3235) on :
Excellent article Rick.
And I might add that there are people with multiple diagnoses (i.e. several other dx's which pre date a Lyme dx ) who use the dx that's covered by insurance... it's a fact of life- that even if it's wrong dx- you use the wrong one if it gets you coverage of what you need.
I know 2 people being treated for Lyme but under a MS dx. You do what you have to.
I would be interested in knowing more about Baxter's Lyme vaccine- like who's advising them on it?? ANy conflicts of interest there?
And also if CT. Atty General is persuing anti-trust angle.
Thanks. Barb
QUOTE:Connecticut Attorney General Richard Blumenthal thinks the IDSA's science is good. He also believes that the science is incomplete, and that the IDSA may have held back the science that did not enhance its conclusion. If so, Blumenthal contends, the IDSA may have violated state antitrust laws. END QUOTE
Posted by Lymetoo (Member # 743) on :
up
Posted by klutzo (Member # 5701) on :
Bravo! This is to the point and well written. Now if we could just get it on the front page of every newspaper in the country.....fat chance.
Klutzo
Posted by bettyg (Member # 6147) on :
thanks for posting...
Posted by CaliforniaLyme (Member # 7136) on :