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This interesting response to my post just came in from Janet. [My comments
in brackets.]  ~Valerie in Tacoma
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I just wanted to put my two cents in on the medical records issue: Valerie
is 100% right about the nature of medical records.  Currently, almost all
doctors rely completely on patient self-report and do not ask for past
records.  However, the situation may change slowly as we get electronic
medical records.  In fact, the major reason for electronic medical records
is to avoid redundant medical tests, communicate allergies and current
medications, etc.  Medical records may change drastically within the next
decade, so doctors may expect to see documentation from past tests.

Still, I would argue that it may be wise to specifically avoid documenting
CD, for future insurability reasons.  In particular, people who are older,
but not close to 65, and in precarious health insurance
circumstances (self-employed, employee of small company, may change jobs,
company may drop or drastically change health insurance, etc.) may want to
avoid having a formal test for this reason, since people really do find
themselves priced out of the insurance market for things like CD.

Eventually, there will be some kind of reinsurance to make the insurance
companies less skittish about taking on people with pre-existing conditions
like CD, but for the next few years, and
probably longer, people who anticipate being on the individual or small
group health insurance market are probably best with less testing rather
than more.

Janet
(PhD candidate, Health Policy)
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[It's not just health insurance premiums that are impacted by pre-existing
conditions.  Life insurance as well.  On average, diagnosed celaics have a
higher death rate than the general population.  That increased death rate
may only apply to non-diet-compliant celiacs, but when it comes to setting
fees the insurance company doesn't care whether you are compliant or not.
For example, several years ago, I applied for life insurance.  At the time
of testing, my cholesterol was temporarily elevated (440) due to my
forgetting to fast for breakfast.  So they set my fee at a higher rate.  No
matter what evidence I presented that  my cholesterol levels are usually
normal, they stuck with the higher fee.]

Valerie in Tacoma

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