http://www.kela.fi/in/internet/suomi.ns ... 02135501HN
So now you have to have a biopsy to get the benefits?
gluten and kela?
Re: gluten and kela?
If you're an old case, then not necessarily. For new diagnosis that seems to be the requirement now.
Re: gluten and kela?
Sounds like medical politics, namely the Americans asserting their usual dominance again. There's been argument about this biopsy requirement for almost 15 years now. Europeans have thought it was unnecessary but American gastroenterologists have absolutely insisted the diagnosis could not be made without it.
Many experts have said for years that the European standard of tissue transglutaminase antibody testing was actually more reliable than biopsy (the American standard), which yields too many false negatives if the characteristic intestinal lesions are localized. In fact I know more than one person personally who needed a second endoscopy to establish that they did, in fact, have active celiac disease. Finland and Italy were in the forefront of the research that created the transglutaminase antibody standard. And if you've got the antibody reaction to that enzyme (or even a positive on some of the earlier, less specific antibody tests) and you don't adopt the gluten-free diet, you've got other medical problems waiting for you in the future besides only the intestinal lesions.
Apparently this is yet another instance of a self-doubting Finnish institution, in this case its medical establishment, mistakenly yielding to the the misplaced but supreme self-confidence of BSD American specialists, in this case American gastroenterologists. (Who, just by coincidence we're sure, make dozens of times more money on each and every endoscopic procedure than they do on diagnosis based on the immunological evidence.) In America the odds are STILL today 20-to-1 or worse against an actual celiac patient ever receiving the correct diagnosis. Someone important in Finland must have their head up their arse to be following the American lead on this subject. Just because we SAY we're best in the world at medicine doesn't make it anywhere close to the truth. Not on the everyday clinical level, at least. It's almost insane for a medically advanced country like Finland to take cues from the death-spiraling institution of American clinical medicine.
This is probably a fairly dishonest pretext for KELA to pinch pennies in the short term by denying payment to some people who deserve or need it. If enough Finnish celiacs were to abandon gluten-free eating as a result, then I have no doubt the long-term cost to KELA for medical expenses would be be higher than the short-term savings. Then again some such institutions will pounce on such bargains without hesitation.
I wonder how long it takes to get scheduled for the endoscopy. Even a simple knee surgery can take over 6 months to get in these days, apparently.
As sad and disappointing as this is in principle, does it matter in practice? Can it really be noticeably more expensive to live without gluten in Finland? I mean sure if you insist on gluten-free versions of all your old favorites, maybe, but what about just avoiding flour-based products altogether? It's healthier anyway and rice and potatoes easily replace the starch.
Many experts have said for years that the European standard of tissue transglutaminase antibody testing was actually more reliable than biopsy (the American standard), which yields too many false negatives if the characteristic intestinal lesions are localized. In fact I know more than one person personally who needed a second endoscopy to establish that they did, in fact, have active celiac disease. Finland and Italy were in the forefront of the research that created the transglutaminase antibody standard. And if you've got the antibody reaction to that enzyme (or even a positive on some of the earlier, less specific antibody tests) and you don't adopt the gluten-free diet, you've got other medical problems waiting for you in the future besides only the intestinal lesions.
Apparently this is yet another instance of a self-doubting Finnish institution, in this case its medical establishment, mistakenly yielding to the the misplaced but supreme self-confidence of BSD American specialists, in this case American gastroenterologists. (Who, just by coincidence we're sure, make dozens of times more money on each and every endoscopic procedure than they do on diagnosis based on the immunological evidence.) In America the odds are STILL today 20-to-1 or worse against an actual celiac patient ever receiving the correct diagnosis. Someone important in Finland must have their head up their arse to be following the American lead on this subject. Just because we SAY we're best in the world at medicine doesn't make it anywhere close to the truth. Not on the everyday clinical level, at least. It's almost insane for a medically advanced country like Finland to take cues from the death-spiraling institution of American clinical medicine.
This is probably a fairly dishonest pretext for KELA to pinch pennies in the short term by denying payment to some people who deserve or need it. If enough Finnish celiacs were to abandon gluten-free eating as a result, then I have no doubt the long-term cost to KELA for medical expenses would be be higher than the short-term savings. Then again some such institutions will pounce on such bargains without hesitation.
I wonder how long it takes to get scheduled for the endoscopy. Even a simple knee surgery can take over 6 months to get in these days, apparently.
As sad and disappointing as this is in principle, does it matter in practice? Can it really be noticeably more expensive to live without gluten in Finland? I mean sure if you insist on gluten-free versions of all your old favorites, maybe, but what about just avoiding flour-based products altogether? It's healthier anyway and rice and potatoes easily replace the starch.
As he persisted, I was obliged to tootle him gently at first and then, seeing no improvement, to trumpet him vigorously with my horn.