The insurers got what they wanted, IMO -- they delayed this kid's expensive treatment so long, she passed away hours after they finally reversed their decision. (Which only happened after protesters gathered around their office buildings and groups of doctors signed a letter urging them to reconsider their refusal to pay for the transplant surgery.)
From the article:
Geri Jenkins of the California Nurses Association said the teen had insurance, and medical providers felt comfortable performing the medical procedure. In that situation, the the insurer should defer to medical experts, she said.
"They have insurance, and there's no reason that the doctors' judgment should be overrided by a bean counter sitting there in an insurance office," Jenkins said.
(Emphasis added by me.)
NO KIDDING. That's precisely what I went through when I was trying to get physical therapy for my knee, years ago. Some freaking bean counter in some office declared that I'd had "enough" treatment, and meanwhile I couldn't walk without a cane *and* there was a very visible difference in the amount of muscle tissue in my left vs. right leg. Enough treatment? WTH? I was brought up with the admonition, "Never raise your voice on the telephone", but I raised it THAT day when I called to find out why they were stopping my treatments. The wheels got put in motion for them to talk to my orthopedist and physical therapist, and extend the treatment. But that's a conference call that never should have been necessary, nor WOULD it have taken up everyone's afternoon if the insurance company had relied on the actual medical staff who were treating my injury for an evaluation. (Incidentally, this was a DIFFERENT cheapskate corporation than the one spotlighted in the news article. They all have the same philosophy.)
Anyway, if I was furious over something as non-life-threatening as treating a knee injury, how must this poor bereaved family feel right now? I hope the family sues, and I hope the cheapskate corporation pays out more in damages than they EVER would have paid in medical expenses if the girl had received the treatment and survived.
1 comment:
I understand your anger, but unfortunately there was a reason the insurance company wouldn't pay for the transplant. While the transplant would have solved one problem, it would have created a slew of new problems. Ponder the ramifications of putting a child with leukemia on immunosupressant drugs. The immunosupressants are critical in ensuring the transplanted organ is not rejected, but it would have killed her because the cancer would have literally had free reign.
It really was a catch-22
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