Cancer patient's response to insurer who said, "No biopsy for you, you're going to die anyway"

Janet says, "Despite what the official statistics say, metastatic (stage IV) lung cancer is NOT an automatic death sentence. Newer therapies and personalized medicine now offer such patients months or even years of quality time to spend enjoying family, friends, hobbies, even travel and work. Yet insurance companies and doomsday doctors still tell many patients… READ THE REST

See, this is what gets me about people who complain about the affordable care act. They don’t want the government to control their health care. As if the government is only out to let people die with their gridlocked and inefficient ways. Yet a for-profit insurance company is supposed to be a better alternative.

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I bet the response would have been different if the patient happened to have a 7-figure salary!

I’m fortunate that none of my ailments are life threatening, but there’s still a laundry list of options I’ve had to pass on just because my insurance said no and paying for them myself would have been ruinous.

Allowing these corporations to pick and choose what they’ll pay for is fucking criminal, especially when they love to run ad campaigns bragging about how their services promise a long and active life. Isn’t that false advertising?

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Who’s got the “death panels,” again?

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Then we realized that all of our customers are just going to die sooner or later. You wouldn’t believe the cost savings we’ve been able to achieve from that realization

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Ridiculous. I’m sure everyone has a story about someone they know that managed to extend their lifetime through treatment or beat terminal cancer. I think of my mother who was given 18 months to live and lived six years instead. And that was thirteen years ago, and medicine has only advanced. You can’t really say that a cancer patient is going to “die anyway” anymore, not at any stage. How cruel and baffling.

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If someone besides me has to make a call on my healthcare, I’d trust a government employee over a corporate employee whose bonus depends on denying my care. Sure government employees can be assholes like anyone, but the moral hazard isn’t baked in to a government employee’s job.

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The ‘Death Panel’ NHS have just instigated issuing tamoxifen or raloxifene to women with a family history of breast cancer (should they want it). As a health service (rather than an illness service) prevention is far cheaper than treatment.

I’m requesting that the OP/Blogger post a de-identified photocopy of the letter from Blue Cross

I work with and assist many small human resources departments and help them deal with insurance companies on behalf of their employees. I regularly interact with Humana, United Healthcare, Aetna and specifically Blue Cross Blue Shield of Illinois who is mentioned in this article. I see enough denial letters to know that this sounds like a gross exaggeration of the true reason for denying a claim. No letter ever says “there’s no need for you to have another biopsy because you’re going to die anyway”

I’m not yet defending the insurance company, but rather I want the author to provide a better summary of his claim denial. He may be accurate in his summary, but I’d rather make that determination for myself before jumping on the “insurance companies are all evil” bandwagon.

For the eleventybillionth time, this is a blog, not a news site.

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By which you mean what? That all the stories here have be from personal experience? One of the staff here replied to a similar comment the other day that his criteria for submissions to BB were anything that he found interesting. This website is like reading over the shoulder of some people who I have interesting taste, and I am pleased to do so.

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You want to turn this into a thread with lots of readers letting you know exactly how bad insurance companies are? Sure thing, dude:

I was turned down for catastrophic medical insurance (no coverage for prenatal care, delivery, or infertility issues) when I was 36 and 4 months pregnant because BCBS said I “had the potential for future infertility”. I believe it’s called menopause.

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The author’s blog had the following sentence fragment in quotes: “is not going to affect long-term health outcomes”. Am I wrong in assuming she’s quoting from her insurance company’s response? If that was in the insurance company’s response, I fail to see how “you’re going to die anyway” is a misleading summary.

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…insuring those patients will die sooner rather than later.

Clever intentional typo, or humorous coincidental mistake?

Profit-driven businesses should never be responsible for getting people medical care. Full stop.

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If you work involves dealing with for-profit insurance companies, you yourself should be able to provide plenty of examples to corroborate the fact that the industry makes life or death decisions all the time, to either offer, or to deny further care. If their profits (and executive bonuses) are based on declining extended or experimental care, it would be impossible for it to work any other way.

And as Wendell Potter (former insurance executive) has pointed out, it is not only the life or death care which gets rationed, it is also the small scale, everyday stuff which is subject to company decisions based solely on profitability, rather than health.

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Insurance companies are driven by incompetence at the lower levels and shortsighted greed in the executive suite, with a sprinkling of ethical individuals throughout making any particular decision somewhat unpredictable.

The longer it takes to pay a claim, the more money the insurance company makes, so the insurance company that has the least efficient people in the paying-out departments makes the most money and eventually buys out the less profitable competition. Darwinism of a sort.

Why yes, I do deal with insurance companies quite frequently. How could you tell?

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It’ll be interesting to see how Obamacare fixes this, just to see how deep into industry pockets it is.

Whoever decided that healthcare should be in the hands of capitalism was one sadistic fuck.

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If you want an interesting counterpoint, consider veterinary care. It’s really similar medical treatments, but the pricing is totally different because the lives being operated on are not all automatically considered infinitely valuable, and taboo to even think anything else.

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