Posted on 12/21/2007 4:37:17 AM PST by Erik Latranyi
That would explain our experience. We got new insurance a few years back, and my wife scrutinized every bill and EOB form. She is a wonderfully detail-oriented person. Things would get denied for no reason at all, and she was constantly calling to get things corrected.
After a while, they stopped making mistakes. It appears of file has been placed in the "Won't take any sh!t" pile, which is a pretty good pile to be in!
PBR’s correct. It was probably an inborn error of metabolism like Gaucher’s disease or Hurler’s syndrome. There are enzyme defects in both the liver and other organs and people will sometimes grasp at desperate measures seeking a cure.
So what would have happened had they not had insurance at all???
Then again - what would have happened if they were citizens of Canada or Great Britain?
Agreed.
I would really like to know the whole story on this one.
The purpose of establishing a government health care system is so that a government agency can routinely deny medical care in the same manner as the insurance company did in this case -- BUT WITHOUT ANY EXPOSURE TO PATIENT LAWSUITS.
Tell that one to the folks over at DU and see what they think about it.
So what makes this OK and the Terri Schiavo incident not OK? Shouldn’t insurance companies do everything possible to assure someone’s right to life? What makes an insurance company’s decision to not pay for a procedure which assures someone’s imminent death ethical? </stirring the pot!>
I found this on another website:
“The 17-year-old, who has recurring leukemia, has been on a waiting list for a new liver because she developed complications after a bone marrow transplant and chemotherapy.”
Having worked in the health insurance industry for 17 years for big national companies and smaller regional ones, I can tell you this is BS. Health Insurance companies are tightly regulated by the states in which the coverage policies are written. In most states, medical necessity criteria used to deny claims must be scientifically sound AND approved by state regulators.
Any such policy of random denial would be quickly spotted by the regulators. Furthermore, there would be far fewer denied claims if physicians didn't instill unrealistic expectations in patients and order unnecessary tests.
>> There has never been a Socialist system devised, anywhere, that did not include a way for the elite to escape the ministrations of their benevolent creation.
That is a universal truth, my FRiend, and somehow it ought to be front and center where we can all be regularly reminded of it. How about we tattoo it on Hillary’s forehead?
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I own a grass strip and used to run a not for profit glider club from my strip. I was told by AIG that I could not use a general liability waiver to protect myself from the club members because, as an agent of the insured, it might prevent them from suing me for negligence if somebody insured with them balls up an airplane on my runway and as a result AIG has to pay a claim for the damages. Essentially, AIG wanted to reserve the right to come after me to recoup their losses, regardless of whether I was at fault or not. That is not insurance. That is a law firm masquerading as an insurance company.
Needless to say, I no longer tow gliders from my strip and I do not allow anyone to operate from my strip besides me. AIG was foolish enough to send me a statement to this affect in writing, which was promptly forwarded to the State Insurance Commissioner. The Commissioners office seems pretty interested in this tact of AIG, although I'm not at all hopeful that anything will come of it.
That’s interesting. CIGNA already paid for a bone marrow transplant that fried her liver. Now they’re looking to get her a new liver, too?
Wow!! You are right on the money with that! Insurance has already socialized our medicine. You can go to this doc, but we won’t pay for that one. You may have 30 days of meds, but NOT 31. According to your numbered diagnosis, we will not pay for treatment. We need to get back to the days of cash medicine. Insurance is and has been a scam from the beginning. That being said, I have it for my kids.
At DU?......This IS socialized medicine! When A family cannot decide what’s right for their children, THAT is socialized medicine....
Is anyone taking into account that the person who was taken off life support was a child? This child did not have the financial ability to pay for the surgery. She was completely at the mercy of her parents and the insurance company. To me, that is the tragedy here.
Before anyone gets started, no, I am not in favor of “socialized medicine” or the S-Chip. It absolutely saddens me when a child’s life is cut short, particularly when something could have been done. God bless this child’s soul.
Can you imagine what would happen if liberals had their way with cloning and universal healthcare?
They would keep cloning and installing parts into people not matter how terminal they might be and regardless of the ethics.
I won’t dispute your contention. As I said, I was looking at it from the consumer’s point of view, where it is very difficult to see any sense in the procedures. To us, it appears random.
It could be they cleaned up their act, generally. Or maybe our doctors got better at filing claims. Hard to say. I will say we have been having remarkably fewer problems in recent years.
Thats the company I have...I hate dealing with them.
They would have been protesting in front of the local government health office. Good luck with that!
Doctors don’t like to tell families that there is nothing more they can do.
Doctors will install parts and do anything....provided they are paid.
Oh, how about the availability of a liver? Just because you are approved for a transplant does not mean one if immediately available for you!
There is a lot more going on here. This girl had leukemia and just received a bone marrow transplant and chemotherapy.
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