Posted on 01/05/2005 8:20:19 AM PST by RushCrush
A Cedar Rapids family says their 8-year-old son’s medical insurance carrier won’t pay for a bone marrow transplant to save his life. Daniel Canfield, 8, was diagnosed last month as having a d r e n o l e u k o - d y s t r o p h y (ALD) — a rare genetic disorder that damages a membrane surrounding nerve cells in the brain. The disorder was spotlighted in the 1993 movie, ‘ ‘ L o r e n z o ’ s Oil.’’ If left untreated, Daniel could degenerate to a vegetative state and die in two to five years, the family says. Daniel already is having eye troubles, his stepfather, Larry Anspach, said. A student at All Saints School, Daniel was to be admitted today to Fairview-University Children’s Hospital in Minneapolis to begin a 10-day procedure leading to a bone marrow transplant from his older brother, Thomas, 12. But the boys’ insurance company last week branded the procedure ‘‘experimental’’ and denied coverage. And on Sunday, the hospital took Daniel off its surgical schedule.
(Excerpt) Read more at gazetteonline.com ...
The Rainmaker. Good book.
I don't know. I don't belong to an HMO right now
and they are different.
Sorry about the double post. My computer is acting up and it is a new one.
You are ridiculous. Probably one of the worst
narrow-minded.
You know full well that a hospital is not going
to do anything like this without it being paid
for.
I am not being funny here. Why doesn't he just take Lorenzo's Oil?
Your very welcome. I loved calling the head office
this mornng. It was funny. I could tell the woman
who anwered was thinking "oh s***, bad press coming".
You said it. In this case, they should simply do the procedure, then bill insurance and continue to hound them for the money until they pay. Other insurers are providing this, and this insurer has no reason to turn down this procedure. Once again, I feel that the hospital is dropping the ball on this one - they are the primary advocates for this procedure, and they are the primary advocate for this child. They should be lobbing this insurer to cover this procedure, and the hospital should be bombarding the with information regarding the non-experimental status of this treatmen.
Oh yeah, and the insurers should pay for it. If they pick up ONE dime for some transvestite somewhere, they should pick up THIS.
Good question and it came to me as well. I'll try to find out...
I agree.
I have a congenitally tooth that had to be surgically removed when 3 attempts at surgical correction failed. When I got my dental policy I was aware that it didn't cover a dental implant. Now, several dentists and specialist dentists agreed that a bridge and crown restoration would not be suitable for replacing this tooth - go figure that I was missing the one tooth in my mouth where bridges would repeatedly fail!
Just because medical experts agreed that this was the best/only treatment for me did not mean that the insurance company now had to pay for it. I ended up paying out of pocket for the implant and the insurance company covered half the cost of the crown after I asked them to review my case. The insurer agreed that the implant was the best restoration and that's why they paid for the crown, 3 bone graft surgeries, and orthodonics in order to meet the end goal of an implant - but that didn't change the fact that the actual implant wasn't covered.
It would be wonderful if we could all have whatever medical care we'd like without needing to meet insurance policy requirements. It also would never happen...insurers are businesses and have policy rules for a reason. Sadly if this boy were living in a country with socialized medicine it'd likely be months before his family even got a firm diagnosis and he likely would not recieve a transplant at all unless he met very specific government-specified guidelines for the procedure. At least under our system he has a chance of getting it even if the insurer won't cover the expense.
I hope this boy can get his transplant because it sounds as if it's the standard of care for his condition. It may mean that his family will need to find charitable sources for the funding, or even try to self-pay. If it were my kid I'd move heaven and earth to make it happen regardless of the insurer.
Yes, that too. Intensive care units are now about $20,000 a day or more.
From what I've read, Lorenzo's Oil is used to stall the disease's progression, and is not a cure. A bone marrow transplant is considered when symptoms have started to appear or the early stages of degeneration of the brain tissue has been detected by an MRI scan.
Didn't feds ban it? Making it criminal to have?
Someone please enlighten me.
It's just a mix of derivitives of olive and rapeseed oil. Where'd you get the idea that it had been criminalized?
I will admit my only source of information is a stupid movie, but I thought that it stopped the progress cold if used soon enough.
Wan't this a John Grisham movie starring Matt Damon and Claire Danes?
I don't know. Maybe I was thinking about something people
used to use called Laitril or Latril or something like that.
Anyone know what it is or hear about it?
Sure they will. They recommended the treatment to save the boy's life. They are obligated to provide the service whether it is in their contract or not ...
No...hospitals only have to do treatment for people regardless of their ability to pay in EMERGENCY situations that unfortunately do not include diseases that slowly kill someone.
I know its an emergency for the boy and the parents know it, but the hospital doesn't have him on life support, that is why the won't do it until the are paid.
another problem, there are many reasons why the claim wasnt covered, from small details to false claims. this story has very little info, and my question is why isnt this child being seen at Gillette Childrens hospital or Shriner's Childrens hospitals rather than at Fairview, which is a good hospital but not known for their pediatrics when compared to the other two.
My typing is garbage today.
I meant to say:
That is why THEY wont do it until THEY are paid (the hospital).
Sorry all.
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