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MrLogical
Cheshire, CT
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Norm G Smith wrote: I feel sorry for these people. Here in Canada this is unheard of. Everyone has "Universal Health Care." That means any doctor, any hospital, anytime, and no medical bills allowed.
Our single-payer system means all bills are sent to the Government.
To learn more watch Michael Moore's new movie "Sicko." Then why do so many Canadians with grave medical problems come to the US for their care? I've got a hunch that if this girl had been in Canada with the same malady, the outcome would have been the same.(In fact, her life might have ended sooner.) Canada's vaunted universal healthcare system is over-hyped and overrated - just like the UK and France.
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What about the providers
Brunswick, ME
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FireMedic wrote: just an observation, all those defending the insurance companies are from CT....insurance capital of the world. It is easy to guess what side they are on, until they have a tragedy strike their family. At that point, I would be curious to see how they feel about those 1.8% denials if they were in the "denial" pool and suffered a tragic outcome from the denial.
To those from the insurance company: Ultimately what you are seeing here is the collective frustration of American with the power you have bought from our Congress. Realistically, the sad reality is that the liver transplant for this girl was a bad option because she would require drugs to suppress her immune system which would worsen the leukemia. The sad tragedy is that she had cancer. One hopes that the liver went to a person it could truly benefit (if their insurance company agreed to pay, that is). The insurance companies can argue all they wan that Americans are entitled to whatever they want if they pay out of pocket...no one can afford it. I have a serious worker's comp injury (I am a firefighter). The insurance company has never questioned the legitimacy of my injury; however, they deny and delay care to the point of worsening my injury. As to why the doctors don't pay, well, my surgeon did pay for my 1th and 12th surgeries b/c he was so fed up with you b@#stards. It was not his financial responsibility, however. The insurace company was responsible for my treatment. Start paying for treatment that is due or stop collecting premiums and leave the business. Isn't worker's comp a state program? Do they have minimum benefits that have to be offered? Have you spoken with your HR rep about this?
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What about the providers
Brunswick, ME
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CT citizen wrote: On the other end of the spectrum CIGNA battled me for the reimbursement of a $300 wig that I needed when I lost all my hair due to chemotherapy trements. CT, which is the state where CIGNA is headquartered, has a law that was signed into effect about two years ago, that makes all insurers in this state cover this for cancer et al patients. That wig, as silly as it sounds, enabled me to go back to work full-time in my professional position and be part of society again. I had to get the Attorney General's office involved to force CIGNA to pay this reimbursement. My only point is that CIGNA (and I'm guessing the rest of the insurance companies) battles on everything from the very costly to the very low cost as well. And when you are the one who is sick, you absolutely need an advocate to battle for you as you typicallly are not up to the 50 phone calls, letters, documentation, faxes, etc., when you are battling for your life.
SAD. Do you get your insurance through your employer? Does your employer self insure? If so, your employer can design a plan that does not have to meet state mandates. You may wnat to blame your employer for not covering wigs, not the insurance company. If this is a fully insured plan, then the insurance company is at fault.
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