weswelker#83

Primary Physician Care, a privately-owned insurance company based in Charlotte, North Carolina, has now twice refused to pay for a 3-year-old's special leukemia treatment recommended by doctors at Duke University Hospital—even after the child's mother called the insurance company and spoke personally to the president.

http://citizen-times.com/apps/pbcs.d...132&source=rss

Stokes

In this particular case its sad to say, but the therapy regimen he is being put on has almost no chance of success. Should the insurance company be forced to pay for treatment that will most likely have no effect on outcome? Honestly I don't know the right answer to that question. You'd like to have them pay for every opportunity, but is that realistic? It makes for a tough decision. If he's my child, sure, I go for it, I'd try anything, but at some point a cost - benefit analysis needs to be made by the people paying. This unfortunately will be true whether the program is run by a private company or by the government. In fact I worry that a government run program will be even worse at these kinds of decisions than the current private system. There's only so much money to go around in providing healthcare, and exhausting every single therapeutic opportunity no matter what the chances of success will bankrupt the system.

cupofjoe1962

I hate insurance companies !

They should have to pay as long as the procedure is approved by the
AMA and two doctors sign off on the recomendation of treatment.

otis p. driftwood

As long as you don't wind up being one of the people complaining about the cost of your health insurance, that's fine.

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Stokes

I like the idea of putting the decision making in the hands of doctors rather than bureaucrats. I guess the question is would the cost of that kind of process be prohibitive? I mean a doctor is going to try anything that has even a 0.001% chance of working irrespective of cost. Of course it should be tried, but is there any system that cold actually pay for all those treatment options? I'd love to think that there is, but I'm skeptical it would work, even with a huge, highly funded government run program.

It sounds awful, but at some point the decision, and the payment, has to be left up to the individual, doesn't it?

wistahpatsfan

Wtf.............

QuiGon

There's one ridiculously vague passage in the article:

"But then his doctors heard from doctors at Duke University Medical Center about a treatment protocol that has proved effective in cases like Paxten’s."

Fact is that most insurance companies will not pay for protocols unless used for the original purpose intended. Sorry, but that's a fact of life. If every insurance company had to pay for every treatment that worked in "cases similar to such-and-such" then we'd all be paying... oh, about $250,000 annually for health insurance.

This is a fundamental difference between liberals and conservatives. Liberals love to play on emotions... here's a picture of a cute kid that has a very deadly disease - how can you be such a heartless bastard and not help...? Conservatives approach from a much more logical, rational standpoint.

sdaniels7114

You're oversimplifying. The kid's doctors approve of the procedure. We don't know who it is in the insurance company that disagrees. The exact person or people who denied payment is secret. We're not talking about putting magical stones on the kid's body to suck the evil spirits away. We're talking about a well-documented procedure that's working. The kid is unquestionably getting better.

QuiGon

Of course the doctors approve - they've got nothing to lose. But as I said above, insurance companies generally do not approve of protocols except for their original intended purpose.

shmessy

Funny, how the same people who were screaming to keep Terry Schiavo breathing in a vegetative state for 15+ years at great cost are now protesting to pull the plug on a 3 year old kid who is alert and wants to live because of the "high cost".

Congratulations. You folks just defined yourselves in this thread.

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