Welcome to PatsFans.com

Not Everyone's "Happy" With Their Health Insurance

Discussion in 'Political Discussion' started by Mrs.PatsFanInVa, Feb 10, 2010.

  1. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

    Joined:
    Sep 7, 2009
    Messages:
    15,376
    Likes Received:
    246
    Ratings:
    +350 / 8 / -3

    #12 Jersey

    5 year old Kyler VanNocker has neuroblastoma, a rare, deadly childhood cancer that attacks the nervous system, creating tumors throughout his body.

    He was diagnosed in 2007 and endured a year of medical treatment, with complications he barely survived. Thankfully, it knocked his cancer into remission for 12 lovely months, and he got to revel once again in the glories of childhood.

    Last September, the disease came roaring back. This time, only one form of treatment, something called MIBG therapy, could help save his life.

    But HealthAmerica refused to pay for the MIBG, which it considers "investigational/experimental" because there is "inadequate evidence in the peer-reviewed published clinical literature regarding its effectiveness." Nor is MIBG approved by the Food and Drug Administration, another criterion that HealthAmerica requires.

    How come, then, asks the lawsuit, HealthAmerica covered not one but two prior therapies for Kyler that did not possess these supposed requirements?


    Ronnie Polaneczky: Parents suing to force insurance firm to cover their ailing son's therapy needs | Philadelphia Daily News | 02/09/2010
  2. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

    Joined:
    Sep 13, 2004
    Messages:
    31,383
    Likes Received:
    138
    Ratings:
    +283 / 9 / -9

    #24 Jersey

    No-one has said that everyone is happy with their insurance. But polls show that most are at least satisfied with it.

    Regarding the issue as opposed to the title, we all want kids to get life saving treatment if we have it but we also can't just throw tons of money as every theoretical solution without premiums going up. Each unusual case needs to be considered on a case by case basis.
  3. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

    Joined:
    Sep 7, 2009
    Messages:
    15,376
    Likes Received:
    246
    Ratings:
    +350 / 8 / -3

    #12 Jersey

    Right - and this differs from Sarah Palin's threatened "death panel" how?
  4. resnor

    resnor Rookie

    Joined:
    May 6, 2009
    Messages:
    220
    Likes Received:
    0
    Ratings:
    +0 / 0 / -0

    Are you serious? Determining whether to use money on experimental treatment is much, much different than telling old people they can't be covered because they're too old.
  5. patsfan13

    patsfan13 Hall of Fame Poster PatsFans.com Supporter

    Joined:
    Jan 4, 2005
    Messages:
    24,624
    Likes Received:
    67
    Ratings:
    +126 / 7 / -13

  6. MrSparkle

    MrSparkle Rookie

    Joined:
    Nov 5, 2007
    Messages:
    813
    Likes Received:
    7
    Ratings:
    +7 / 0 / -0

    There will never be ANYTHING that everyone is happy with.

    Reform is needed. Where Reps and Dems disagree is how, not if.
  7. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

    Joined:
    Sep 7, 2009
    Messages:
    15,376
    Likes Received:
    246
    Ratings:
    +350 / 8 / -3

    #12 Jersey

    Determining who and what to treat, regardless of the reasons, is still denying treatment to some and allowing it for others. It's a decision being based on something other than humanity - be it age, cost or possible effectiveness.
  8. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

    Joined:
    Sep 13, 2004
    Messages:
    31,383
    Likes Received:
    138
    Ratings:
    +283 / 9 / -9

    #24 Jersey

    It depends on what would not be allowed in a "death panel" but it's the difference between something known to work vs. a shot in the dark. It would be difficult to defend an expensive experimental procedure on an 80 year old but not so much, say, a hip replacement.
  9. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

    Joined:
    Sep 13, 2004
    Messages:
    31,383
    Likes Received:
    138
    Ratings:
    +283 / 9 / -9

    #24 Jersey

    No wonder healthcare is so f*cked up as you are in the industry and can't see the craziness of not considering "possible effectiveness" as a determination for treatment.

    :bricks:
  10. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

    Joined:
    Sep 7, 2009
    Messages:
    15,376
    Likes Received:
    246
    Ratings:
    +350 / 8 / -3

    #12 Jersey

    Part of what people who are upset about the possibility of a national health care plan is that they would no longer be allowed to persue any avenue they desire - and that includes "possible effectiveness."

    In the context of THIS particular care the insurance company was the one who was not taking into consideration the "possible effectiveness" of the treatment - and they should have been because

    "It's considered the standard of care in Europe and the United States for recurrent neuroblastoma," Kyler's oncologist, Stephan Grupp, told me then. "It's not an unproven treatment with no basis in medical science. Actually, the results are often very good."

    What I'm pointing out is that insurance companies don't always base their reimbursment on "possible effectiveness" but rather on things like, oh say, cost.
  11. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

    Joined:
    Sep 13, 2004
    Messages:
    31,383
    Likes Received:
    138
    Ratings:
    +283 / 9 / -9

    #24 Jersey

    Of course cost is a factor. Insurance companies have a tight profit margin, yesterday there was a thread complaining about premiums going up, today about denied coverage. All the time the profit margin, historically, is about 3%. They can't cover more, not increase premiums and stay in business unless the cost they pay goes down. The math doesn't work.
  12. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

    Joined:
    Sep 7, 2009
    Messages:
    15,376
    Likes Received:
    246
    Ratings:
    +350 / 8 / -3

    #12 Jersey

    Interesting - since a hip replacement, which is always elective surgery, for an elderly person costs approximately $45,000.00 and is expected to last an average of 10 to 15 years (if the patient lives that long) and the drug being requested to save the life of a 5 year old child was $110,000.00 and could keep that child alive for another 80 years.

    Of course, the 80 year old doesn't have nearly as long to live so the insurance companies aren't taking on a possible greater burden by giving him a hip whereas a child with cancer may have a reoccurance.....probably more cost effective to make sure he doesn't get the chance, I suppose.

    Hip replacement - Wikipedia, the free encyclopedia
  13. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

    Joined:
    Sep 13, 2004
    Messages:
    31,383
    Likes Received:
    138
    Ratings:
    +283 / 9 / -9

    #24 Jersey

    I don't care how much a hip replacement costs, I just picked a typical old person thing. It's silly to judge insurance companies on this one case; the fact remains that most people are happy with their insurance, most people are happy with their healthcare and most people think it costs too much.

Share This Page

unset ($sidebar_block_show); ?>