3 ms·
The cancer turned out to be more aggressive than was first surmised. Obviously, the insurance carrier was right to demand the aggressive, rather than "mild", ch
by polski-g 21d ago
The cancer turned out to be more aggressive than was first surmised. Obviously, the insurance carrier was right to demand the aggressive, rather than "mild", chemotherapy.
- stahtops 21d agoI returned to an email from the company’s chief scientific officer. Will approve tomorrow per oncologist request, his email said. The next day, I received multiple emails from company executives, authorizing milder chemo and apologizing. Milder chemo came and went. My body felt like it was filled with cement after infusions; my eyes could not stay open; but the hairs on my head grew longer, and there were no more boils in my throat making it impossible to swallow or speak. I went into remission that fall, and set myself to moving beyond cancer while also beginning to process the changes it had wrought on my body, and the nearness of my brush with death.
- polski-g 21d agon=1
- deleted 21d ago[deleted]
- DangitBobby 21d agoI'm sure the doctor arrived at that treatment plan magically without and without any clinical evidence whatsoever. If insurers want to practice medicine they can go work in a hospital.
- polski-g 20d agoDoctors should do the treatment for free, and only bill if the outcome is positive. If they're so confident, put their money where their mouth is.
- atmavatar 21d agoPerhaps the insurer should defer to the doctor, who is not only generally an expert at treating cancer but also much more familiar with the details of the patient. It baffles me why people are OK with insurers dictating care to doctors rather than the other way around.
- LorenPechtel 21d agoThe problem is the doctors have a big financial incentive to do something. Whether it's useful or not is secondary. Likewise, the patients want to do something, it's a source of hope. Remember the big flap about bone marrow transplants for advanced breast cancer? End result: a successful transplant meant you lived longer, but the risks of the transplant offset that, there was no survival advantage. This is not to say that there are no improper denials. It's pretty obvious some companies use red tape, and I suspect some reviewers are either being held to unreasonable standards or being overworked, resulting in deliberately lost paperwork. (Remember the scandal with the VA dropping patient visits to make the numbers look better?) And reading the article a few things stand out to me: 1) I can't find the name of the drug being denied. 2) She gives the stat that 49 million claims are denied but 0.2% were appealed--is that truly evidence of wrongdoing, or is it evidence of the insurance companies providing the no that doctors are afraid to give patients? And how many are entirely legitimate (my wife had a denial--right drug, right digits, wrong form, wrong dose. Clearly a human selected the wrong thing from a list)? 3) She talks about lives that would supposedly be saved by Medicare for All--never mind that that would collapse our system as there is considerable cost shifting from Medicare to those with commercial insurance.
- DangitBobby 21d agoYou don't update standard of care by not trying new treatments, and insurance companies also have financial incentives. It turns out they are the opposite of the incentives of their customers and the doctors.
- tekla 21d agoIt's not baffling because insurers are not dictating care. They only decide if they want to pay for it. Doctors are free to give any care they want.