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The sad fact that exists today is that our current system wastes $210 billion/year just in ER, but a five year old doesn't deserve the chance that might make him and his family feel better because it is just "experimental treatment".
BTW, how do these insurance companies come up with the idea that they can overrule a doctor's advice with the statement that it is merely "experimental"? Are the middle men that much more qualified than a physician involved with the treatment?
The sad fact that exists today is that our current system wastes $210 billion/year just in ER, but a five year old doesn't deserve the chance that might make him and his family feel better because it is just "experimental treatment".
BTW, how do these insurance companies come up with the idea that they can overrule a doctor's advice with the statement that it is merely "experimental"? Are the middle men that much more qualified than a physician involved with the treatment?
The sad fact that exists today is that our current system wastes $210 billion/year just in ER, but a five year old doesn't deserve the chance that might make him and his family feel better because it is just "experimental treatment".
BTW, how do these insurance companies come up with the idea that they can overrule a doctor's advice with the statement that it is merely "experimental"? Are the middle men that much more qualified than a physician involved with the treatment?
I guess it is a classic example of insurance companies getting between you and you doctor.
This is a very sad case and I certainly hope this young man receives the experimental treatment. At the same time, this case is not so cut and dry. The MIBG treatment is not the standard of care. I don't see how any physician can claim a non-FDA approved medication and a medication that lacks peer reviewed evidence is the standard of care. People think the FDA is a villain but it's there to protect you and I. They have nothing to gain by failing to approve of a drug. It's funny because the anti-FDA conspiracy theorists bash the FDA for approving medications like Viox yet when they are doing their job and not approving a drug like MIBG without good studies, they are suddenly the bad guy. Make up your mind!
And it pains me to say this but the insurance company is within it's right. Why shouldn't money be a factor? If it costs 110,000 for two rounds of a therapy that isn't even proven to work then why can't they make a decision based on that? It's one thing if a procedure costs 10,000 but an extra 100,000 is a lot of money.
And I have many examples of the government (Medicaid) rationing and not providing treatment based on money that only private insurance pays for. I know the government wouldn't have paid for this either.
This is a very sad case and I certainly hope this young man receives the experimental treatment. At the same time, this case is not so cut and dry. The MIBG treatment is not the standard of care. I don't see how any physician can claim a non-FDA approved medication and a medication that lacks peer reviewed evidence is the standard of care. People think the FDA is a villain but it's there to protect you and I. They have nothing to gain by failing to approve of a drug. It's funny because the anti-FDA conspiracy theorists bash the FDA for approving medications like Viox yet when they are doing their job and not approving a drug like MIBG without good studies, they are suddenly the bad guy. Make up your mind!
And it pains me to say this but the insurance company is within it's right. Why shouldn't money be a factor? If it costs 110,000 for two rounds of a therapy that isn't even proven to work then why can't they make a decision based on that? It's one thing if a procedure costs 10,000 but an extra 100,000 is a lot of money.
And I have many examples of the government (Medicaid) rationing and not providing treatment based on money. I know the government wouldn't have paid for this either.
Ya, $100,000.00 IS a lot of money...and some insurance CEOs make more than that in one day.
An economic note: In 2006, William “Dollar Bill” McGuire, CEO of parent-company UnitedHealth Group, walked off with a $1.1 billion golden parachute (on top of the $500 million he had already raked in) — though he had to return some of it in an options-backdating scandal.
In my opinion, denying life saving claims to enrich a CEO is murder in the first degree for the intent of robbery!
In my opinion, denying life saving claims to enrich a CEO is murder in the first degree for the intent of robbery!
Yes , but the Repugs who Worship the Wealthy as their new "god' have been brainwashed to defend and protect these slaughterhouse kings, the legal Mafia...they will fight any reform so the U.S. can be on equal footing with all the other industrialized nations...they prefer Third World status....one day it will be them...and then and only then will they see the light...I hope it's too late for them.
I bet if we left this boy to the "free market," he'd be dead.
Experimental treatments would not be covered under the proposed health care bill as written. They allow a review periodically, but he would have been denied for this as well until some future date of review. This review can be requested currently with your insurance company as it stands.
There are private cancer treatment centers that do allow experimental treatments and they are funded mostly by donations.
St Jude's is a Children's hospital (not for experimental therapy per se), but are there to handle any child regardless of ability to pay. There are other centers and opportunities for children like this.
Many people believe that because the government would be in charge that risky and experimental treatments will open like a flood gate, but there is nothing that would indicate this will happen.
I'm worried that homeopathic medicines may not be allowed or covered as I cannot find specific language pertaining to this and a portion of the advice for "proper" treatment will be from big Pharma... blech.
Last edited by Robinstyler; 02-10-2010 at 06:55 PM..
Reason: spelling corrections
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