Insurance company deny treatment to 5 year old with Cancer

[geauxtohell]

Oh. That reminds me. Since we have collective amnesia in this country, we forget that the issue of access to rationing has always been an issue in medicine.

Look at the history of dialysis in this country and the "God Panel" (I believe that was what it was called) in the 60s.

 

[xotoxi]

An insurance company doesn't cover a treatment that the federal government has deemed is experimental, and a treatment that is more than 50 times more expensive than a typical non-experimental treatment?

What is the gripe again?

Here's my question, Modo. If we had the public option, would the GOVERNMENT cove such an experimental treatment?

No.

But, I believe (and I may be mistaken) that the government mandates insurance companies to cover ALL chemotherapy and cancer treatments if they are NOT labled experimental. And some of those treatments are UBER-COSTLY.

 

[Si modo]

An insurance company doesn't cover a treatment that the federal government has deemed is experimental, and a treatment that is more than 50 times more expensive than a typical non-experimental treatment?

What is the gripe again?

Here's my question, Modo. If we had the public option, would the GOVERNMENT cove such an experimental treatment?

Likely not as it's they are the ones who say it IS experimental.

What is your gripe again?

 

[elvis]

An insurance company doesn't cover a treatment that the federal government has deemed is experimental, and a treatment that is more than 50 times more expensive than a typical non-experimental treatment?

What is the gripe again?

Here's my question, Modo. If we had the public option, would the GOVERNMENT cove such an experimental treatment?

Likely not as it's they are the ones who say it IS experimental.

What is your gripe again?

my gripe? not enough sex.

 

[geauxtohell]

The problem with drawing the line is that people will have a hissy fit...just like in the UK, where at a certain age, people with kidney failure are no longer eligible for a transplant.

That is where a line was drawn. It might seem arbitrary and cruel, but there are reasons for it.

In this country, we do not draw lines. There is a sense that everything should be done to keep us alive, no matter what the cost. Like the death panel thing. Like hospice. Like Living Wills.

The notion that discussing these options is condemning someone to death is the most insane ridiculous thing that I have ever heard. It makes me sick.

And because of this philosophy the dying is bad, we end up with exorbitant end of life costs...like this boy's costs.

Alas, it always comes down to people.

And isn't Hospice something that doesn't keep you alive? I mean I don't see Hospices or Living Wills as bad things.

But let me ask you something about something you said earlier.

Shouldn't they be giving this boy the drug for free if what you say is true? Not the insurance company but the other party involved here.

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

 

[Si modo]

Here's my question, Modo. If we had the public option, would the GOVERNMENT cove such an experimental treatment?

Likely not as it's they are the ones who say it IS experimental.

What is your gripe again?

my gripe? not enough sex.

A valid gripe. Mine too.

 

[Modbert]

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

I know what they are. I was confused by what Xo said for a moment. I thought he said they keep people alive and are worthless. But then I reread it and realized what he was saying.

 

[geauxtohell]

You expect an insurance company to pay $110,000 for two treatments??? And you wonder why the costs are skyrocketing?

What on earth about this procedure costs so much?

I feel for the family. But I think there comes a point where you have to be reasonable. I mean if you arent willing and able to pay for your son's treatment, why should anyone else?

How many people in this country can afford to pay $110,000 out of pocket for medical bills? You could easily rack up that amount with a hospital stay. If it were your child, would you think that their life wasn't worth that?

That's why people buy insurance with the reasonable expectation that their bills will be covered.

That's not the issue.

The issue is the cost versus the outcome.

Everyone thinks that their loved ones are priceless and that a price cannot be placed on a life. But, in actuality it can, and it should.

The unfortunate thing is seen in this case...the final treatment for this child is located just behind an impenetrable glass wall. It exists, but he is not eligible for it due to cost.

It would be better if the treatment did not exist at all. Then, he and his family would be able to eventually come to terms with the inevitable.

These crazy experimental treatments are giving people false hope.

Do you truly believe that last sentence, or is that vintage Xotoxi snarkiness?

 

[xotoxi]

The problem with drawing the line is that people will have a hissy fit...just like in the UK, where at a certain age, people with kidney failure are no longer eligible for a transplant.

That is where a line was drawn. It might seem arbitrary and cruel, but there are reasons for it.

In this country, we do not draw lines. There is a sense that everything should be done to keep us alive, no matter what the cost. Like the death panel thing. Like hospice. Like Living Wills.

The notion that discussing these options is condemning someone to death is the most insane ridiculous thing that I have ever heard. It makes me sick.

And because of this philosophy the dying is bad, we end up with exorbitant end of life costs...like this boy's costs.

Alas, it always comes down to people.

And isn't Hospice something that doesn't keep you alive? I mean I don't see Hospices or Living Wills as bad things.

I think they are GREAT things. They allow people to end their lives with dignity and without the feeling that they MUST keep fighting.

It also costs less.

But let me ask you something about something you said earlier.

Shouldn't they be giving this boy the drug for free if what you say is true? Not the insurance company but the other party involved here.

I don't know enough about the experimental treatments. I would think that they are considered "experimental" because they are still part of clinical trials. As a result, I would think that the drug companies would pay for them. However, maybe this child did not meet the criteria for the trial, and therefore, he would be taking the med and not be included in any study. This might be why it's not paid for. But I don't really know.

 

[geauxtohell]

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

I know what they are. I was confused by what Xo said for a moment. I thought he said they keep people alive and are worthless. But then I reread it and realized what he was saying.

Gotcha. I spent some time (not a ton of time, but some) volunteering in a hospice, so I am a little overly passionate about what they do.

 

[xotoxi]

How many people in this country can afford to pay $110,000 out of pocket for medical bills? You could easily rack up that amount with a hospital stay. If it were your child, would you think that their life wasn't worth that?

That's why people buy insurance with the reasonable expectation that their bills will be covered.

That's not the issue.

The issue is the cost versus the outcome.

Everyone thinks that their loved ones are priceless and that a price cannot be placed on a life. But, in actuality it can, and it should.

The unfortunate thing is seen in this case...the final treatment for this child is located just behind an impenetrable glass wall. It exists, but he is not eligible for it due to cost.

It would be better if the treatment did not exist at all. Then, he and his family would be able to eventually come to terms with the inevitable.

These crazy experimental treatments are giving people false hope.

Do you truly believe that last sentence, or is that vintage Xotoxi snarkiness?

I believe that in some cases. Like the med I mentioned before...$50,000 to survive an extra 2 weeks?

Wouldn't hospice be a better option?

 

[Modbert]

I think they are GREAT things. They allow people to end their lives with dignity and without the feeling that they MUST keep fighting.

It also costs less.

Trust me, I understand and completely agree. I had just originally misread what you said and thought you said they kept you alive. So I was like, wait what?

 

[xotoxi]

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

I know what they are. I was confused by what Xo said for a moment. I thought he said they keep people alive and are worthless. But then I reread it and realized what he was saying.

I may have mispoken or you may have misread it.

I think hospice is the most wonderful facet of out medical field. I have never heard of anyone who has had a negative experience in hospice.

 

[Modbert]

Gotcha. I spent some time (not a ton of time, but some) volunteering in a hospice, so I am a little overly passionate about what they do.

Good for you and I understand why. When I first read this article, I'll admit I was outraged and that reflected upon the title. Which is why I'm going to have it changed sometime soon.

But, I'd rather be a person who can get outraged rather than a person who has more apathy in them than anything.

 

[xotoxi]

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

I know what they are. I was confused by what Xo said for a moment. I thought he said they keep people alive and are worthless. But then I reread it and realized what he was saying.

Gotcha. I spent some time (not a ton of time, but some) volunteering in a hospice, so I am a little overly passionate about what they do.

The hospice nurses are the most caring nurses in the world.

 

[geauxtohell]

Everyone thinks that their loved ones are priceless and that a price cannot be placed on a life. But, in actuality it can, and it should.

The unfortunate thing is seen in this case...the final treatment for this child is located just behind an impenetrable glass wall. It exists, but he is not eligible for it due to cost.

It would be better if the treatment did not exist at all. Then, he and his family would be able to eventually come to terms with the inevitable.

These crazy experimental treatments are giving people false hope.

Do you truly believe that last sentence, or is that vintage Xotoxi snarkiness?

I believe that in some cases. Like the med I mentioned before...$50,000 to survive an extra 2 weeks?

Wouldn't hospice be a better option?

In that case, certainly. I am not a physician and certainly not an oncologist, so I don't know a ton about how experimental treatments work (logistics wise) and just keeping the regular chemo drugs straight at this point is busting my ass.

But yeah, an extra two weeks life on chemo, spent retching your guts out? That's not how I'd want to spend my last days.

Set me in a chair on Bourbon Street and stick a drink in my hand.

Man, this is bringing bad bad memories of medical ethics classes.

 

[xsited1]

Insurance company deny treatment to 5 year old with Cancer

It's easy to get emotional over this, but it all comes down to money. $110,000 is a lot of money. By paying this, they'll most likely have to deny other patients treatment or run the risk of going out of business. Someone has to make the tough choices.

 

[xotoxi]

Gotcha. I spent some time (not a ton of time, but some) volunteering in a hospice, so I am a little overly passionate about what they do.

Good for you and I understand why. When I first read this article, I'll admit I was outraged and that reflected upon the title. Which is why I'm going to have it changed sometime soon.

But, I'd rather be a person who can get outraged rather than a person who has more apathy in them than anything.

Outrage is the proper feeling to have. This family and child is going through hell. And they see a possible solution, which is being blocked by a for-profit insurance company. They don't understand why, nor does the general public.

And this one thing I would like to see in healthcare reform...drawing some lines and setting some limits that everyone is aware of BEFORE they get to that point. And better education as to what is the next step when all else has been used up.

 

[geauxtohell]

Hospices and hospice care is for people who have a terminal prognosis (usually less than six weeks) and exist with the sole mission to make patients as comfortable as they can with the dying process, both physically and spiritually.

They are not bad things, they are wonderful things, but it has taken the medical community a long time to reach that conclusion.

It seems that for a long time it was considered poor form for physicians to admit what we all know: everybody dies.

I know what they are. I was confused by what Xo said for a moment. I thought he said they keep people alive and are worthless. But then I reread it and realized what he was saying.

I may have mispoken or you may have misread it.

I think hospice is the most wonderful facet of out medical field. I have never heard of anyone who has had a negative experience in hospice.

Though this is not quantifiable (sorry to sound like a dork), I think their main utility is helping patients and families bypass the "denial" (or get over it much more quickly) stage of grief.

The patients I dealt with at the hospice house were at peace with their situation in life and they weren't afraid.

Contrast that with being on the wards and watching while a patient goes in and out of AFIB and is scared to death or a patient who was just told he had their heart was failing who now can't sleep at night.

I guess the difference is knowing that, no matter what, your time is coming soon.

 

[xotoxi]

Set me in a chair on Bourbon Street and stick a drink in my hand.

And Super Bowl XLIV on continuous loop.