Blue Shield Won't Pay NorCal Mom's Cancer Treatment

[IndyColtsFan]

Originally posted by: jpeyton
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--snip--

That is terribly sad, but I would like to know the survival rates of patients treated with the gamma knife vs. the whole brain radiation approach. If they are the same survival rate, I can understand the logic, though it doesn't make it easier to swallow for her or her family.

Any government plan will likely operate on the same principles. If there are two treatments with the same survival rates, the government is going to offer the cheaper of the two alternatives.

 

[Starbuck1975]

Who needs a government bureaucrat between you and your doctor when an insurance claims adjuster is so much better? Apparently these claims adjusters know more about cancer treatment than world-renowned oncologists.

Under a government health care plan, it is doubtful the patient would even have the flexibility or option for treatment by a world-renowned oncologists.

PRO of current system: You can seek the best treatment, and recommendations from medical experts of your choice.

CON of current system: Insurance may not pay for the prescribed treatment.

There is no reason to suspect a better outcome under Obamacare.

 

[IndyColtsFan]

Originally posted by: senseamp

The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

The company is paid to provide a service, in this case, health insurance. Each health insurance policy has defined limits as to what it will pay for, including treatments. It is extremely unfortunate in this case but in BCBS' view, there are equally effective treatments which cost less. Are they right? I don't know, as I have not seen any studies comparing the effectiveness of gamma knife vs. whole brain radiation.

It will not be any different with UHC and you are very naive if you believe it will be. Sure, maybe UHC will support gamma knife -- who knows. But the point here is that instead of a company deciding her care, a government bureaucrat will.

 

[IndyColtsFan]

Originally posted by: Carmen813

Yah lets worry about money first and people later. I believe cost controls are important to, but there's no reason we can't do more than one thing at a time.

You guys are amazing. First your argument (not you specifically, but many in this forum) is that "We pay too much!! It is too expensive!! UHC will fix that and we'll all be happy!!" Then, when shown that the CBO said that the Democrats plan will do NOTHING to address cost issues except burden the federal government with a greater share of the cost, increase the deficit, AND not stop the skyrocketing costs, the argument suddenly shifts to "Quality of care, costs be damned!" At least you acknowledge both are important.

There would have to be an interim period where people are covered even without proper cost containment being in place, I acknowledge that. However, any plan MUST have a roadmap to how we get to the point where people are covered and costs are contained appropriately. Thus far, no one has this plan. This is why I support limited and specific reform and NOT destroying the entire system.

 

[Pneumothorax]

This story is already FAIL as even Obama has been quoted as saying (paraphrased) "To reduce costs, We will find the treatments that work, and stop doing expensive treatments that don't work" Do you think a government run entity is going to listen to the opinion of one oncologist or base it on the "standard of care"? BTW the standard of care in this case is palliative whole brain radiation as unfortunately, this patient has pretty much very little chance of long-term survival. (I believe metastatic breast cancer with brain mets has a under 10% survival rate in 3 years)

 

[Fear No Evil]

I love how Doctors are somehow seen as having no interest in the treatment options they choose. You do realize that healthcare companies do try to influence the decisions of doctors for financial reasons to use their products right? Not always because they are 'better'. What if this doctor has stock in the company that produces this gamma-knife treatment? Should BCBS still be forced to pay for it? What if the doctor owns the company that produces the gamma-knife product?

Obviously there HAS to be instances where the insurance companies can decide differently than the doctors.

 

[IndyColtsFan]

Originally posted by: Pneumothorax
This story is already FAIL as even Obama has been quoted as saying (paraphrased) "To reduce costs, We will find the treatments that work, and stop doing expensive treatments that don't work" Do you think a government run entity is going to listen to the opinion of one oncologist or base it on the "standard of care"? BTW the standard of care in this case is palliative whole brain radiation as unfortunately, this patient has pretty much very little chance of long-term survival. (I believe metastatic breast cancer with brain mets has a under 10% survival rate in 3 years)

Exactly. I think people here seriously think that with UHC, it will be like an all-you-can-eat smorgasboard and you can pick whatever treatment you want and Uncle Sam will pick up the tab. This is NOT what will happen.

 

[Slew Foot]

Not giving out treatment for metastatic brain cancer? Sounds like Oregoncare.

 

[BoberFett]

Originally posted by: senseamp
The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

I thought you Democrats said we paid too much for health care as it is. You want to pay more?

 

[IndyColtsFan]

Originally posted by: BoberFett

Originally posted by: senseamp
The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

I thought you Democrats said we paid too much for health care as it is. You want to pay more?

Didn't you get the memo? When the CBO proved that the Democrat's plan would do nothing to alleviate the skyrocketing costs of health care, the new Democrat mantra became "Quality of care, costs be damned!!!!"

 

[BoberFett]

Originally posted by: blanghorst

Originally posted by: Carmen813

Yah lets worry about money first and people later. I believe cost controls are important to, but there's no reason we can't do more than one thing at a time.

You guys are amazing. First your argument (not you specifically, but many in this forum) is that "We pay too much!! It is too expensive!! UHC will fix that and we'll all be happy!!" Then, when shown that the CBO said that the Democrats plan will do NOTHING to address cost issues except burden the federal government with a greater share of the cost, increase the deficit, AND not stop the skyrocketing costs, the argument suddenly shifts to "Quality of care, costs be damned!" At least you acknowledge both are important.

There would have to be an interim period where people are covered even without proper cost containment being in place, I acknowledge that. However, any plan MUST have a roadmap to how we get to the point where people are covered and costs are contained appropriately. Thus far, no one has this plan. This is why I support limited and specific reform and NOT destroying the entire system.

Incredible, isn't it? The feeble minds of bleeding heart fools in action.

 

[Hayabusa Rider]

Originally posted by: BoberFett

Originally posted by: senseamp
The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

I thought you Democrats said we paid too much for health care as it is. You want to pay more?

No, he wants private insurance to get out of the way of medicine. If UHC gets passed, then the government needs to make those decisions, and that will be conserving resources and cutting costs to maintain the system in the long run.

Gov>physicians>insurance companies.

 

[soulcougher73]

Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

 

[Fear No Evil]

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

 

[Sheik Yerbouti]

Originally posted by: Budmantom

Originally posted by: jpeyton

Who needs a government bureaucrat between you and your doctor when an insurance claims adjuster is so much better? Apparently these claims adjusters know more about cancer treatment than world-renowned oncologists.

Are they depriving her of those pain killers that treat cancer?
[/quote]

Pain killers treat cancer?? DUDE YOU FOUND THE MAGIC BULLET!!!!
I gotta get me some the that ibupr.. er cancer treatment...



Yet again you prove your level of stupidity knows no limits.

 

[soulcougher73]

Originally posted by: Fear No Evil

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

If she was offered a lower cost treatment that is equally as effective then why the news article? Why not just accept it and move on? Their must be more to this story then we are getting.

 

[Hayabusa Rider]

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

Most of us aren't defending the insurance companies, we are saying that any government sponsored program will have limited resources, and therefore impose limits on what providers may do. I've read the article and the key element missing is the prognosis. She has 15 metastatic tumors in her brain, and she isn't going to survive. Perhaps the gamma ray treatment is most appropriate, and the insurance company is wrong. We've heard about profits, however more people covered means more utilization and if that's being addressed I don't see it. Well, we don't see much of anything.

Given that the government has limited dollars, that the already at full capacity health care system will be further stretched, and that more people than ever will use the system, rationing will happen. This woman may not be any better off than she is now. "Well she might be covered so she's better off if we have it" is hardly a rational argument.

 

[Genx87]

Originally posted by: soulcougher73

Originally posted by: Fear No Evil

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

If she was offered a lower cost treatment that is equally as effective then why the news article? Why not just accept it and move on? Their must be more to this story then we are getting.

Because a private insurance company denying anything is news worthy to the big govt UHC whores. Regardless of context.

 

[Fear No Evil]

Originally posted by: soulcougher73

Originally posted by: Fear No Evil

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

If she was offered a lower cost treatment that is equally as effective then why the news article? Why not just accept it and move on? Their must be more to this story then we are getting.

Because the news media has an agenda? Lets try to think a little bit outside the box. You also ignored all my questions. Do insurance companies have ANY recourse against physicians that prescribe treatments or drugs for financial reasons? Why are the insurance companies evil capitalists but doctors are not? Do they not have an interest in making money as well?

 

[soulcougher73]

Originally posted by: Fear No Evil

Originally posted by: soulcougher73

Originally posted by: Fear No Evil

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

If she was offered a lower cost treatment that is equally as effective then why the news article? Why not just accept it and move on? Their must be more to this story then we are getting.

Because the news media has an agenda? Lets try to think a little bit outside the box. You also ignored all my questions. Do insurance companies have ANY recourse against physicians that prescribe treatments or drugs for financial reasons? Why are the insurance companies evil capitalists but doctors are not? Do they not have an interest in making money as well?

I am all for cheaper alternatives assuming they both achieve the same desired effect. So yes if some greedy doctor is choosing a higher prices alternative then i believe the insurance company should be able to let the doctor know we are not accepting this treatment but instead use (insert equal cheaper alternative treatment here). But at the same time what is the point of having all this advanced treatments if they never get used because they cost too much.

I am for UHC myself. After watching the PBS documentary that was posted i personally like Englands system the best. Although any of those would be an improvement on our system in my opinion. I feel like the doctors are well rewarded for keeping people healthy in Englands system. When did doctors become some special class of people that deserve millions of dollars? Its just a job like any other. You should choose to be a doctor because you want to help people. Not because you think its some path to wealthiness.

But that is all just my opinions. If its utopian thinking so be it. I like to strive for the best even if it seems like a pipe dream.

 

[Hayabusa Rider]

Originally posted by: Fear No Evil

Originally posted by: soulcougher73

Originally posted by: Fear No Evil

Originally posted by: soulcougher73
Im only through the first page of this thread, but man. I would think the American people would be better than this. Sometimes my own country discusts me. I guess that is what you get when you build a county on greed and wealth. Nothing like paying insurance premiums only to be denied when you actually need to use it. And then these idiots here defending the insurance companies. Sickening.

You should read more carefully. She was not denied treatment. She was offered a lower cost treatment that by all accounts seems equally effective. Do you think there should be ANY limits on health insurance? Do you believe doctors don't have any interest in suggesting higher priced alternatives? Are you willing to pay 10x the amount you currently are for health insurance to have this 'unlimited' care?

If she was offered a lower cost treatment that is equally as effective then why the news article? Why not just accept it and move on? Their must be more to this story then we are getting.

Because the news media has an agenda? Lets try to think a little bit outside the box. You also ignored all my questions. Do insurance companies have ANY recourse against physicians that prescribe treatments or drugs for financial reasons? Why are the insurance companies evil capitalists but doctors are not? Do they not have an interest in making money as well?

Because insurance companies exist for one reason, and that is to turn a profit like any other business. The overwhelming majority of health care providers don't exist to maximize their profits. Making more money by harming their patients has happened, but if we find out that another is doing that, they will be excoriated by us. I could steer a prescriber into making certain choices that would benefit a particular drug company stock that I held, however the idea doesn't even occur to the overwhelming majority. We collectively choose what we believe is the best for the patient over having the fattest paycheck. It's our moral obligation, and we live it. That's why we are often at odds with insurance companies, private or governmental. I've beaten up on the government because it's the one with all the real power, and there hasn't been any demonstrable fact put forward that their system is superior. The fact is that I have a whole lot of WTF moments with private insurance where we have to get prior authorization for what would have been routine matters. A patient is allergic to a particular medication and the doctor writes for the only alternative which happens to be brand and more expensive. The MD has to go through the process of submitting paperwork, and most likely it gets approved, because it's necessary and the only viable option. So why is it that every time the prescription is renewed the process has to be repeated? The miraculous event of spontaneous allergic remission isn't going to happen. It's a mechanism put in place to frustrate people enough to give up.

That's a sucky system

 

[nobodyknows]

Originally posted by: blanghorst

Originally posted by: BoberFett

Originally posted by: senseamp
The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

I thought you Democrats said we paid too much for health care as it is. You want to pay more?

Didn't you get the memo? When the CBO proved that the Democrat's plan would do nothing to alleviate the skyrocketing costs of health care, the new Democrat mantra became "Quality of care, costs be damned!!!!"

Isn't that all you want for yourself?? Of course it is, so quite accusing others of exactly what you are. You're only fooling yourself.

 

[nobodyknows]

Originally posted by: BoberFett

Originally posted by: senseamp
The company has no business deciding her care. It's health insurance, they are there to pay for care her treating doctors decide is necessary, not pick and choose care for her. They are just providing a financial product.

I thought you Democrats said we paid too much for health care as it is. You want to pay more?

If you had any thinking skills you would realize that what the Dem's are saying is that for what we are spending on health care, everybody could have it and we could still save some money.

But alas, you have no thinking skills.

 

[WhipperSnapper]

<Sigh>. Another poor person constructively murdered by the insurance companies and our nightmarish health care "system".

 

[WhipperSnapper]

Originally posted by: fallout manWhat makes you think that UHC would deny her treatment? The government can just print/borrow more money to pay for her treatment.

They certainly did it to kill thousands, so why not do it to save thousands?

No money printing would be necessary. The money would come from the billions of dollars that are wasted on insurance company administrative costs, profits for insurance companies, hospitals, and pharmaceutical companies, and outrageous salaries for the CEOs and executives of those organizations.

Right now the U.S. is spending about 17% of its GDP on health care, far more than any other country while still having tens of millions of uninsured and under-insured. Surely we can find a way to dramatically improve the efficiency of the system and to reduce the huge amounts of wasted money we're currently spending.