On Wednesday, a ProPublica investigation traced how a Michigan company would not pay for an FDA-approved cancer medication for a patient, Forrest VanPatten, even though a state law requires insurers to cover cancer drugs. That expensive treatment offered VanPatten his only chance for survival. The father of two died at the age 50, still battling the insurer for access to the therapy. Regulators never intervened.
Land of the free*.
*As long as we can fleece you.
My mother-in-law’s sister survived cancer once. Years later, she started feeling pain and worried that the cancer had come back. Her insurance company repeatedly denied basic scans/tests to see if the cancer had returned.
My wife’s cousins finally got sick of all this and paid out of their own pockets for the tests. She had cancer again. Only by this point, it had spread. It was in the base of her tongue and was blocking her throat. They had to remove her tongue, but that didn’t stop the cancer. She eventually passed away.
Would she have survived if the insurance company approved the tests in the beginning? There’s no way to guarantee this, but she would definitely have had a better shot at survival.
But at least the insurance company saved some money, right? Isn’t that the most important thing? 😡
As long as the cost of breaking a law is less than the cost of complying, American businesses will choose breaking the law every single time.
American governments often fail to realise that they literally hold all the cards. At any time they can dissolve or threaten to dissolve a company for flagrantly disregarding the law, and yet this rarely happens.
In fact the opposite is true. Since Citizen’s United allowed unlimited
briberypolitical donations, companies hold all the cards. Unlimited funding and advertising can make or break most any candidate’s chances for election, especially in purple areas.Believe me when I say that a dissolved company can’t fundraise shit.
Explain please, exactly who’s going to do the dissolving? The same government representatives who are controlled via donations by that corporation? Wishful thinking doesn’t make it so.
Looks like you can report them to your local State Insurance Agency
By June, she was so fed up she decided to submit a complaint to the Texas Department of Insurance. Five days later, she received a call from an Ambetter employee apologizing and saying they would process the procedure as an emergency and pay up.
Unless:
Not all health plans have to follow state mandates. About 65% of employees who get insurance through their jobs work for companies that pay directly for health care. Those companies often hire insurers solely to process claims. Known as self-funded plans, they are regulated by the federal government and exempt from state coverage requirements. Employers increasingly are turning to these types of plans, which tend to be cheaper, partly because they don’t have to cover care that states require. (The federal government also imposes coverage mandates, but state laws can be more robust.)
Propublica wants you to report to them if you were denied coverage when you were supposed to receive coverage so they can keep looking into it.
Oops. My bad, there. I changed the law. — the health insurance company.
This news story has come out every few years for decades now. Nothing has changed.
How nice of you to notice
Wait, what!?!
