Posted on 12/11/2017 12:40:06 PM PST by nickcarraway
Cara Pressman sobbed in the big red chair in her living room. The 15-year-old tried to absorb the devastating news relayed by her parents: that their insurance company, Aetna, denied her for a minimally invasive brain surgery that could end the seizures that have haunted her since she was 9 years old.
“When my parents told me, I went kind of blank and started crying,” she said. “I cried for like an hour.”
Her friends had been lined up to visit her in the hospital for the surgery three days away, on Monday, October 23. Between tears, she texted them that the whole thing was off.
(Excerpt) Read more at kfor.com ...
Did her parents vote for 0bama. If so she can blame them
She and her folks could work for the money, like the old days...
where is the go fund me page?
Reading the article, Aetna did not deny her care, they just disapproved the particular treatment (laser surgery) as “experimental”. They would cover regular surgery.
Or did they vot for the 'rat senators and congresspeople who passed it?
Sounds like the procedure that she wants is still in the clinical trials stage. Maybe it will be available to her in a couple more years.
Actually, they only refused to pay for it. You can still have this procedure.
Curiously though, Aetna did approve her for the "more invasive and more expensive open brain surgery, called a temporal lobectomy." You'd think if it was a money issue, Aetna would have taken the cheaper route.
Not so much now that the government has made healthcare unaffordable for most people.
Ah, the rest of the story.
Imagine Paul Harvey with today’s stories...
Thanks. I figured it was more complicated than the headline suggests.
“You’d think if it was a money issue, Aetna would have taken the cheaper route.”
################
I’m speculating but it might be a liability fear because of the newness of the procedure. All I can say is that modern medical care, while technically a marvel, is an administrative, bureaucratic and budgeting lunatic asylum.
The approved method probably will leave significantly more scaring. Not sure I would want a large hole in my skull either. At least, as a girl, she is less likely to go bald later in life, showing the scar.
However, somebody has to make the call. Typically it is the one paying, be it the government or the insurance company.
Wonder what the result would be if it were a member of the establishment’s kid?-
$300,000.00 for the surgery? When in the “old days” did they charge that kind of money for one procedure? That is a big part of the problem with the health care system. I am as much a free marketer as anyone else, but if they don’t bring this crap under control they will be holding the door open for a government takeover of the whole damn thing. It is in the self interest of the health care system to bring costs under control.
The surgery has a success rate of <50%.
Poor investment.
Usually, the insurance company does not pay the hospital/docs the amount billed. The $300,000 amount is what it will cost her parents. The insurance companies have contracts with the hospitals/docs in their network that state what the “allowed charge” is and that is all they will pay (and the hospital/doc cannot bill the patient for more).
There is no free market system in health care, and the liability is insane. If govt were to get out of the health care business writ large.....the costs would plummet and everyone would be taking home more money.
Fkin lawyers.
Seems to me, I’d be in negotiations with the doctors and hospital to figure out a way to pay for it directly.... Not going to let some paper pusher stop me from helping my daughter.
[[She and her folks could work for the money, like the old days...]]
With all due respect- things are way way way more expensive these days medically thanks to greedy people suing medical professionals constantly. Get the3 prices down to semi reasonable prices again, and many folks i would wager woudl be glad to do so
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