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.
“You’d think if it was a money issue, Aetna would have taken the cheaper route.”
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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.
Define cheaper. It depends on whom will pay how much for what. I spent a good bit of today trying to get cash prices for medical procedures from a medical provider. I thought cash wouldn’t be a problem. Silly me. The provider told me that I would find out what I would be charged after an appointment with a financial counselor. I told them I didn’t need or want financial counseling, just a price. I didn’t get one. Wonder if this family raises cash for the procedure, if they’ll get taken by a medical industrial complex that apparently can and does charge different patients different sums for the same damn procedure.
Which tells me this is a stupid bureaucracy issue and not a cost issue at all.
If Aetna's really concerned about the "bottom line" on this one, some bureaucrat needs to look at the two costs and make the determination that this girl can have the cheaper "experimental" procedure.
Common sense is so dead in this country, isn't it?
Sounds like Aetna is worried about also having to pay to fix a potential bad outcome if the experimental procedure she wants to try goes badly.