Is it murder?

[Wing Nut]

http://abclocal.go.com/kfsn/story?secti ... id=5850665

Well, here's a sticky wicket.  A teenage patient has died after her insurance company refused to pay for her liver transplant.  Personally, after lawyers, I happen to think insurance companies are the lowest form of life on earth.  They had the ability to prevent a death, but they just let her die because they thought it was too expensive to care for her, calling the transplant 'experimental.'   What a load of crap.

I would consider this a crime, and the company should not only have to lose their license, they should have to pay for every liver transplant that comes up for the next year.  

[Craig.]

further proof the american medical system is generally flawed. when you need money to be able to keep yourself or a family member alive even when there is an option right infront of you. The doctors knew this would help her, there first responsibility is supposed to be to their patient, they should have just done the surgery and worried about any ramifications later. Thats why they have liability insurance.
It's not just the insurance companies these days i'm afraid.

[Romulus111VADT]

I consider the insurance company at fault for the most part. It amazes me how you can pay for medical insurance for 20 years. Then use it once and they drop you or refuse to cover something. The insurance company should be forced to reimburse the family for every dime they spent over the years for coverage.

But one thing that baffles me, why didn't the doctors and hospital donate their services? It happens all the time throughout the US. It normally accompanies all sorts of press though and lots of notriety. In other words, allot of PR that will normally end with the medical parties involved getting lots of money from the government and the private sector. An article in the AMA or other medical publications also adds to the potential for making money for their, "Selfless acts of charity."....

[Katahu]

If I was that girl's surgeon, I would've performed the transplant anyways whether or not I got the approval.

[Chris_F]

Why didn't the insurance company pay for the surgery?

Why didn't the hospital pay for the surgery?

Why didn't the bank loan the family money to pay for the surgery?

Why didn't their neighbors or extended family pay for the surgery?

Why didn't YOU pay for the surgery?

[BFMF]

Shows you how corrupt insurance companies are.... :-/

[Brett_Henderson]

This is a toughie, for sure. First note regarding the U.S. medical system... I'd rather it be that a person who can afford extra-ordinary care, get it... than it not be available at all, to anyone. That's the problem with Euro/Canadian treatment. A person whose liver has failed as a complication from Luekemia treatment, wouldn't even be considered for a transplant in Canada. They just don't have the time or resources. People come to the U.S. quite often.. and pay for treatment out of pocket, because of this. That's what socialized medicine does... it turns healthcare into an inefficient, government bureaucracy.

Now the politics (that I did not start) aside.... Yes.. the insurance company's behavior was horrid. You have to fault on the side of common, decent compassion.. even if it's not profitable. Even looking at it like cold, hard business.. As an insurance company, you take a risk that what you take in will be more than what you pay out.. Sometimes you lose that bet and you HAVE to pay up. Just the sheer inhumanity of this episode is hard to stomach.

I'm sure that the fact that she was already terminally ill... probably not lived much more than a year, even with the transplant, was a consideration. Private insurance or socialized medicine... you still have to factor in feasibility and practicality... To quote a doctor from that article, "everybody can't have everthing".

[C]

That's the problem with Euro/Canadian treatment.

I'm not entirely sure one can really use the term European treatment/healthcare, purely as each individual country's health systems are very different - for example the UK's in Europe, as are Bulgaria and Romania - and I don't think it'd be fair to link their comparative healthcare systems at all!

[Brett_Henderson]

I'm not entirely sure one can really use the term European treatment/healthcare, purely as each individual country's health systems are very different - for example the UK's in Europe, as are Bulgaria and Romania - and I don't think it'd be fair to link their comparative healthcare systems at all!  

Agreed  :)   My only personal references are my uncle (doctor in Montreal), and a flying friend whose a dentist in Thunder Bay... And I don't want to get into the politics...  I just felt a need to respond to the U.S. healthcare reference. It's by no means ideal, but it seems to be the world's safety net.

[Craig.]

[quote][quote]I'm not entirely sure one can really use the term European treatment/healthcare, purely as each individual country's health systems are very different - for example the UK's in Europe, as are Bulgaria and Romania - and I don't think it'd be fair to link their comparative healthcare systems at all!

[Brett_Henderson]

[quote]Sorry Brett but I have to disagree.
If my mom had lived in the US when she had her car accident, it would have bankrupt the family several times without the best insurance. Here she received immediate care and all the subsequent minor treatments such as the cosmetics quickly and more importantly free. We were speaking with a doctor at the time and he gave us a rough figure in total of over

[Hagar]

I don't have much confidence in governments ability to run anything. The NHS is in a bit of a crisis right now due to incompetence at a high level. However, Craig's mum would have received the same level of care whether she or her family had paid one penny in taxes or not. The whole principle of the NHS is that treatment is available to all whenever it's needed regardless of ability to pay. Unfortunately, like any other form of insurance, there is a limited amount of money in the pot to pay for it. New drugs & treatments tend to be extremely expensive & there has to be a point where difficult decisions will have to be made. I wouldn't like to be in the position of making them.

I have mixed feelings about the case in question & I don't know enough about it for sensible comment. Because the victim was a pretty young girl this becomes a very emotional subject. I wonder if it would have made the headlines if it had been someone of my age. The question is whether the treatment was in fact "experimental" as the insurance company stated & whether a transplanrt would have given her a reasonable chance of recovery or at least a reasonable quality of life. This would apply whichever form of health care it's based on.

On the subject of "experimental treatment" I'm wondering who funds this under a totally private insurance basis. Without research we would still be in the Dark Ages. I can remember, not really that long ago, when a heart bypass operation was very risky indeed. Now it's almost commonplace. A good friend of mine had a triple heart bypass at a local NHS hospital a couple of weeks ago & he's going back to work in January. He will tell you that the treatment he received was second to none.

[Dr.bob7]

Insurance companys are evil after things like Katrina and the Fires in California they literaly make stuff up so they dont have to pay for the damage like: oh, where sorry your home insurance cover's electrical fires not wildfires.....

[Brett_Henderson]

The problems funding research are key, too. New drugs and new procedures don't just materialize out of good intentions. Like it or not, these things come more quickly, more often, and in greater variety when there's profit to be made.

I agree there are short-comings in the U.S. healthcare system. And there are downsides to socialized medicine, too. I'm just of the school that the more of it in the hands of people whose jobs are on the line; and in the hands of companies competing; and with doctors who don't have the government writing their paychecks... the better off we all are.

And the biggest concern of mine (as our country faces the prospect of socialized medicine if certain elections go certain ways), is what will happen to the overall quality in available treatment.. and the caliber of people willing to work for the government.. and administer that care. We have versions of it for the poor and elderly... and both of those systems are bankrupt. There just isn't enough money floating around (whether paid by individuals to insurance companies.. or collected in the form of taxes), to see to it that