Tuesday, December 1, 2009

Man with cancer says Blue Cross rations care

Posted by CJ Janovy on Tue, Dec 1, 2009 at 2:19 PM

A couple of people were hanging out with signs in front of the Blue Cross Blue Shield building near Main and Pershing Road this morning. It was a pretty unusual sight.

sign_distant.JPG

And up close, the signs turned out to be incredibly sad.

signs1.JPG

Vic Wolf, of Mission, says he's had eight surgeries in 12 months to treat his colon cancer. He also has four tumors in the left lobe of his liver. In July, he says, his radiologists and oncologists recommended treating the liver tumors with TheraSphere, radiolabeled glass beads that, as Wolf puts it, "explode the tumor from within." (The National Institutes of Health says this "may be an effective treatment for liver cancer that cannot be removed by surgery.")

And, yep, Blue Cross won't pay for the treatment, he says.

"They say it's an experimental procedure, but they've done it in other states. They also approved it for another patient in Kansas this year -- but they had to get the Kansas Insurance Department involved." (That patient blogged about her experiences here.)

"I pay Blue Cross $1,200 a month for my wife and myself, and then they deny us benefits," Wolf says.

His wife, Linda, was there holding a sign with him. He says he

had his own business selling "aftermarket automotive supplies," but now

they've been through all of their savings. Linda says she got a

part-time job at the YMCA for $8.50 an hour, but it doesn't pay the

bills.

"You get sick and you lose everything you have in this

country," Wolf says. "They they send you a letter saying 'Due to rising

costs, we have to raise your rates.' To be on Medicaid, I'd have to

have nothing -- lose my house and everything I've worked for."

Which is just another argument for a single-payer national health plan. If only Americans were brave enough to demand real health-care reform.

I put in a call Blue Cross for a statement, but haven't heard anything back.

They'd probably just point me to all of those big new Blue Cross "bigger and better" billboards around town.

Update: Blue Cross and Blue Shield of Kansas City's Director of Corporate Communications, Sue Johnson, later issued this statement: 

Federal HIPAA regulations don't allow me to speak to any case specifically, and I can tell you that we were not contacted directly by the people outside our offices this morning. Our members have the right to appeal any decision they don't agree with, and we advise them of that right. There are three levels of appeal available, with third-party expert physicians reviewing the cases at each level. We welcome our members to contact us for more information or to talk further about their issue. Our medical policies are consistent with the Blue Cross and Blue Shield Association medical policies and we evaluate all policies on an annual basis, updating them as technology changes and evolves.


Tags: , , ,

Comments (10)

Showing 1-10 of 10

Add a comment

Profiting from sickness and disease is disgusting. This is our number one domestic industry. That's pathetic. I'm pro-life. That means across the board.

Whenever money is brought into the equation, then morality is tossed out the window.

report   
Posted by Liberty on 12/03/2009 at 9:18 PM

Denying someone a potentially life-saving treatment to increase profits is the DEFINITION of greed.

report   
Posted by Al on 12/03/2009 at 12:26 PM

I need you to understand I am not trying to get Thera Spheres, I need SIR Spheres that is FDA Approved. Please check it out.

report   
Posted by Victor A. Wolf on 12/03/2009 at 6:26 AM

So do you all feel that the Government run health care system will or should pay for this type of procedure? I believe this man would not even have a second opinion if some Bureaucrat in DC is looking at this. Please wake-up there are problems but is this the way you want all your issues to be solved? A profit is NOT greed.

report   
Posted by Larry on 12/02/2009 at 6:18 PM

Where are the pro-life folks?

report   
Posted by Liberty on 12/02/2009 at 5:46 PM

Experimental or not, if I were in this man's situation, I would want the fucking treatment. For the insurance company to deny someone the chance to extend his or her life - regardless of whether that's for five months or five years - to increase profits is disgusting and truly illustrative of what's wrong with the American health care system.

report   
Posted by Al on 12/02/2009 at 1:57 PM

I hate to say it, but end of life care is some of the most expensive care provided by the health care system. This gentleman wants his insurance to cover an experimental treatment; his policy probably clearly states no coverage for experimental procedures. How long will it lengthen his life and at what price? The sad reality is that everyone will die - some sooner than expected, but everyone will die. We can't fight death forever -even with experimental treatments.

report   
Posted by Mallory on 12/02/2009 at 1:29 PM

This is another prime example at how the "healthcare system" in this country is profit oriented and not patient oriented. I, unfortunately, have BCBSKC thru my place of work. It is like fighting tooth and nail to get them to cover things. In this month alone they have refused to cover my doctor's appointment for an infected mouth, my son for orthonics as well as his treatment for Autism. All of us need to rise up and say NO MORE!! It is apparent that our elected officials are in their back pockets, so it is up to us.

report   
Posted by David on 12/02/2009 at 9:59 AM

Thanks for doing this piece.

report   
Posted by Jenk on 12/01/2009 at 3:23 PM

Way to fight, Vic, both cancer and the health insurance company. I guess that last part was redundant.

report   
Posted by Caroline on 12/01/2009 at 1:38 PM
Subscribe to this thread:
Showing 1-10 of 10

Add a comment

Most Popular Stories

Slideshows

All contents ©2012 Kansas City Pitch LLC
All rights reserved. No part of this service may be reproduced in any form without the express written permission of Kansas City Pitch LLC,
except that an individual may download and/or forward articles via email to a reasonable number of recipients for personal, non-commercial purposes.

All contents © 2012 SouthComm, Inc. 210 12th Ave S. Ste. 100, Nashville, TN 37203. (615) 244-7989.
All rights reserved. No part of this service may be reproduced in any form without the express written permission of SouthComm, Inc.
except that an individual may download and/or forward articles via email to a reasonable number of recipients for personal, non-commercial purposes.
Website powered by Foundation