Because "Free Enterprise" is Good for You

Ken,

Nice, but I checked stories.  Aislin, after review, has gotten health insurance and is fully covered. Jaxon now has health insurance after his initial denial.  Sick babies are expensive and until the insurance company new what it was getting into they denied coverage.  Not sure your point with the first two. Kyler wants a non-FDA approved treatment, i.e. experimental, for his recurrent, highly fatal cancer.  Even the parents agree his denial has nothing to do with cost (the insurer already had paid out between $1.6 and $1.8 Million) but the fact that the FDA has not approved the treatment (Government death panel anyone?).  So why would you expect a government run health care to not do exactly the same as the insurance carrier?  Or do you expect the government panel to approval all treatments any MD says might help a patient? 

So a quick recap: 2 of your potential sob stories actually got insurance coverage after the initial denial, but upon review were covered.  The third case was denied not for cost but becuase the US FDA does not approve of the treatment.

So exactly what am I going to complain to my Senator about? To get the FDA to approve the treatment right now? Do you have any idea how long it takes for the FDA to approve anything?

Ken your better than this. Its a pitiful attempt to gain support to pass a crappy, unpopular bill.

Islam will change

buffpilot:

If you only had “some” knowledge on the topic this might be a decent coinversation; but as usual, you don’t.

Lets start with the first child, Aslin. Under the Senate Bill in the house; the child would be covered with no questions asked. Claiming pre-existing conditions for a baby is ridiculous. Under either bill, the baby would have been covered . . . to be redundant. Under either bill there would have been a right of appeal if something was denied to a board of review. Private healthcare insurance is a lottery where you win and lose coverage. Government sponsored healthcare is insurance.

Aslin is covered under the more expense Cobra coverage and not normal healthcare insurance. That is not an alternative to life time coverage and only lasts 18 months from the time the parent left their job. Under the Senate Bill, health insurance companies would not have been able to drop more expensive insurees and would have to comply with an 80:1 or an 85:1 ratio.

Jaxon had a pre-existing condition which would have been allowed under either the House or the Senate Bill. In any case, a denial of treatment again would have been brought to a government review board for a ruling as insurance companies do not know best. Under a PO, Jaxon would have had coverage. In any of the three instances, the child would have been covered for other circumstance. It should not take publicity for an insurance company to insure a baby.

And now there is the matter of Kyle. I have to admit the treatment is expensive; but then, this is the real problem of healthcare. The costs of healthcare are the driving force behind much of the rise in healthcare insurance. However the insurance company did set a precedent by allowing other non FDA treatments and it hasn’t established a reason to back away from this one. Not much of a basis to deny this treatment.

“But Kyler’s insurance carrier, HealthAmerica, has refused to pay for MIBG, which is not FDA-approved and which it deems ‘experimental.’

The baffling thing, says Paul, is that HealthAmerica has covered other non-FDA-approved treatment for Kyler in the past, including experimental therapies.

Besides, MIBG is routine for neuroblastoma that has progressed as Kyler’s has.

‘It’s considered the standard of care in Europe and the United States for recurrent neuroblastoma,’ says Kyler’s CHOP oncologist, Stephan Grupp. “It’s not an unproven treatment with no basis in medical science.”

In any case, it would not have been a “profit-motivated insurance death panel” that would have decided on treatment or not. Again the Senate bill would have had a review board to decide. Are you this unknowledgeable on the issues of healthcare insurance or are you so ingrained with the other Angry Bear parrots that you truly do not know any better. Ken has it right and you owe him an apology for your blatant silliness.

run,
 
My post stands – or did you actually read it? 
 
The first two got health insurance and will continue to get it.  So the system actually worked. 
 
As for Kyler – you missed the point were even the parents admitted it was NOT ABOUT MONEY.  Its about denying treatment for non-government (i.e. FDA) approved procedure.  Just because it approved some other non-FDA approved treatment has no bearing here unless you believe that any and ALL non-FDA approved treatment has to be covered.  I doubt you do.  A precedent would have been set if HealthAmerica had covered MIBG in the past, but there is no evidence that they had.  Your grip is still with the FDA not HealthAmerica.
 
HealthAmerica already has spent in the region of $1.6-1.8 million and the parents admit its not about the money. So we see your nonsense about profit motive is out the window.
 
Lastly you make a great leap of faith that the Government run review board, under huge pressure to control costs, would approve non-FDA approved treatment.  Quite the contrary I would expect your government review board (aka the Death panel) would routinely deny all non-FDA approved treatment. A clear line in the sand to hold the line on costs.  Or do you believe that the government will and should just rubber stamp any and all treatment??
 
This brings up what I have always pointed out about these health care plans that none on the left will answer.  If Kyler’s parents were Bill and Melinda Gates the parents would just write a check and cover the procedure.  So if you truly plan to bend the cost curve down what procedures will people like the Gates get that the poor won’t? What will procedures will the rich Kyler’s get tat the poor Kyler’s won’t??  Is your answer none?  If so then you will never bend the cost curve down, heck it will just continue to skyrocket.

Lastly, I beleive the comment about hard cases makes bad law being appropriate here. 

And the bill is still crappy and wildly, bi-partisanly unpopular. Kill the bill.

Islam will change

If only we could get reporters to ask questions about everyone who gets denied we could have universal coverage right buff?

“the bill” of which there are two, are very popular check the polls. I personally don’t like the Senate bill one bit, but the public, informed or not, does.