Friends,
Because "Sicko", Michael Moore's new documentary about the health care industry does not open until June 29th, I have not seen it yet, but I have seen the trailer and watched online an Oprah interview with Moore that showed some clips. I got angry just watching the trailer. It featured a Dr. who used to work for one of the insurance companies, testifying to Congress how her job was to routinely deny payments to insured clients, many of whom were cancer patients, in order to increase profits for the company. Insured patients died as a result of the denials.

When I was diagnosed with Stage IV base of tongue SCC in 2002 and was scheduled for the routine treatment plan of 5 weeks of radiation concurrent with 4 chemo treatments (cisplatin and taxotere) at M.D. Anderson (the number 1 or 2 cancer hospital in the world) I was shocked to learn that my insurer was attempting to deny paying for part of my treatment by characterizing the chemo portion of the treatment as "experimental" (which, according to the Moore interview, is one of their common tactics).

M.D. Anderson and my insurance agent battled them for me and eventually the insurer did approve payments for the chemo. This was not the kind of aggravation that I needed as I was preparing to go through treatment to save my life. Fortunately I am a lawyer and have lawyer friends and was in a position to protect myself, although at the time, treatment was imminent and I did not have time to screw around.

The moral of the story, is to keep fighting these people and get a lawyer if you need one. All the insurance companies care about is the bottom line and the best way to insure their profits is to pay you less. They also know that if one of these cases ever gets before a jury, they will lose. I was fortunate to have disability insurance as well, but dealing with two disability carriers was no pleasure either. A fraud investigator, who "just happened to be in my part of the country" wanted to come by and meet me so he "could put a face with the name". One of my former partners represented me for free and instructed the guy to meet me at his office and did most of the talkiing for me. By this time I was already beginning to feel badly from the radiation and might have already been on the feeding tube.
Later on the other company sent its former cop, fraud investigator, and then accountants to go through my records. Their medical staffs were constantly picking over the required monthly reports that my doctor and I were required to fill out, suggesting, then alleging that I was fully ready to go back to my work in my specific occupation as a "trial lawyer." Sure I was ready.... 20 pounds underweight, living on a liquid diet, with a sore throat, fatigue and a very hoarse voice, taking vicodin, concentration lacking, wondering if I was going to survive, I was ready to go pick a jury and begin a murder trial! Fortunately my health improved eventually and I quit receiving the disability payments, but not until I was ready to begin doing trial work again.

Just remember, the nice guy that you grew up with or the friendly neighbor down the street who sold you an insurance policy is not the same guy or lady that you have to deal with when the time comes to make a claim.

Give 'em hell!

Danny G.

Hello Danny

It all comes down to money. Our whole stinking existance is about money. You are programed to go get in your tin coffin and drive everyday and go make money for someone else.

In the 50's & 60's I man could work 40 hours and the wife could stay home and raise a fine family and you would live a modestly comfortable life.

Now both husband and wife MUST work just to SCRAPE by. And the kids are programed for the $150.00 sneakers.

The illegal immagrants here in S. Fla. won't work for less than $10.00 cash. And don't let anyone fool you. They are stealing valuable jobs. $10.00 an hour is $20,800.00 a year.

Minimum wage is $5.15 hr. it will go up .70 cents every July for the next three years. 5.85 07', 6.55 08', 7.25 09'.

If it were 2009 now and your making 7.25 @ 40 hrs. = $290.00 wk. = $15,080.00 yearly.WTF! You could just get by if you were single and alone and very boring with no interests.

Damn, did I just describe the perfect spouse?

Money, money, money. THE ROOT OF ALL EVIL!

I wish I could just go to Montana and live off the land. Now that's good living!

Or move to Canada!

C'mon up! we've got lots of space, some of the most beautiful mountains you'll ever see, and pretty damn good health care that's not costing us a thousand bucks a month in insurance premiums.

Plus, we Canadians are really friendly !:^)

Yes us Canadian's are very lucky to have our health care system. Everyone is treated equally; rich or poor, young or old. Yes there are pro's and con's to everything; however we really can't complain.

Best wishes to you all!
LisaB

It is a money issue. You have to constantly fight with the insurance company. My significant other has a cancer policy. It has been a month since we submitted a claim to get the cash, and nothing yet.You can never talk to the same person and all they say is that it is being processed. I call every week to no avail. This company, United American out of McKinney, Texas is downright terrible. They have a website, but no toll free number to call. I had to call the Texas Insurance Commission to get a phone number. Dealing with cancer is frustrating enough, then componded by dealing with these idiots. What's a person to do?

Hi junklady

I found that with my Cancer policy, it took about 5-6 weeks to get things processed and checks out the door. As more claims were submitted, it seemed to get somewhat better.

Hang in there, but don't let them get the best of ya.

Kevin

So far, and I mean SO FAR, I have had no trouble dealing with the insurance company, but then i havent had my surgery yet of course so we will see!!

Being originally from England (been in USA since '99) I still find it hard to reconcile that you have to pay (even with insurance) a quite large chunk of money to get treated!

I couldn't agree more that our health care system is badly broken and it's because we allow the companies paying the medical bills to make a profit. In fact, they are contractually obligated to try to make as big a profit as they can for their shareholders. That is just fundamentally at odds with receiving good quality care. And we should all be up in arms about it. There are a lot of people that think things would be worse if health care were run by the government but the fundamental difference is there wouldn't be that root-level conflict of interest between profit and good care. Yes, government programs can be messed up, but they could hardly be more messed up than our system is right now.

That said, my insurance company has been remarkably good, so far, about paying for everything, including out of state second opinions on things. Maybe it's because I was diagnosed with two cancers at once and they know if they mess up with me I could become a really good newspaper story about the heartlessness of insurance companies, I don't know. But I have really not had to do much fighting with them about coverage. And for that I am *extremely* grateful!

Nelie

Here in the Uk we are lucky in that it's possible to pay for 'Private Treatment' or go with the National Health Sevice where everyone is treated the same and drugs are a reasonable price if you can afford them, free if not!

However, i went to the dentist with first symptoms in January, referral to Maxillo-facial surgeon was scheduled for April 19th, took til May 15th to get MRI and was June before final diagnosis!

And not really any choice of specialists or cancer treatment centres, and we've to 'fight'--and wait for--'second opinion'
That said, having finally 'got into the system', my team is absolutely wonderful--thorough, caring and providing extra support emotionally when needed--nothing is too much trouble.

I don't know how we'd cope here if we had to go through what you Americans have to organise and pay for!
Brenda