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(ABC)   Cancer survivor loses her insurance because she had the audacity to move to a different address   (abcnews.go.com) divider line 127
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15966 clicks; posted to Main » on 22 Mar 2010 at 10:32 AM (4 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2010-03-22 08:26:00 AM  
Of course in this case it was Medicare that screwed her so this must be a good thing because if there's one thing we all agree on today, it's that Government run health care is always better.

//ducks and covers, runs out giggling
 
2010-03-22 08:33:59 AM  
Damn those private insurance companies dropping coverage.
Reads article.

Well shave my back and call me suzie...I never expected the caring government system to do this.
 
2010-03-22 08:41:28 AM  
People lose things all the time when they move. I'm sure her insurance is in a box somewhere. She just needs to keep looking for it, it's gotta be around somewhere.
 
2010-03-22 08:46:38 AM  
This wouldn't be a problem if all insurance was not for profit. Which is what this bill made happen, right? RIGHT?
 
2010-03-22 08:57:32 AM  
FTFA: He has contacted both U.S. Sens. Herb Kohl and Russ Feingold from Wisconsin, Oertel's congressman, Thomas Petri, her state senator and assemblyman, the state Commissioner of Insurance, the private company that administers Medicare in Oertel's area and the Medicare office in Chicago - all without success.

Discuss.
 
2010-03-22 09:00:30 AM  
Off label drugs are off label.
 
2010-03-22 09:02:13 AM  
Bastards. Aetna wouldn't have been so damned cruel. They would have denied coverage from the get-go, thereby not toying with her emotions
 
2010-03-22 09:05:07 AM  
Makh: FTFA: He has contacted both U.S. Sens. Herb Kohl and Russ Feingold from Wisconsin, Oertel's congressman, Thomas Petri, her state senator and assemblyman, the state Commissioner of Insurance, the private company that administers Medicare in Oertel's area and the Medicare office in Chicago - all without success.

Discuss.


Go Cigna!
 
2010-03-22 09:32:36 AM  
Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?
 
2010-03-22 10:09:42 AM  
gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?
 
2010-03-22 10:16:42 AM  
ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?


I just naturally assumed their profits were astronomical - is it really 3%? Across the board?
 
2010-03-22 10:23:51 AM  
gopher321: ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?

I just naturally assumed their profits were astronomical - is it really 3%? Across the board?


Add in some creative accounting, and yes, you could call it 3% net profit. 3% gross profit, not so much.
 
2010-03-22 10:35:40 AM  
I_Am_Weasel: gopher321: ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?

I just naturally assumed their profits were astronomical - is it really 3%? Across the board?

Add in some creative accounting, and yes, you could call it 3% net profit. 3% gross profit, not so much.


What's 3% of six Brazilian?
 
2010-03-22 10:36:30 AM  
Man, this kinda stuff will make your head asplode.
 
2010-03-22 10:36:31 AM  
Death panels? In my Obamamerica?
 
2010-03-22 10:36:43 AM  
Medicare doesn't.
 
2010-03-22 10:40:16 AM  
FTFA: He has contacted both U.S. Sens. Herb Kohl and Russ Feingold from Wisconsin, Oertel's congressman, Thomas Petri, her state senator and assemblyman, the state Commissioner of Insurance, the private company that administers Medicare in Oertel's area and the Medicare office in Chicago - all without success.

Discuss.
 
2010-03-22 10:44:29 AM  
Marcus Aurelius: Off label drugs are off label.

unfortunately, this is the crux of the argument.
 
2010-03-22 10:45:33 AM  
simpsonfan: If some bean counter makes a decision that would cause me to die, I would have nothing to lose.

So I would not be the only one to end up dead.


ssssh Citizen. Sleep now. There's nothing here worth waking up for.

/the hand of the Government rocks the cradle
 
2010-03-22 10:46:03 AM  
have had similar issues as well since my accident. I am the 3rd and having a suffix on your name is a pain cause I get denials on alot of my insurance submissions because its missing or not put the correct way or something stupid like that. I have to go round and round such a pain oh and if use my middle name then it really gets confusing.

/Yes this is for both Private and Government healthcare.
 
2010-03-22 10:46:35 AM  
gopher321: ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?

I just naturally assumed their profits were astronomical - is it really 3%? Across the board?


It goes something like this:
Income = 1 billion trillion dollars
Expenses = 0.2 billion trillion dollars
Exec. salaries, stock options, expense accounts, jets = .77 billion trillion dollars
therefore
Net profit = .03 billion trillion dollars, a mere 3%. We're practically starving here.

/exaggerating, but not joking
//works for non-profits too...check out how much some of them pay for CEOs and fundraising, with $0 net profit resulting
 
2010-03-22 10:47:01 AM  
His office also contacted Biogen, the maker of interferon (Avonex) to see if it would supply the drug for free on the grounds of medical hardship. That too was denied because the drug was being used for someone who was not diagnosed with MS.

I find this particularly interesting considering yesterday's greenlighted article on preventing drug companies from promoting off-label use. This drug is not approved for treating cancer. If Biogen wanted to make the big altruistic good-PR move of giving this woman her life-saving drug for free, would that count as promoting it for an off-label use?
 
2010-03-22 10:53:11 AM  
Way to go Cigna.

There's really no good reason why private companies need to be involved in medicare. It just inserts another layer of bureaucracy and costs into the mix.

If this really worked, why don't we abstract the Pentagon and the Army with a private corporation who proxies all orders for a % of the cost. That should improve things right?

/Oh yea... it was done as a favor to insurance companies to make them some easy money.
 
2010-03-22 10:58:15 AM  
Well she is getting her insurance back.
 
2010-03-22 10:58:50 AM  
Reading this article gives me daymares...

Everybody involved is passing the buck so when this poor woman dies they can each say, "hey, it wasn't me."
 
2010-03-22 10:58:56 AM  
And so it starts.
 
2010-03-22 11:04:02 AM  
Since insurance companies - and certainly Medicare - must have reams of personal information on the patient, wouldn't it only be fair to provide the patient with at least name, address, etc of those worthies who deny her claim for interferon? After all, how could they really be afraid of a terminal cancer patient with no hope and nothing left to live for?
 
2010-03-22 11:08:45 AM  
THe most disgusting thing about this article is this:

Both drugs are expensive - temozolomide, about $2,500 a month, and bevacizumab, about $20,000 a month...

Wow.

I realize that pharmaceuticals are expensive to develop, but really? This drug must be made from platinum-coated dinosaur DNA soaked in printer ink.
 
2010-03-22 11:11:14 AM  
are there no competent people in the entire damned country?

oh. this was the USA. never mind, already know the answer to that.
 
2010-03-22 11:12:14 AM  
This seems more like a case of antiquated medical record keeping. The drug was not approved for the treatment of cancer. With a more effective record keeping system I would think this would be less likely to happen.

It was a private insurer being paid by medicare (sounds confusing) but, much as I don't like private insurers, it does not sound like their fault since medicare is the one that would not pay.
 
2010-03-22 11:13:43 AM  
If she was so darn sick, why the heck was she moving anyway? Probably the old "brain tumor" scam, seen in hundreds of times
 
2010-03-22 11:13:44 AM  
Pump_ThePurpleWarrior: FTFA: He has contacted both U.S. Sens. Herb Kohl and Russ Feingold from Wisconsin, Oertel's congressman, Thomas Petri, her state senator and assemblyman, the state Commissioner of Insurance, the private company that administers Medicare in Oertel's area and the Medicare office in Chicago - all without success.

Discuss.



Hmm I see your point. The private company needs government assistance to make business choices that do not fark people. Of course why didn't anyone ever think of that.
 
2010-03-22 11:14:04 AM  
PirateKing: THe most disgusting thing about this article is this:

Both drugs are expensive - temozolomide, about $2,500 a month, and bevacizumab, about $20,000 a month...

Wow.

I realize that pharmaceuticals are expensive to develop, but really? This drug must be made from platinum-coated dinosaur DNA soaked in printer ink.


This is my challenge about healthcare on a moral level.

What is in these things that makes them cost so much? It's like 'you'll die if you don't take this' and then 'ok, to stay alive, $20k a month'. What the fark is in that thing that makes it so expensive?

I mean it sounds like they have a customer for life by giving her this stuff, charging 20k a month for it means it runs out pretty quick and no sale.
 
2010-03-22 11:15:29 AM  
DIGITALgimpus: There's really no good reason why private companies need to be involved in medicare. It just inserts another layer of bureaucracy and costs into the mix.

Missouri does it for the state's ultra-expensive, barely-covers-anything insurance of last resort. The people running the show are the same motherfarkers who turned you down for regular insurance.
 
2010-03-22 11:17:35 AM  
Came in wondering if I'd see a bunch of potheads ranting about how she just should start using pot as it's natural and magical and such and that the medication from the big evil drug corporation was nothing but over-expensive crap that did nothing but cause terrible side effects that pot wouldn't do to her.

But I see that you guys are still buzzing around that whole 3rd world style health care thing that you're so proud of.

Somehow, I still see the word "fail" all over this.
 
2010-03-22 11:17:44 AM  
The funny part here is that apparently some of you think your doctor has some say in your care. All they do is determine which codes are applicabe (potentially applicable) then based on those codes they order treatment. This has been the case for quite a long time and will forever remain so. Unfortunately this is basically wakey wakey for everyone to come to the realization of what many of us already knew (outside of Sarah Palin etc).
 
2010-03-22 11:20:16 AM  
wait till the AD MEN start with the commercials. nothin but insurance,Pharma,and dick lawyers.
 
2010-03-22 11:20:20 AM  
I_Am_Weasel: gopher321: ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?

I just naturally assumed their profits were astronomical - is it really 3%? Across the board?

Add in some creative accounting, and yes, you could call it 3% net profit. 3% gross profit, not so much.


This is the thing that pisses me off the most about "insurance." Take a look at the big insurers, how many of their executives are making obscene salaries? Managers? Sales people?
Yeah, them too. Phylis, the nice blue haired insurance sales lady with the new suv, house on the hill & the country club membership?
That's all paid for with dollars we, you and I, paid into the insurance system, ostensibly for our health care, that these people are siphoning into their own wallets. And no, it's NOT profit. Under corporate taxation laws, those are all legitimate EXPENSES.

That, and why does a drug cost $20K / month? Is it that hard to make? Pressed by the bossoms of virgins? Yeah, I know, gotta recover the cost of R&D. I smells BS, though...
 
2010-03-22 11:22:41 AM  
tboucher: What is in these things that makes them cost so much? It's like 'you'll die if you don't take this' and then 'ok, to stay alive, $20k a month'. What the fark is in that thing that makes it so expensive?

Research & Development.
 
2010-03-22 11:23:06 AM  
tboucher: This is my challenge about healthcare on a moral level.

What is in these things that makes them cost so much? It's like 'you'll die if you don't take this' and then 'ok, to stay alive, $20k a month'. What the fark is in that thing that makes it so expensive?

I mean it sounds like they have a customer for life by giving her this stuff, charging 20k a month for it means it runs out pretty quick and no sale.


Maybe it depends on the drug and how it's made. Some are extracted and it takes a lot of base materiel from which it's extracted from. (for example; 10 gallons of blood to extract 10cc of a particular protein that's the base of the drug)

May also be a case that for this drug to be created, you need a very expensive lab with very expensive equipment, lots and testing and lots of specialists, and a very precise setting to produce it.

Lot's of variants that causes the manufacturing of certain medication to be very complex.
 
MrT
2010-03-22 11:24:15 AM  
So, after at very least nine years in the wild, this drug is still not approved for this condition. Has anybody considered that this might actually be because it doesn't farking work. A single doctor, who shows far too much tendency to get emotionally worked up about his work, and a single patient have decided together that this treatment is a magic bullet based on a sample size of 1. Color me sceptical, but isn't this the same process by which people in Africa end up believing that ground tiger penis will cure their impotence?

9000 people per year with the condition gives a potential market of $850M anually. Don't you think the drug company would be trying pretty farking hard to get the drug approved?
 
2010-03-22 11:25:37 AM  
Another notch in the belt of the "BEST HEALTHCARE IN THE WORLD"!
 
2010-03-22 11:27:33 AM  
www.benwetmore.com
 
2010-03-22 11:27:47 AM  
o4tuna: I_Am_Weasel: gopher321: ne2d: gopher321: Hey - don't be so harsh. How do you expect insurance companies to keep their obscene profit margins if they have to pay to constantly update their records?

A 3% profit margin is obscene?

I just naturally assumed their profits were astronomical - is it really 3%? Across the board?

Add in some creative accounting, and yes, you could call it 3% net profit. 3% gross profit, not so much.

This is the thing that pisses me off the most about "insurance." Take a look at the big insurers, how many of their executives are making obscene salaries? Managers? Sales people?
Yeah, them too. Phylis, the nice blue haired insurance sales lady with the new suv, house on the hill & the country club membership?
That's all paid for with dollars we, you and I, paid into the insurance system, ostensibly for our health care, that these people are siphoning into their own wallets. And no, it's NOT profit. Under corporate taxation laws, those are all legitimate EXPENSES.

That, and why does a drug cost $20K / month? Is it that hard to make? Pressed by the bossoms of virgins? Yeah, I know, gotta recover the cost of R&D. I smells BS, though...


Some of the really expensive drugs have two problems
1. They are difficult to make
and/or
2. They have a really really small market

Sometimes it is the cost of the rare ingredients in drugs that drive their cost up, but usually it is the following scenario

If you have a really difficult product to make, and only 100 people a year need it, those 100 people are going to have to pay for 1. R&D to develop it 2. The factory to make it.

If you have a really difficult product to make, and 1,000,000 people a year need it, the 1,000,000 people share those fixed costs
 
2010-03-22 11:31:38 AM  
From the article, she didn't lose her coverage because she moved. She lost her coverage because it was tied to her disability payments. When she moved and didn't tell SSA, she lost her disability and as a result, she lost her medical coverage.

It is entirely her fault. All it takes to tell SSA you are moving is a phone call. You can also do it by mail or come into the office. It isn't the government's job to try and track you down ever person getting benes somehow. Newsflash, most of those people move constantly. When you are getting disability payment you have reporting responsibilities. Just do it, if you don't do it then suffer the consequences.
 
2010-03-22 11:32:19 AM  
tboucher: PirateKing: THe most disgusting thing about this article is this:

Both drugs are expensive - temozolomide, about $2,500 a month, and bevacizumab, about $20,000 a month...

Wow.

I realize that pharmaceuticals are expensive to develop, but really? This drug must be made from platinum-coated dinosaur DNA soaked in printer ink.

This is my challenge about healthcare on a moral level.

What is in these things that makes them cost so much? It's like 'you'll die if you don't take this' and then 'ok, to stay alive, $20k a month'. What the fark is in that thing that makes it so expensive?

I mean it sounds like they have a customer for life by giving her this stuff, charging 20k a month for it means it runs out pretty quick and no sale.


The disgusting thing to me is, the drug that will keep her alive is $8000 per month, which they won't cover. However, they'll happily pay $20,000 per month for a drug that won't work. WTF?
 
2010-03-22 11:32:41 AM  
FTA: "Both drugs are expensive - temozolomide, about $2,500 a month, and bevacizumab, about $20,000 a month"

How is that even farking possible? Seriously? I understand there's probably a lot of expensive research that goes into developing drugs, but once you've got something figured out, how could it possibly cost that much to produce and ship it each month? After they recoup their expenses, how do they have the juevos to say (to the sick people for whom they developed the drug in the first place), "Sorry, that'll be $20k." What's driving it? Is it really just CEO salaries or what?

Obviously the health care issues in this country are huge and there's not just ONE THING that could be tweaked to make it all better for everyone. But seriously, how can something that's not made of incredibly rare space-chemicals or encrusted with space-diamonds possibly cost 20,000 farking dollars a month?

/dyed-in-the-wool moderate
//honestly does not understand how anything could be that expensive
 
2010-03-22 11:32:47 AM  
She will be fine in 2014.
 
2010-03-22 11:34:58 AM  
MrT: So, after at very least nine years in the wild, this drug is still not approved for this condition. Has anybody considered that this might actually be because it doesn't farking work.

Yes, clearly it is unreasonable for the doctor to continue administering a drug to the patient which treats her brain tumor successfully. The drug companies only make expensive drugs for those that can afford such luxuries. It's the patient's fault that the drug is too expensive for her.
 
2010-03-22 11:35:29 AM  
Why do we still care about addresses? This is 2010, not 1847.

People move now, they move great distances and do it alot. Why can't I just get a government email account so they can bug me with shiat securely?

As for warrants, that system is already used to people running.

So, why can't I just become a federal citizen or something? Also, how come when I go to irs.gov I can't simply fill out a form on their site? Why am I being forward to HR Block to fill shiat out?
 
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