Tuesday, August 18, 2009
"Death panels"? I'll tell you about death panels. My husband faced one some years ago, and it didn't involve any government bureaucrat. It was run by our private insurer, the sort of corporate entity that foes of health care reform say will give you anything you want.
My husband was diagnosed with liver cancer. We were "insured" by United Healthcare. The deal was as follows: You had to use doctors on its list, but if you needed specialized care outside the network, United's health-maintenance organization would pay for it. Fair enough.
A liver expert within the network said point blank that for my husband's case, there was but one place to go, a specialized chemotherapy program at Deaconess Hospital in Boston. Fortunately, it was only 50 minutes away.
But United Healthcare refused to pay for it. Instead, it directed us to a small, local hospital unequipped to deal with this kind of cancer. Our liver specialist warned, "Don't waste your time."
We naively tried to go through United Healthcare's appeals process. We would call the number and speak to a handler who said our case would be reconsidered. Days later, a one-sentence letter would arrive by slow mail saying that we were being denied, but call this number to challenge the verdict.
Around and around we went. We could never speak to anyone making the decisions. No one would even talk to our doctor, who at one point whispered to us, "Mortgage the house."
I became convinced that the insurance company was trying to run out the clock on my husband's life. Had it issued an outright "no," we would have gone to Deaconess, paid for the care ourselves and fought the insurer later. But it always pretended that a possible "yes" could be around the corner.
Having already lost precious time confronting this cancer, we simply rushed to Deaconess. On hearing the story, the head of the chemo program told us: "HMOs don't care whether you live or die. They just want to save money."
My husband underwent the arduous chemo. Meanwhile, powerful people were pulling strings for us with the insurer. Upon learning we had "connections," United Healthcare finally said it would pay.
The cancer came back. This treatment was never a sure thing, but I often wonder how much the delay affected the outcome.
An ex-Marine, my husband was a tough customer. Toward the end, he said to me, "You know, fighting the insurance company was worse than fighting the cancer."
A year after my husband died, I was still receiving medical bills for some of the treatment that United Healthcare had agreed to cover. Oh, they eventually paid. The game is to break you down.
An economic note: In 2006, William "Dollar Bill" McGuire, CEO of parent-company UnitedHealth Group, walked off with a $1.1 billion golden parachute (on top of the $500 million he had already raked in) -- though he had to return some of it in an options backdating scandal.
What we wouldn't have done to have traded Dollar Bill's minions for a government bureaucrat. The bureaucrat would have given a simple "yes" or "no" based on official guidelines. He or she would have had no personal stake in denying you care.
By the way, a government-run program doesn't tell you what treatments you may or may not have. It tells you what the taxpayers will subsidize. You are free to go out with your own money and buy whatever you want. We would have been prepared to do that. Instead, we got tied up in a private insurer's web of tricks.
Believe me, "death panels" already exist, and they have nothing to do with the government.
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