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Teenage girl denied life-saving brain surgery because insurance company says no


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"In denying Cara her surgery, Aetna said it considers laser ablation surgery "experimental and investigational for the treatment of epilepsy because the effectiveness of this approach has not been established."
 
"Clinical studies have not proven that this procedures effective for treatment of the member's condition," Aetna wrote in its rejection letter.
The insurance company did approve her for the more invasive and more expensive open brain surgery, called a temporal lobectomy, even though her medical team never sought approval for the procedure."
 
She got approved for the normal surgery but not the experimental one....
...so the obvious response is to cry on social media and say that the Insurance company is killing her.
 
Edited by unbillievable
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4 minutes ago, unbillievable said:
"In denying Cara her surgery, Aetna said it considers laser ablation surgery "experimental and investigational for the treatment of epilepsy because the effectiveness of this approach has not been established."
 
"Clinical studies have not proven that this procedures effective for treatment of the member's condition," Aetna wrote in its rejection letter.
The insurance company did approve her for the more invasive and more expensive open brain surgery, called a temporal lobectomy, even though her medical team never sought approval for the procedure."
 
She got approved for the normal surgery but not the experimental one....
...so the obvious response is to cry on social media and say that the Insurance company is killing her.
 

 

So "insurance company denies life-saving surgery" is actually "insurance company approves alternative surgery for non-life-threatening condition?"

 

I'm sure there's a name for this sort of logical fallacy.  It's called...oh, hell, I'll just pick one at random...let's call it the isomorphism complexity fallacy.

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6 minutes ago, DC Tom said:

 

So "insurance company denies life-saving surgery" is actually "insurance company approves alternative surgery for non-life-threatening condition?"

 

I'm sure there's a name for this sort of logical fallacy.  It's called...oh, hell, I'll just pick one at random...let's call it the isomorphism complexity fallacy.

Non sequitur

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22 minutes ago, B-Man said:

I have spent the last 39 years working in the heath care field, from both sides of this issue

 

and this thread is a big pile of embarrassing sh*t.

 

I would be ashamed to have posted it.

 

.

If its so bad

 

Then say why lol

 

U just embarrass yourself when you fail to make an argument

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2 minutes ago, westerndecline said:

If its so bad

 

Then say why lol

 

U just embarrass yourself when you fail to make an argument

No, you embarrass yourself by posting something and interpreting it completely wrong. Aetna was willing to pay for the more expensive but proven surgery rather than something that they thought was experimental. Insurance companies----bad!

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1 hour ago, joesixpack said:

You act as though state run healthcare doesn’t deny care. They do. Often.

Who said im for single payer??

 

:blink:

1 hour ago, 3rdnlng said:

No, you embarrass yourself by posting something and interpreting it completely wrong. Aetna was willing to pay for the more expensive but proven surgery rather than something that they thought was experimental. Insurance companies----bad!

Whether its an ins comp or not.

 

Why is a corporation deciding care instead of the patient....???

 

Many experimental care has saved lives

 

This was the premise of the post

 

But you immediately went to your ideological talking pts when im not even for single payer

 

Good lord

27 minutes ago, TakeYouToTasker said:

Insurance companies do not cover experimental treatment as a standard practice, and for very good reason.

 

 

Whats the reason

 

Dr says patient could be cured from brain cancer with new drug

 

Patient signs waiver.

 

Go

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1 hour ago, westerndecline said:

 

Why is a corporation deciding care instead of the patient....???

 

 

I suggest you learn how insurance works before you B word about it.  

 

BTW I really hope there's a petition going around that will allow us to say bi&%$.  B Word?  Who the !@#$ are we protecting from not being able to say Bit3h??

 

Edited by Chef Jim
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1 hour ago, westerndecline said:

Who said im for single payer??

 

:blink:

Whether its an ins comp or not.

 

Why is a corporation deciding care instead of the patient....???

 

Many experimental care has saved lives

 

This was the premise of the post

 

But you immediately went to your ideological talking pts when im not even for single payer

 

Good lord

Whats the reason

 

Dr says patient could be cured from brain cancer with new drug

 

Patient signs waiver.

 

Go

No, the insurance company is not deciding care, they're deciding what they will pay for. In this case (you know, the one you embarrassed yourself with) they approved the more expensive but approved procedure. By your logic you would expect the insurance company to pay for any procedure that the patient wanted. What if they thought being bled out was what was necessary? Is that something the insurance company should pay for? You need to up your game before you lose all of your self of steam.

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1 hour ago, /dev/null said:

Dunno which of these makes me feel the worst

 

"Teenage Girl" in title makes me think "Pic?"

The Picture, yeah I would

She's going to die

westerndecline is a member of the same species that I am

You're right. She will die.  But it's not from this, essentially. It's a grosse over exaggeration

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3 hours ago, 3rdnlng said:

No, the insurance company is not deciding care, they're deciding what they will pay for. In this case (you know, the one you embarrassed yourself with) they approved the more expensive but approved procedure. By your logic you would expect the insurance company to pay for any procedure that the patient wanted. What if they thought being bled out was what was necessary? Is that something the insurance company should pay for? You need to up your game before you lose all of your self of steam.

Wrong again...

 

What the DR wants.... The one who went to school for this, not an insurance agent.

 

Try again

Oh strawman

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7 hours ago, 3rdnlng said:

No, you embarrass yourself by posting something and interpreting it completely wrong. Aetna was willing to pay for the more expensive but proven surgery rather than something that they thought was experimental. Insurance companies----bad!

Another question

 

Does the dr decide what is "experimental"

 

Or does the insurance agent?

 

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