2y ago

Big Insurance Met Its Match When It Turned Down a Top Trial Lawyer’s Request for Cancer Treatment

www.propublica.org Big Insurance Met Its Match When It Turned Down a Top Trial Lawyer’s Request for Cancer Treatment

Blue Cross and Blue Shield denied payment for the proton therapy Robert “Skeeter” Salim’s doctor ordered to fight his throat cancer. But he was no ordinary patient. He was a celebrated litigator. And he was ready to fight.

News @lemmy.world

www.propublica.org /article/blue-cross-proton-therapy-cancer-lawyer-denial

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News @lemmy.world

Big Insurance Met Its Match When It Turned Down a Top Trial Lawyer’s Request for Cancer Treatment

www.propublica.org /article/blue-cross-proton-therapy-cancer-lawyer-denial

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41 comments

Is this supposed to be a feel-good story of the little guy working within the system?
It feels like a capitalist dystopia where health insurance will tell everyone else to go die in a ditch.
- Is this supposed to be a feel-good story of the little guy working within the system?
  No. The story admits that early on. It's yet another expose on how crooked the system is so that even one of the elite have to fight to get the treatment that their doctor recommends.
  
  Orphan Crushing Machine
- That's pretty much what insurance does these days. Too bad we're not all top trial lawyers.
  
  Top trial lawyers with personal doctors who are willing to invest tons of their own time into your case. Personal doctors who also happen to be experts on the technology in question.
  Overcoming this type of abuse is utterly impossible for the average person, as the patient himself acknowledges.
- It's called an Orphan Crushing Machine story. As in, "how nice it is that the whole community came together to raise money to stop little orphan Annie from being tossed into the orphan crushing machine!". Stories that don't bother to ask the important questions like "Why is there an orphan-crushing machine?" and "Why on earth did they all have to raise money to pay someone to stop an orphan from being tossed into said machine?!"
  Once you learn to recognize them, you realize it's what 99% of 'feel good' news stories really are.
  But this one is a lot more sensitive to that narrative than most, so I'd still recommend the read.
- And the only people who can fight it are the powerful and elite, who, it just so happens, won’t even consider doing so until the problem impacts them.
- "Hello yes I'm your insurance agent, now before I read this decision to you, are you now or were you ever a lawyer? No? Okay denied get fucked L + ratio."
- My first thought was oh is that supposed to make me feel better that he had to be a bigshot lawyer to be able to get healthcare?

Had a similar problem with Aetna earlier this year.
I had snapped an achilles tendon. Physical therapy wouldn't touch me until they ran an MRI to determine the damage.
Damage that can't be seen on an xray because the achilles tendon doesn't appear on an xray.
Aetna denied the MRI, need to to an xray first. An xray that my doctor, my physical therapist, and I all knew was pointless.
- And the MRI machine they cover has no appointments for 6 weeks. There are probably 3 other MRIs on the drive to that one sitting unused. You sit there and wait for no reason. Welcome to America.
  
  And then you probably have to pay thousands of dollars out of pocket before they will even see you for an MRI
- I went through the same thing on my knee. 3 pointless appointments and two months to get to the MRI, that should have been the first step.
  How can they be saving money by adding extra steps to my diagnosis? It's not just the insurance companies that are the problem. Medical providers have their own schemes to milk the insurance for more money.
  
  How can they be saving money by adding extra steps to my diagnosis?
  They kinda save money when people give up on getting care at all. Insurance companies should have no input in any diagnosis.
- The more they can do the more they can charge and or deny
- Went through that twice with shoulder injuries.

With all of the violence going on in the world today, I am constantly surprised at how little of it is directed towards insurance company offices.
- Look, I'm not saying that I endorse or encourage the idea. I'm just saying that it's a constant source of disappointment that American society decided that school shootings are a thing to do, and not "bank and insurance company headquarters" shootings.
  
  In my experience most offices and banks have more security than schools. You can’t even get into the building where my office is without a keycard for the front door and a virtual pass that’s tied to your work email.
  
  Maybe not the offices, but the homes of the owners and CEOs. I have family that works in insurance as a typical office peon, they don't deserve to be shot they'd probably join you in shooting the CEO lol
- I'm not sure why it's surprising, they're literally preying upon the people that are too sick to fight back against them.
  
  Those people have families and friends who understand their loved one's death was preventable.

"I didn't care until it happened to me."
- Read the article, he literally spend his entire fucking life fighting companies for Committing medical malpractice. I know lawyers are known to be sleazy but this man seems to be fighting this battle every day
  
  It’s a profitable business.

41 comments