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July 2, 2013 § Leave a comment
When I returned home from my recent road trip, a letter from Blue Cross Blue Shield of Illinois (my health insurance company, also known as BCBSIL) was waiting for me. Even though I already knew they denied my appeal for last September’s biopsy, I was amazed at how quickly I transitioned from tired but happy traveler to enraged cancer patient.
The upshot of their message was this:
“You already have metastatic lung cancer. A biopsy won’t change the fact that you’re going to die from cancer.”
The statement probably came from the independent “physician who specializes in Internal Medicine/Pulmonary Disease” who reviewed my appeal. You can judge for yourself whether I’m overreacting from this excerpt. I bolded some words for emphasis.
” … in this case the member is already known to have progressive Stage IV Bronchogenic carcinoma even after therapy. Specifically identifying the histopathology of this right upper lobe lesion is not going to affect long-term health outcomes.”…
When BCBSIL denied the claim, I appealed. I explained my treatment history, including that my cancer is aggressive, and we needed to know if the nodule were BOOP or cancer to give me appropriate treatment. My doctor reviewed my letter and wrote a letter of his own to stick in the packet. I included scan CDs and appropriate medical reports.
Evidently that wasn’t enough. Because, well, I’m gonna die anyway…
What frosts me about this letter is that a “specialist” decided there was no urgency to get a biopsy because it wouldn’t change my “long-term health outcome.” Did he expect me to go on steroids AND chemo (both of which have a significant impact on quality of life) in case one of them MIGHT work? Or do nothing, since I’m going to die anyway? Well, here’s a news flash: we’re ALL going to die! The purpose of medicine is to keep us as healthy as possible while delaying that inevitable long-term outcome as long as possible. read more
ART: Andreas Bahn