Blue Cross Blue Shield health care disaster: Man with brain tumor needs care STAT, not a death panel.

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Lolly Jean Twitter profile health care

One of my longtime Twitter pals, @Lolly_Jean, is desperately trying to raise the profile of what health care insurance companies are doing in the employer provided field; maybe shaming Blue Cross into allowing her husband to continue the care they have already approved, the care her husband was receiving until he became sick, will help.

She has tried tweeting to news and cable outlets to no avail. Any suggestions anyone might have to help her raise the profile of this devastating issue--for her husband and the others in employer-provided health care policies that will likely follow-- would be greatly appreciated.

Here is her story in her own words (bolding is mine):

My husband has a brain tumor and has been under care of Memorial Sloan Kettering in Manhattan, and receives his radiation treatment from Memorial Sloan Kettering in Commack, Long Island, New York. He became ill from side effects, was taken to our local hospital on January 28th, where he remains today.

We have been fighting Empire Blue Cross Blue Shield for the past 2.5 weeks, as they refuse to allow him to be transferred to Memorial Sloan in Manhattan (MSK) for acute care and resumption of his remaining radiation treatments to the brain. We receive our insurance through my husband's employer, and we pay an additionally for Direct Point of Service care, which allows us choice of doctors and facilities. To note, my husband has been under the care of Memorial Sloan Kettering for the prior 4 years.

Blue Cross, at first, wanted to transfer my husband to a hospice facility with a standing DNR (do not resuscitate) order. My husband is not in end stages of his illness.

They fought us for a precious week of treatment time until they agreed that my husband did not warrant end of life care. They still refuse to allow us to take him to MSK, where his doctors know him, have knowledge of the rare form of tumor he has, and where until 5 weeks ago, he was receiving his treatment.

As I mentioned, this is employer-provided health care. My husband's employer is advocating he be moved to MSK for the remainder of his treatment, and has been very helpful in contacting Blue Cross in advocacy of his case.

MSK is 'in network' on our plan. They accept the negotiated payment as per their contract with Empire Blue Cross Blue Shield. And as I stated, we do have a Direct POS plan which allows us to go outside of network, should we choose.

To force us to change our doctors at this stage is unconscionable, immoral and dangerous.

To force us to go to a facility that cannot provide the same level of cancer care would not allow for the outcome that MSK feels my husband's condition should have.

And the more time we fight Blue Cross, my husband becomes weaker. This truly is a death panel, one run by the actuaries in Empire Blue Cross.

Please, help us by lending your voice by advocating for my husband.

By the way, here's the @AskAnthem Twitter profile. Notice the link they provide at the bottom:

Anthem on Twitter health care

Here's what you see when you follow the "customer support" link they provide, because, you know, they CARE:

anthem support health care under maintenance

I'm sure Anthem's "improving your online experience" and apologizing for "any inconvenience" are a huge comfort to Lolly Jean and her ailing husband.

You can get the ball rolling by tweeting this post to @empirebcbs (Sally Kweskin, their PR director in New York) and @askAnthem.

I don't know about you, but I'm not letting up until we get more action than a pleasant, solicitous response.

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  • KatieAnnieOakley

    I agree completely. Often, the people answering the phones are RN's or even LVN's / LPN's; they didn't always understand the depth of my medical history or what the progression of my treatments meant - and they certainly were not doctors.

    For example: they'd ask when I had my kidney transplant; I'd say 19** - then they'd say a few nice things, like "oh, you are lucky!" then say something incredibly stoooopit, such as "are you still on dialysis?"

    These were (supposedly...) educated, specially-trained medical professionals (I use the term loosely) making life and death decisions - but they didn't understand the course, progression or success of my medical treatments! This has happened with at least half a dozen insurance companies over the past 30+ years. It was NOT an isolated incident, and happened as late as 2+ years ago.

    This type of question has always floored me (like I said, its happened numerous times) because when you have a successful kidney transplant, you don't need hemodialysis as long as the transplant is working!

    OK - that is just ONE person's experience - mine. Multiply that by thousands of people a day. And Lolly's hubby? I'd guess that the person(s) making the decision didn't understand shit about his treatments.

  • http://thepoliticalcarnival.net/ GottaLaff

    Thank you!

  • Make it go away

    i recommend if she hasn't appealed their decision I would appeal. also I would go on the aca website and see what insurance is available that utilizes Sloan Kettering and cancel ABC. Also have his doctors call and demand treatment from ABC. Remember its pencil pushers w/no medical experience who make these decisions. demand to talk to doctor on utilization board..
    This unfortunately is normal private insurance behavior the louder you yell the more they get done. good luck

  • kurtbateman

    Insurance corporations who care only about return on our premium dollars ARE the real "death panels".

  • KatieAnnieOakley

    I am *convinced* that my husband's termination in late 2009 was due to my having 4 surgeries late in that year; he had just had an excellent performance review in late October 2009 - then, before Thanksgiving he was terminated for a silly reason. Self-insured group policies are just as bad as individual policies in denying coverage. Lolly, I wish you and hubby good luck.

  • Chris Herz

    We lose 42,000 persons yearly to denial of care for monetary reasons. Our privatized delivery and insurance are the most efficient death panels in the world.

  • http://thepoliticalcarnival.net/ GottaLaff

    My pleasure. Now let's get them to do something already!

  • Lollyjean

    Thank you, Laffy.