patrick.net

Bellingham Bill says

I don't know anything about this case, but you just can't fix a condition by surgically removing tumors. That's like trying to fix a roach problem by only killing them when they come out.

Well if I understand you, you are suggesting that the insurance company is refusing to pay because his condition is terminal and the surgery is not a "cure" for cancer. That doesn't make sense to me. There IS no cure for cancer. So could insurance companies declare ANY cancer treatment to be "experimental", since no treatments actually cure cancer? Again, I've heard of tumors being surgically removed before; I was pretty sure it's not a new, experimental thing.

Suburban Gal says

Whatever methods, techniques and/or devices/instruments the doctor used in the surgeries and whatever methods, techniques and/or medications the doctor is using and/or prescribing to the patient afterwards is considered "experimental" and "exploratory" in nature. Therefore, the procedures/surgeries are being classified in and of themselves as "experimental" and "exploratory," which then leads to them being denied by the insurance companies.

Not sure if you are being facetious now. That's just circular reasoning. You basically said it's exploratory because it's exploratory.

This is an end of life issue.

The guy went through seven months of chemo, and the cancer is still spreading.

This surgery is to remove a lot of his liver that has tumors. There is nothing to say that this will fix anything. It's just another thing to try in hopes it will slow his demise.

I applaud the guy for bringing this issue to the press, because insurance company denial is pretty common.

Nobody says

The total bill came out to more than $100K. I thought C-section was rather a simple procedure.

I don't believe a c section cost 100k. Including a long stay in the NICU, maybe. I've never seen one even close to that and I've done a lot of work in medical billing. Post the bill to show how this is possible.

Very poorly written article. The guy has stage 4 colon cancer which means it has spread outside the colon to other areas of the body. The 5 years survival rate is less then 10%, regardless of treatment. Colon cancer typically spreads first to the liver and liver resections are not uncommon or an experimental treatment. They can help extend life. We don't know what else is going on in his body but the claim of 5 to 7 years further life from the surgery is IMO pretty much bunk. He will almost certainly not be cured and while it is possible he could live another 7 years it is very very unlikely that will happen, surgery or no. Most people with stage 4 colon cancer go on 'permanent' chemo which damps down the disease but never cures it.

This post is one of those very common can't win situations that the bitchers and moaners love so much. If the guy gets denied surgery then it's heartless death panels. If he gets the surgery then it's wasting money on someone who is terminal anyway.

Homeboy says

Weird. Why would they consider removing tumors as "experimental surgery"?

Read the article more carefully. It doesn't say what the new surgery is going to be. It only says he had surgery in the past to remove tumors.

rdm says

Very poorly written article.

That's what I figured. It didn't add up the way it was written. I appreciate you actually explaining it rather than just going in circles and repeating what the article said.

bob2356 says

Read the article more carefully. It doesn't say what the new surgery is going to be. It only says he had surgery in the past to remove tumors.

Actually, I think I read it more carefully than YOU did. That's not what it says.

"Lewis' insurance carrier would not pay for the SURGERIES TO REMOVE HIS TUMORS, treatments that doctors told him would stretch his life expectancy from one to two years to at least seven.

Lewis and Blansit got that news just hours before Lewis' second surgery in October but decided to forge ahead with THAT PROCEDURE, as well as a third and final operation...

Lewis' insurance carrier declined to cover the operationS (PLURAL) because they were classified as "experimental" and "exploratory,"..."

Anyway, I think the problem is that it's just a poorly written article.