The Toldeo Blade has a sad article about the effects of delays and denials caused by for profit insurance companies making health care decisions for residents instead of health care professionals. This should be criminal the way the health care industry denied this man’s chances of survival.
The article discusses various specific cases. Randy Steele, 64, of Oak Harbor was transferred back and forth between health care facilities as physicians attempted to stay ahead of the hepatitis C virus that was slowly threatening his liver and kidneys.
He was finally referred to specialists at Cleveland Clinic to offer a second opinion on a potentially life-saving kidney-liver transplant. Cleveland Clinic fit Mr. Steele onto its schedule. But instead, his appointment was canceled and he waited weeks to learn if his insurer would pay for this life saving measure.
Mr. Steele, like many patients across the country, was the victim of a complex health-care bureaucracy and an insurance industry that repeatedly denies doctors’ orders — leaving patients bewildered and suffering.
Bill Hodnik, 41, endured the same shortcomings.He suffered months of avoidable pain while his insurer delayed and denied coverage for a necessary surgery ordered by his physician. Mr. Hodnik’s physician told him the optimal solution to his problems would be cutting-edge artificial disc replacement surgery.
The surgery was scheduled, but he never underwent the procedure. After months of repeated delays and denials from his insurer, and with his disability insurance running out, Mr. Hodnik needed to return to work, and so — against doctor’s orders — he settled on fusion surgery.
Doctors nationwide believe there is an emerging crisis in providing health care to their patients because insurers routinely challenge their orders.
Doctors said patients usually receive some of the therapy, testing, medication, or procedures needed and prescribed for them. But too often, physicians said, there’s a lapse in time between the office visit and when the care or test is delivered because of interference by insurers.