Private Health Insurance Organizations Shouldn ’t Dictate Quality of Care

By LYNLY JEANLOUIS Health insurance companies are standing in the way of many patients receiving affordable, quality healthcare. Insurance companies have been denying patient claims for medical care, all while increasing monthly premiums for most Americans. Many of the nation’s largest healthcare payers are private “for-profit” companies that are focused on generating profits through the healthcare system. Through a rigorous approval/denial system, health insurance companies can dictate the type care patients receive. In some cases, this has resulted in patients foregoing life-saving treatments or procedures.   In 2014, Aetna, one of the nation’s leading healthcare companies, denied coverage to Oklahoma native Orrana Cunningham, who had stage 4 nasopharyngeal cancer near her brain stem.  Her doctors suggested she undergo proton beam therapy, which is a targeted form of radiation that can pinpoint tumor cells, resulting in a decrease risk of potential blindness and other radiation side effects. Aetna found the study too experimental and denied coverage, which resulted in Orrana’s death. Aetna was forced to pay the Cunningham family $25.5 million.   In December of 2007, Cigna Healthcare, the largest healthcare payer in Philadelphia, denied coverage for Nataline Sarkisyan’s liver transplant. Natalie was diagnosed with leukemia and had recently received a bone marrow transplant from her brother, which caused complications to her liver. A specialist at ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Health insurance Lynly Jeanlouis private health insurance Quality improvement Quality of care Source Type: blogs