Man Dies After Insurance Co. Refuses To Cover Treatment

[deadparrot]

Tracy Pierce, 37, lived a full life. He grew up with family and faith. He went to a Catholic school, got married, had a son, and he even had the car of his dreams. It was the perfect life.

"He's been strong. He has," his wife, Julie Pierce, said.

Two years ago, Tracy Pierce's life changed dramatically when he was diagnosed with kidney cancer.

"I have no treatment. Three months has gone by and I haven't had any treatment," Tracy Pierce told KMBC's Jim Flink in May 2005.

http://news.yahoo.com/s/kmbc/3257367

[xultar]

1. Bush's Amercia. You gotta love it!

[Hosnon]

16. Ummm...did I miss something or was there Univ. Health Care before W? nt

[loudsue]

19. Umm...no, but REPUBLICANS have had an iron grip on congress

for the past 12 years, and things have gotten MUCH WORSE in the 5 years they've had a totally dumb shit republican sitting in the oval office. People used to be able to get medicare and medicaid. The republicans have whittled that number so far down that nobody is sure anymore if they can get much of any kind of help.

:kick::kick::kick:

[Hosnon]

24. I'd agree with that more easily...so...Welcome to Republican's America. nt

[smoogatz]

31. No, but millions of Americans have lost health insurance under Bush

and he has no plan to cover the uninsured, and zero interest in developing one. I think part of the blame falls on Bush and those who share his "go it alone" ideology, sure.

[CBHagman]

44. Here's a timeline for what happened in the 1990s...

...regarding the Clinton health care plan. It's pretty lengthy (you have to click on a second page) but contains a lot of information. As far as I know, it's based on the book "The System" by Haynes Johnson and David Broder.

http://www.pbs.org/newshour/forum/may96/background/health_debate_page2.html

There's a lot of blame to go around concerning the failure to provide universal health insurance in the U.S., but I think even the savviest citizens need to be reminded of what power structures, money, and concerted political efforts went into creating the system we have, in which families are made bankrupt, people die or suffer permanent consequences due to lack of treatment, and some people are shut out of health insurance entirely. For example, I think people tend to forget that it was a priority of certain Republicans to ensure that the Clinton plan failed, that there was no compromise.

We are still paying the price for what happened just before, during, and after the GOP took over Congress.

[MadMaddie]

2. And another American dies for the lack of care...

America 2006....it's something isn't it?

[phantom power]

22. I sure feel like a superpower. Don't you?

[MadMaddie]

23. SuperDuper...

Meanwhile all other countries are passing us by in medical coverage for it's citizens, science, technologye, education, infrastructure and the list goes on....

[dubya_dubya_III]

75. Don't they usually collapsedue tor a critical crisis of infrastructure

because they have foregone or exported all their means of practical consumer gods production and only have a aetificially protected productive war materials industrial capacity left and the most ultra costly post-arms race arms race in history, together with a depressing loss of manufacturing and finished consumer goods exports, we can no longer support the crushing burden of debt due to even broader unending war and military overextension?

[davekriss]

70. I read a short while back...

...that we're now losing around 18,000 people a year due to lack of access to adequate healthcare. I'm sorry, it's been a long day and I'm too tired to dig it up. But I want to share this (the link that follows). Lot's of good stuff, including the fact that if we restructured our healthcare delivery system along the lines of the other first world nations, we'd save $200 billion a year or more (the cost that goes down the drain to our byzantine anti-care/insurance system), and that savings would be enough to fund care for the 48 million without coverage today. However, that would be a shift of funds flow from the politically powerful insurance industry to the providers of health care themselves. So in Bushworld, it will never happen.

Remember, when a Republican says we need to spend less for healthcare in the U.S., they mean everyone but their advantaged constituents go with less or even without. And that means death. Are we as a society willing to allow 18,000 of our fellow citizens to die simply to enable deep tax cuts for a few. Apparantly, yes. But such is the success of the Rovian Wurlitzer, the near-monopolized major media, of twenty five years of sacrificing life at the altar of "economic efficiency".

A useful link: http://www.pnhp.org/

[alfredo]

80. We have a local that has been cut off his AIDS medication.

No telling how many people will die because of bush's risky manipulation of health care.

[Mandate My Ass]

3. "Despite being fully insured..."

every treatment his doctors sought for him was denied by his insurance provider. First-Health Coventry deemed the treatments were either not a medical necessity or experimental."

"And you know, it's not going to get better anytime soon. It's going to get worse," said Myra Christopher, who is the president and chief executive officer of the Center for Practical Bioethics." :grr: :grr: :cry:

[shireen]

4. this should be a BIG national story

we need to raise hell.

this is utterly sickening and heartbreaking.

Forward this story to your members of Congress!

[kurth]

10. What human being can defend this?

except the free-market free-enterprise compassionate conservative Christian crowd.

[SnowGoose]

5. Too bad Bush couldn't sign some emergency bill

like he did with Schaivo. Odd, isn't it?

[Warpy]

30. Magical thinking doesn't pay for care

it just waves a magic wand or prays to cure somebody or bring them out of brain death into full human life again.

Paying for care is just so grubby and practical. How much better to ask the fairies and angels to intercede!

[ThomCat]

6. That company needs to be Sued off the face of the earth!

There should be riots about this.

[silverweb]

7. We're there now.

Before, we could just say, "This is where we're headed" -- but we're there now, in a corporofascist world completely devoid of mercy and justice.

:cry:

On edit: K&R, and sent to everyone on my e-mail list.

[kurth]

8. "Even as he was dying, his insurance company denied him oral morphine"

May the CEO of this insurance company burn in the deepest depths of hell.

[MuseRider]

12. I just read that and was coming to post

that is the most disgusting thing I have ever read. These people are in serious pain. How in the hell can someone live with themselves knowing that they did that?

I remember when this first hit the press. I wrote a couple of letters but somehow knew this would be the ending.

[davekriss]

71. Now that;'s just f*cking evil!!!!

That is enragingly stupid and immoral and f*cking ridiculous! They denied a dying man morphine in his hours of agony?!

I am just ... let me leave it there ...

[noshenanigans]

9. That's barbaric.

They wouldn't even allow oral morphine for him when he was ravaged with cancer and on the verge of death. That is so insane I can't even wrap my head around it. My mother died of colo-rectal cancer last month and was fortunate she had such good care- completely thanks to the insurance. It's terrifying how much power they have.

[eek]

dig the Webster's definition of 'Coventry"

It can be used as slang, y'see:
http://www.m-w.com/cgi-bin/dictionary

Main Entry: Cov·en·try
Function: noun
Etymology: Coventry, England : a state of ostracism or exclusion: "sent to Coventry"

[rodeodance]

11. this the US for form of rationed medicine

that the repugs do not admit to.

[ClintonTyree]

13. From their web-site........

"Our mission is to provide high quality care and services to our members and to be profitable in the process. Coventry Health Care is also committed to maintaining excellence, respect, and integrity in all aspects of our operations and our professional and business conduct. We strive to reflect the highest ethical standards in our relationships with members, providers, and shareholders".

I guess that part about "excellence, respect and integrity" is pure Corporate bullshit then, isn't it? So what else is new? Corporate America is fucking evil, there's no other wat to put it. They are the reason our country and the world, for that matter, are in the shape they're in now. Capitalism run amok with little or no oversight...ge, I wonder where bush got the idea for his imperial presidency? That seems to be the only thing from his MBA that sunk in. Fuck the little people, 101.

[phusion]

29. They put to "be profitable" in their mission statement

Maybe they should have put that first...
:puke:

[LiberalEsto]

14. If an individual had caused Pierce this kind of suffering

that individual might have gotten arrested and prosecuted for causing grievious bodily harm.

But because a corporation did it, they can get away with it. Business as usual.

We desperately need to change the laws in America to make corporation officers legally liable for harm they cause. We have to stop letting corporations get away with murder.

[bleedingheart]

18. I agree with you entirely BUT

insurance companies are allowed to write up very strict policies that give them "loopholes"....where is the legislation to get rid of these loopholes???? no where...because law makers want to further restrict the rights of patients with tort reform.

[reprobate]

74. Re-instate the corporate death penalty.

In the past if a corporation acted against the public interest it's charter could be cancelled. In effect the company faced a death penalty because without a charter it was no longer a corporation.

It's time to return to the days of yesteryear.

[bleedingheart]

15. Check your insurance policies folks!

there are a great number of insurance companies that have a lot of things they don't cover...at the top of the list ..."experimental procedures"

What is the one area of medical science that is typically cutting edge and with a great deal of experimental treatments? Oncology...of course...and of course cancer patients find themselves always battling insurance companies to cover procedures..

[KansDem]

33. Thanks! My wife's employer uses Coventry!

:scared:

I and our children are covered with my employer's insurance, but my wife has Coventry through her work.

You better believe we'll be going over her policy this weekend!

[bleedingheart]

54. when our company changed all the insurance options a bunch

of us got together and went through all the policies with a fine tooth comb...in fact one of the policies was an HSA/high deductible insurance option and it was the hardest to understand...in fact no one considered an option because of all the loopholes.

Our company also downsized HR so we had no one to go to with questions either.

[iverglas]

17. and here I thought health care was only rationed

up here in Canada.

Anybody ever tried to vote an insurance company out of office?

One hates to sound like one is scoring cheap points off such an utterly appalling and tragic event, but it is precisely events like these that make the point, and make it so hugely important.

A government that killed people by denying them a service after it had persuaded them to vote for it by promising to provide, and taxed them for, would be facing a mob. Give me a ballot box over a marketplace any day, when it comes to how to ensure that I and everyone I care about gets essential medical treatment.

This looks like living proof that profit-seekers aren't always even intelligent enough to act in their own interests (how can what they saved possibly outweigh what this will almost certainly cost them?). Why I'd want to entrust them with the power to decide what's in my interests, I can't imagine.

[shireen]

20. direct link w/ photo of patient

http://www.thekansascitychannel.com/money/6882159/detail.html

[NoMoDem]

21. Great...

My group health plan just switched from BC/BS to Coventry.

Hope my health holds out.

[Lars39]

26. I'd be using this article to make a huge stink about that.

[Sadie5]

32. No morphine for pain

This is so sad that this man was denied pain medication. Whats next?

[ET Awful]

25. Anyone ever read "The Rainmaker" by John Grisham?

It may be fiction, but it comes pretty damned close to this reality.

[silverweb]

49. Yup.

Book and movie -- in a non-fiction version coming to you soon.

[brentspeak]

27. Personal political donations of First Health-Conventry Executive Team

WOLF, DALE B MR.
POTOMAC, MD 20854
COVENTRY HEALTH CARE/EXECUTIVE BUSH, GEORGE W (R)
President
BUSH-CHENEY '04 (PRIMARY) INC $1,500
primary 05/25/04

WOLF, DALE B MR.
POTOMAC, MD 20854
COVENTRY HEALTH CARE/EXECUTIVE BUSH, GEORGE W (R)
President
BUSH-CHENEY '04 (PRIMARY) INC $500
primary 11/14/03

http://www.newsmeat.com/fec/bystate_detail.php?st=MD&last=wolf&first=dale

Soistman, Francis
Mechanicsburg, PA 17055
Health America/Executive PATERNO, GEORGE SCOTT (R)
House (PA 17)
PATERNO FOR CONGRESS $1,000
general 09/27/04

Soistman, Francis
Mechanicsburg, PA 17055
Health America/Executive PATERNO, GEORGE SCOTT (R)
House (PA 17)
PATERNO FOR CONGRESS $2,000
general 06/30/04

Soistman, Francis S Mr. Jr.
Mechanicsburg, PA 17055
Health America/President
REPUBLICAN NATIONAL COMMITTEE (R) $500
primary 06/25/04

http://www.newsmeat.com/fec/bystate_detail.php?st=PA&last=Soistman&first=francis

[iverglas]

52. who says money can't buy happiness?

Of course, I'm sure that if the Democratic Party would just embrace guns ... or condemn abortion and same-sex marriage ... those guys would all be donating differently.

All about values after all, isn't it?

The value of human life, apparently.

[Name removed]

78. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Daphne08]

28. This is unforgivable. It is just so needless and so heartless

and causes me to weep for all of us.

(I imagine this happens a lot in this country today... although I have no proof of it.)

[brentspeak]

34. This country needs a national health care system badly

Because there's going to be a lot more Tracy Pierces in the future.

[Megahurtz]

35. Compassionate Conservatism

at it's finest!!!:sarcasm:

[kurth]

36. "Never been a better time to be an insurance company than right now"

"There's never been a better time to be an insurance company than right now," said Dr. William Soper, with Mid-America Medical Affiliates.

Studies show that insurance companies have doubled profits in just four years.

Doctors are accusing insurance providers of paying out incentives to claims adjusters who deny care. "There's just a huge reward for denying care," said Dr. Bob Gibbons, with the Metropolitan Medical Society.

Dr. James Mirabile said insurance companies go to extremes to meddle in doctor's care. "The insurance companies send people in behind us on our rounds to make sure our patients get sent home within a certain time frame -- sick or not," said Mirabile, who is one of the doctors filing suit against insurance providers...

[ikojo]

68. I have worked as a claim's examiner and trust me

they DO NOT get bonuses for denying claims. So far from it. Most claims today are processed by a computer.

The ones who are "denying care" in an insurance company are those in the "medical management" department. They are RN's who have guidelines stating what is and is not covered.

I am not excusing the insurance companies but in the hierarchy of life forms at an ins co. the claim's examiners are among the lowest on the food chain.

I believe that everyone receives what is called a certificate of coverage (COC). In it is a detailed explanation of what is and is not covered. I suggest that everyone read that document, I know it's boring, but having a rudimentary understanding of that document alone will help you in dealing with your insurance company.

[classics]

37. This is murder.

And we should start calling it murder.

Killing someone to save a buck is no different that putting a slug in thier head with a rifle.

The CEO of this insurance company should be dragged out of his office, arrested, tried and given the pushment his state prescribes for cold blooded murder.

[Tight_rope]

73. You said it..."MURDER"! Sue their asses out of business!

[AnneD]

38. Kidney cancer...

is generally treatable and has a decent survival rate. This is criminal and the co and their bosses should be brought up on criminal homicide charges.

[KAZ]

39. Let em know what you think.

http://www.ahip.org/SupportingOrg/PartnerDetails.aspx?SOPartnerId=352

[Tommy_J]

40. Vote it up on Yahoo

I did

[Child_Of_Isis]

41. I wonder why his doctors didn't step in

and do something? Or a church?

[Bridget Burke]

45. The doctors tried.

As he waited, his doctors appealed again and again, including a 27-page appeal spelling out that Tracy Pierce would die without care. Coventry dismissed each request.

"It's purely economical. You never see an insurance company try to block an inexpensive test," said William Soper.

Soper leads a group of doctors who filed a lawsuit last year against insurance providers. This week, Soper went to Jefferson City to lobby legislators for change.

Some hospitals have whole departments devoted to wringing money out of Insurance Companies & HMO's. Perhaps this was a smaller hospital.

[Child_Of_Isis]

51. If I were the doctors I would have treated him anyway.

I would have stolen the damn medicine.

[sui generis]

42. First-Health Coventry, I say we get the mutha's

Coventry. I'll bet it's faith based insurance. Actually it would appear to be publicly traded and just recently mergered.

This is where we need health-care reform. We don't need private insurers who only insure the healthy, or who take your premiums and never pay out . . .UNTIL YOU'RE DEAD.

At the very least we need state regulation and federal standards that look after the individual FIRST, because this ain't working.

[sui generis]

43. oh yeah, they're a fucked up company

http://phx.corporate-ir.net/phoenix.zhtml?c=107448&p=IROL-NewsText&t=Regular&id=662406&

[sarcasmo]

46. Kick and Nom #7. Welcome to Dictator 43's new Amerika.

This part of the article says it all.

What is going on is that some insurance companies deny even routine treatments because insurance companies treat their patients as costs, not as clients, Christopher said.

[sui generis]

47. this company is going down "Extortion, Fraud & Collusion"

http://www.thekansascitychannel.com/health/4429327/detail.html

They are an umbrella organization that buys up and reinsures a gazillion other little Mom and Pop Mafia insurance companies.

[Atmashine]

48. I thought doctors were supposed to treat

patients even if they couldn't pay? I know this is the insurers fault, but still why didn't anyone treat him first, ask for payment later? I know KC hospitals aren't that bad for forcing people to go home dying.

[pitohui]

56. no they don't have to treat you

they only have to stabilize you in an emergency IF they have an emergency room, so some hospitals have simply closed their emergency rooms

the insurance company didn't kill this man all on their own

they had help, the doctors who wouldn't treat, the hospital that wouldn't provide a bed -- they killed the man just as dead and for the same reason -- the almighty dollar

[sarcasmo]

50. Michael Moore needs to put this in his new Health Care movie.

[Maat]

67. Can you send him the link? (n/t)

[Megahurtz]

53. It's Bush's "Pro-Life" America!

:sarcasm:

[lovuian]

55. This is a Crime and America needs to stop this... People are

DYING in this medical catastrophe of health care just for Insurance companies and Pharmaceuticals and HealthCare companies can make money...

This man should have been given a chance...

:argh:

[ed murrow]

59. This is Horrible

Insurance companies refusing treatment

And I have heard of numerous hospitals who have refused treatement to individuals who don't have insurance

the Washington Post did an expose on Catholic Hospitals who refuse working class patients because they don't have private insurance but work too much to qulaify for Medicaid

http://www.washingtonpost.com/wp-dyn/content/article/2005/08/21/AR2005082101010_pf.html

There is definitely a problem here

[DELUSIONAL]

57. This was murder -- I hope the family has a pit bull type lawyer

[entanglement]

79. I'd prefer REAL pit bulls at the throats of these criminals

n/t

[HuffleClaw]

58. "Even as he was dying, for more than a week...

his insurance company denied him oral morphine, which had been prescribed to reduce his pain."

his punishment for daring to oppose them i suppose. good lord, what a sad and scary tale. their action was criminal imho.

[SCRUBDASHRUB]

60. I forwarded this to Michael Moore; perhaps he can get in

touch with the poor man's family for his film about the "health care" industry.

Disgraceful.

[Lorien]

61. It's hardly a "full life" if he only made it to 37.

Never got to enjoy retirement, grandchildren, etc. There's no way to sugar coat this situation.

[area51]

62. This is so fucking disgusting.

We can afford healthcare for congresspeople, insane wars, etc., but people have to die in agony in our barbaric nation. Disgusting.

[Vinca]

63. I always assumed since I can't afford insurance, I'd probably

die prematurely for lack of treatment. Now it seems I'm not alone. You insured people won't be getting treatment either. What a mess this country is in. Shrub worries about human-animal lab creations while people are denied care for treatable cancer. Democrats have to win a majority in November and must get the White House in '08. Our lives depend on it . . . literally.

[NNguyenMD]

72. in some states you have to prove that you don't own any property (aka lose

everything you own) before you qualify for medicaid. Hospital SW I've worked with have been damn near miracle workers in helping people get some kind of health coverage, but at least in NY you were have to prove that you're bankrupt before they'll pay anything.

[xchrom]

64. first coventry must think they can fight this in a court of law

because they had to know they were jumping into the frying pan when they started denying treatments to a client with cancer.

then they receive a 27 page appeal.

i can only conclude the insurance company knew the guy would -- he has a name, tracy pierce, -- die and they feel confident they can beat this in court.

i think some sort of homicide charges are in order here.

[kineneb]

65. Deep irony time

If he had been in California and poor, he would have gotten better treatment and might still be alive.

Case in point:
We spent down our assets so Hubby could be covered by CMSP/MediCal. He is on insulin, was in renal failure and has congestive heart failure. No insurance would touch him, no matter how much we could have paid. Granted the process of getting coverage was a pain, but they covered him.

Last August he had the surgery to create a dialysis access (I will spare the details for the squemish). At that time the doctors discovered he had cancer in one kidney, an inflamed gall bladder and problems with his appendix. In October, with a two-doctor operating team and 7.5 hours of surgery, the offending organs were removed. He is now on dialysis. He has has had outstanding care and has recovered from all the surgeries. The cost was all picked up by the state. Now granted, our house belongs to the State of California when both of us die, but that matters little to us now. He is alive, and enjoying life as much as he is able.

My heart goes out to the family, and may the vermin in that insurance rot.

[roguevalley]

66. michael moore needs this story. I'm emailing the link.

[usregimechange]

69. Sent this to my rethug rep.

[NVMojo]

76. Welcome to Bushworld! Heaven for the filthy rich, hell for the poor.

[bettyellen]

77. ....