Thursday, September 20, 2012

Things That Make Me Ill

(Editorial cartoon by Joel Pett / Lexington Herald-Leader (September 17, 2012) and featured at McClatchy DC. Click on image to enlarge and then kindly return.)

One of the things I've noticed recently is that my fuse has grown shorter as I get older. Like most people my age, I've come to grips with my mortality. I know that even under the best of circumstances I have far fewer years left than I've already lived by a factor of about two. When I come across news stories like the one noted in a recent David Lazarus column, I realize just how bad things have gotten and how I'll probably not live long enough to see the change which is so desperately needed. Let's just say it's a good thing that I've sold my handguns or I might be tempted to go all vigilante on some people's asses.

Please click on the link to get the skinny on one's family's struggle to get its insurance company to provide and pay for the special occupational therapy required to help its six year old autistic daughter. No, really. It's not that long.

Here's the thing. For over a year California has required insurance companies to provide for such treatment, and the Roberts family has been paying for that coverage. Doesn't matter. Aetna has been playing the time-honored game of stall, delay, dance, and ignore in the hopes that the family would just go away. And that game continued even after a decision in the family's favor by a court:

California passed a law in October requiring insurers to cover behavioral therapy for autistic kids. But for many families, it can be a long, hard struggle to cover clinic bills, which can total as much as $50,000 annually.

Since the beginning of 2011, the Department of Managed Health Care has received almost 600 complaints against the seven largest health plans over problems with authorizing autism-related treatments. ...

What's so sad is that if someone at Aetna had simply picked up a phone and made one call to United Therapy Network and another to Big Fun, almost two years of hassles probably could have been avoided.

Instead, a family has faced months of needless uncertainty. And a 6-year-old girl still awaits a bureaucratic decision authorizing coverage of easily accessed treatment that could give her a chance at a more normal life.

It would be so easy for insurers to avoid ill will.

If that was something they actually cared about.

Thankfully, Lazarus stepped up and hopefully embarrassed the hell out of Aetna and put additional pressure on the state agencies involved to step up and slap Aetna around until it honors its contractual and legal obligations.

And now I'm going to go take a shower to rinse off the slime and to cool off. I'm too old for this.

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