| Last Edited: Saturday, 11 Aug 2007, 5:25 PM CDT |
| Created: Saturday, 11 Aug 2007, 5:11 PM CDT |
"SMITHVILLE, Mo. --
A Smithville, Mo. man battling cancer says he's also fighting his insurance company.
Ed Fenton, 45, claims Coventry Health Care won't pay for a surgery he needs to stay alive. Fenton has been fighting colon cancer for a year."
Also in the report:
"This surgery, if I don't have it I'll die. Period. I don't have a choice," Fenton said.
Fenton's family said the insurance company's decision is tough for them to handle, because Fenton has a lot of living left to do.
"He's so strong. He wants to live. He has two children 13 and 17. He wants to see them graduate from high school. He wants to see them walk down the aisle," Rhonda Fenton, wife, said.
Insurance companies sentencing people to death by denying coverage? When did we start "allowing" that to happen?
Mrs. Fenton is right when she says,
"I think we really need to start stepping up as Americans and saying 'this is not OK,'" Rhonda Fenton said. "If you don't think it can happen to you, you're wrong. It can happen to anyone."
2 comments:
You're right, Carrie. This shouldn't be happening in this country. Do you have any suggestions for improving the current state of the health care system that allows this kind of thing to happen?
Thank you for asking, Erin!
This is merely an overview, but I feel that insurance companies should not be allowed to deny payment of claims, except for exclusions that were clearly defined when the policy was sold and issued. In other words, I don't feel the insurance companies should be allowed to decide a treatment (or test) is not necessary or is a useless gesture, when the actual healthcare providers feel it is. After all, there is definitely a conflict of interest for the insurance companies to be making such decisions.
I also feel that policies should be clearly written in plain English, with no need for legal counsel to give his/her opinion of what the document is saying. It should be obvious what is and is not covered.
I feel that insurance companies should have to pay the claims, and if there is a question about need, then the insurance companies should have to file an appeal to get their money back. And, if they win the appeal, then the healthcare provider -- not the patient -- should have to repay the insurance companies. After all, the patient is at the mercy of both the healthcare providers and the insurance companies.
I also feel that no person should be denied treatment because a company has decided the care is useless and would be wasted on this person. Insurance companies are paid premiums to provide coverage, not judgment of the worthiness or qualify of someone's life.
I feel that healthcare itself and healthcare coverage should be made more affordable to the general public and that preventative medicine should be encouraged. Dental care is a preventive. Bad teeth can lead to all kinds of health issues, for example.
I also believe that if insurance companies are going to accept the premiums, they should likewise be required to pay the claims. Should they fail to do so, I believe this should be a criminal charge of fraud and whatever else would apply.
Should an insurance company pay out for a fraudulent claim, they have only lost money.
Should an insurance company fail to pay out for a legit claim -- a life can be lost! I don't think the latter should ever be allowed!
These are just a few of my thoughts! Please share your thoughts, Erin!
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