# LA Times News Story (nothing to do with Karate but please read)



## Nightingale (Aug 25, 2002)

Reposted from an email I sent to my family and friends.

Hi everyone!

OMG, I've never set out to try to write an internet forward before, but I wanted to tell you all about an article that appeared in the LA Times today, Sunday, August 25th, 2002 on the front page, and I hope you'll want to share their story with others and help out.  The headline was "Hard Choices in a Genetic Calamity" and it was written by Charles Ornstein.  Its about three children, Ciara, Hunter, and Tommy Bennett, who have a rare genetic disorder, Sanfillipo Syndrome.  The disease is slowly killing them and their insurance company, Kaiser, is refusing to pay for a cord blood transplant, which is the only treatment that might save them.  Kaiser's comment about the situation was "If we are going to hold costs down...some people are going to die."  This comment made me feel sick!  The article then went on to say that there is something you and I can do.

Their family has set up a foundation, The Bennett Children Foundation, to try to fundraise the $1.4 million dollars needed to save their children.  Please, please, please, go to http://www.helpachild.net and read their story. Then click on the "contribute" button on the top of the screen and send whatever you can.  The contributions are through paypal, so you can use your credit card.  All the donations are tax deductable. I gave them what I could afford, and I hope you will too, but if not, at least forward this email to everyone you know who might help out.  This is a case where people really can make a difference, and every little bit counts.

-Kris (Nightingale)
nightingale8472@yahoo.com


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## arnisador (Aug 25, 2002)

The story is here (you may need to register).

We had Kaiser in California, twice (southern then northern)--the Kaiser Permanente HMOs in different regions are largely independent I believe. I didn't really like it but my wife did.



> Kaiser's comment about the situation was "If we are going to hold costs down...some people are going to die."



Please read the article. The quote above is from Michael Shapiro, a law professor and ethicist at USC who was asked by the newspaper to comment for the article, not from Kaiser. He is referring to all of us who complain about rising insurance costs--as many people did at my workplace this year when our premiums and co-pays increased. It also stated that the parents believe this is the only hope, but there was no medical support for their belief quoted in the story. The treatment is clearly experimental, judging from the story.

Nonetheless it seems a worthwhile cause both for humanitarian and scientific reasons.


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## Nightingale (Aug 25, 2002)

the treatment is experimental, but the other children who have received it are showing marked improvement. Also, blue cross and blue shield cover the treatment. Kaiser is the only major hmo that doesn't.


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## Nightingale (Aug 25, 2002)

> _Originally posted by arnisador _
> 
> *The story is here (you may need to register).
> 
> ...



The newspaper highlighted this particular quote in a separate box... the way they did it made it look like it was from kaiser. my bad.


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## theneuhauser (Aug 25, 2002)

you do have to register, im still waiting for confirmation here.

sounds like i might have to suspend my boycott of paypal this one time.


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## Rich Parsons (Aug 25, 2002)

> _Originally posted by arnisador _
> 
> *The story is here (you may need to register).
> 
> ...




Numerous Cases of HMO's and other cost saving insurances, and traditional insurance. At My Company it is the same cost for the hourly employees for any choice of insurance. The Salary employees get some allocation for benefits which covers the basic traditional, but if you want an HMO or other the charge is more. So, why do some people still choose these other cost savings insurances. They cover office visits, no co-pay on the office visit, no annual deductible. These two means the primary care taker can take the children to the doctors without needing to know the balance of the checkbook before you go. The other cost saving insurances also cover pre-natal care and various birth control methods.

What they do not tell you is that they do not cover certain tests, if there are two or more tests of varying accuracy of levels of testing, the Cost Saving Insurance have one approved test, and only that test can be run. IF you have more traditional insurance care then you the doctor can determine the correct test based on his/her knowledge. 

My current doctor has a counter law suit against a local hospital and the local 'other cost saving' insurances for lost income (* He did this to get the case in court, so his side could be told and maybe change to system. It is still in the Negotiating stage between lawyers, after many delays and post-ponements. *). They brought suit against him for not giving enough secondary referrals, and trying to run non-approved tests. I mean, when your doctor writes something down then asks, do you have 'Traditional' insurance, and when I answer 'yes' the test changes to a more comprehensive test. One could argue that maybe the doctor was padding the system by running the more expensive test, but in my egocentric point of view for my health, I am glad that the doctor was able to run the tests, Yes, tests not singular test, to find out what the problem is.

At a previous job, there was a young single lady (mom) who had twin pre-mature babies. At age 4 they sill were in and out of Intensive care for lung problems and some minor heart problems. She culd not switch insurance care providers due to the 'existing' conditions. Her doctor, wanted to use an experimental steriod, that had shown good results previously, to get the children out of this condition which included dragging around their own oxygen tanks when the 'played'. The DOctor asked the cost savers to use this drug, but was refused. Cost was around $120,000 for both children. When he was rejected, he checked them into intensive care at $10,000 per day for both kids. Ten days later both kids were checked out as per procedure. About two or three weeks later the children were bad again and the Doctor called and asked again for the treatment. End result he called ever time and when he was rejected, he checked the children into Intensive Care. A total of about $300,000 was spent in intensive care before the 'Cost Saving Ins.' approved the 'experimental' drug.




:soapbox: 

Now, I hope you have listened to my experiences and those of people I know, I have more, but just gave some prime examples here. 


It is boring, but *READ *:soapbox: your medical insurance paperwork before determining your health care. Call and ask for more information from the insurance providers, ask for detail coverage plans. If you do not understand call back and ask for help in understanding. * it is the health of you and your family. *

Do NOT just read the highlight page and determine which one by the immediate out of pocket cost to yourself. Get the information, then make the decision that is best for you and your family.


My Apologies for the long winded soap-box. 

Educate yourselves on your health insurance, it is worth the investment. They are not all the same coverage.

Best wishes to the children and family from the original post.

Rich
:asian:


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## Nightingale (Aug 25, 2002)

unfortunately, not everyone has the option to choose their medical care insurance. I had only one option through my last job, and luckily, it was a good one. I have two options now, one is kaiser, and one is blue shield. It was a no brainer to choose blue shield, because even though it doesn't cover one of the medications I take that is considered "optional" it covers hospitalization and specialists, and all the big stuff.  Kaiser covers the little stuff, but not the really important "I have to have this procedure or I'm gonna die" stuff, and that's what counts.  Scraping together $15 bucks for a prescription isn't a big deal. Scraping together millions, like this family has to do, is really hard.


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## theneuhauser (Aug 25, 2002)

actually, im insurance shopping right now. arizona state student health costs me over 1,000.00 per year and the plan is not all that great anyhow. but im finding that every plan i look at has some major drawbacks, even the high premium plans. anyone have any suggestions for me and my wife here?


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## arnisador (Aug 25, 2002)

It's tough while you're in college. Good luck. I'll be surprised if you find a better option than the school's though.


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## theneuhauser (Aug 25, 2002)

i went to school at SIU carbondale a few years back and the health care was SO much better then, i dont know what the heck is wrong with arizona, or is it just the changing times in general.


i swear im moving to another country if health care gets much worse in the US, it just seems to be like some kind of runaway train to me, nobody's got it under control:idunno:


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## arnisador (Aug 25, 2002)

Canada and the UK have cheaper care but long waits, some of which are blamed for morbidity and mortality of patients waiting for care (esp. in the UK). There's no winning. The Scandinavian countries I think all have good systems, but taxes are astronomical.


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## tunetigress (Aug 25, 2002)

In my community here on the West Coast of Canada, there is some kind of doctor shortage going on.  The doctors here aren't taking new patients, and newcomers to the community have a terrible time trying to get on some doctor's list.  Many people wait hours at the single 'Walk-in Clinic' just to get an overworked doctor to spend 5 minutes with them.  Yes, in Canada one does have the right to see a doctor, if you can get one.


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## Kirk (Aug 25, 2002)

> _Originally posted by tunetigress _
> 
> *In my community here on the West Coast of Canada, there is some kind of doctor shortage going on.  The doctors here aren't taking new patients, and newcomers to the community have a terrible time trying to get on some doctor's list.  Many people wait hours at the single 'Walk-in Clinic' just to get an overworked doctor to spend 5 minutes with them.  Yes, in Canada one does have the right to see a doctor, if you can get one.    *



There's a big debate going on here about US vs. THEM (U.S. &
Canada) regarding health care.  I don't know of an answer.  
Before HMO's came along, Dr's were ripping of ins. companies
billing for tests that weren't necessary or just weren't done.  The
patient often times was subjected to tests that were painful AND
unnecessary, just so the M.D. could make bank on you.  I don't
think Patients have been considered for decades in this country,
not just since HMO's have come about.  IMO all it did was shift
the balance of control concerning your well being.  In the case
of these 3 kids, 20 years ago, they would've got the treatment.
But going by the system of 20 years ago .. there'd be no ins.
company to cover the cost, present day.  Back then corruption
got so bad, the system had to crack, and crack it did.  It
turned into the system we have today, and it's about to crack.
I just hope the next system to come about doesn't follow suit
and end up worse than it's predecessor, what we have now.


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## arnisador (Aug 25, 2002)

Indeed, it was bad in different ways before. You're absolutely right.

All I know is our insurance went up some tens of dollars a month and the co-pays $5 or $10 each time and people screamed. You want more, someone's gotta pay.


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## Nightingale (Aug 25, 2002)

personally, I wouldn't mind paying five bucks a month more for premiums and prescriptions if it means that kids like that can get the care they need.  There are more important things in life than money, the most important thing being life itself.


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## J-kid (Aug 31, 2002)

He proble donate some money for me and him ,  HMOs SUCK,  cheap basterds,  Please watch John  Q


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## Nightingale (Sep 1, 2002)

Thanks.  This is a case where every penny counts.


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