A TRAGIC TRAVESTY: I - 0 views

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  #1 Frederick Smith on 06 Jan 11

   

  A TRAGIC TRAVESTY: INSURER DENIES COVERAGE FOR A 22-Y.O. WOMAN'S RHEUMATOID ARTHRITIS AS A "PRE-EXISTING CONDITION"

  
  

      20 years ago I had an unforgettable patient experience that could have been true one year ago. A 22-yo woman who had just graduated college came to Washington DC to work for a non-governmental organization, with a new health insurance plan. She had been having some hand and wrist swelling which a prior provider in her home town had trivialized, without a diagnosis.
      The wrist swelling pointed to an auto-immune process, and she proved to have rheumatoid arthritis.  Her health insurance company refused to treat her RA after they obtained old records from the previous doctor which documented the joint swelling - even though he had made no diagnosis.  The insurer stuck with its "pre-existing condition denial" in spite of my letter of appeal.
       I often wonder what happened to this earnest, idealistic young woman and her family.  Did she ever receive effective treatment for RA?  Did treatment bankrupt her family? Is she still living (she would be only 42yo now)?  How could this travesty occur in America?

  
  

  Frederick A. Smith, MD, FACP - General Internal, Geriatric, & Palliative Mediicne, and Bioethics, Garden City, NY

   

  <div class="cArrow"> </div><div class="cContentInner"><p>A TRAGIC TRAVESTY: INSURER DENIES COVERAGE FOR A 22-Y.O. WOMAN'S RHEUMATOID ARTHRITIS AS A "PRE-EXISTING CONDITION"</p> <br /> <p>    20 years ago I had an unforgettable patient experience that could have been true one year ago. A 22-yo woman who had just graduated college came to Washington DC to work for a non-governmental organization, with a new health insurance plan. She had been having some hand and wrist swelling which a prior provider in her home town had trivialized, without a diagnosis.<br />    The wrist swelling pointed to an auto-immune process, and she proved to have rheumatoid arthritis.  Her health insurance company refused to treat her RA after they obtained old records from the previous doctor which documented the joint swelling - even though he had made no diagnosis.  The insurer stuck with its "pre-existing condition denial" in spite of my letter of appeal.<br />     I often wonder what happened to this earnest, idealistic young woman and her family.  Did she ever receive effective treatment for RA?  Did treatment bankrupt her family? Is she still living (she would be only 42yo now)?  How could this travesty occur in America?</p> <br /> <p>Frederick A. Smith, MD, FACP - General Internal, Geriatric, & Palliative Mediicne, and Bioethics, Garden City, NY</p></div>

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