A story June 11 in the New York Times strains credulity. Blue Cross Blue Shield (BCBS) of Minnesota refuses to insure Radburn Royer after donating a kidney to his daughter after she developed renal failure. Here is an excerpt of the story:
“When Erika Royer’s lupus led to kidney failure four years ago, her father, Radburn, was able to give her an extraordinary gift: a kidney.
|Radburn Royer (Source: NY Times)|
Like most other kidney donors, Mr. Royer, a retired teacher in Eveleth, Minn., was carefully screened and is in good health. But Blue Cross and Blue Shield of Minnesota rejected his application for coverage last year, as well as his appeals, on the grounds that he has chronic kidney disease, even though many people live with one kidney and his nephrologist testified that his kidney is healthy. Mr. Royer was also unable to purchase life insurance.”
The story goes on:
“Mr. Royer said he is baffled by the denial. “From my perspective, I’d be a good risk,” he said. “I’d just be putting in premiums and helping balance the system out.”
There is little data on how often kidney donors have trouble obtaining insurance, but advocates say the fear of being uninsurable may be a powerful deterrent to donation. A 2006 study done by an advocacy organization for transplant professionals found that 39 percent of transplant centers reported that they had had eligible donors who declined to donate because they feared having future insurance problems.”
There are a couple of things that surprise me. First, someone needs to explain to the insurer that just because the patient donated a kidney doesn’t mean that he has chronic kidney disease. Indeed, even if his serum creatinine hasn’t normalized he doesn’t have a disease per se. And second, whatever happened to Obamacare’s goal of ridding the US of the “pre-existing clause”? Surely, the insurer shouldn’t be able to exclude coverage if someone has a medical problem.
Minnesota’s BCBS shouldn’t be allowed to get away with this. The transplant community should pile on and make sure that BCBS’s position is revered.