“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.
such a deal can lead to continuous litigation, but I think insurer is right in such a case - the insurance can be given only in case of any kind of health disease but not in case of voluntary gift of kidney like that one.
ReplyDeleteIt's not about knowledge or education. It's purely about what BCBS thinks might be a plausible excuse. At 53, he theoretically could be entering a life period where he needs more medical care and thus creates more expense. Why would BCBS gamble with their profits? They are a private for-profit corporation in a system that encourages socialization of loss.
ReplyDeleteI think BCBS of Minnesota is ridiculous thinking that a health problem will occur before it has even happened. If this is the case later on, Mr. Royer can apply for Social Security Disability and let the system take care of him. This is what the greedy insurance companies want everyone to do. They only want healthy, young participants in their program and they didn't mind taking premiums from Mr. Royer for years when he had both kidneys.I guess the insurance company would have been happier if Mr. Royer would have let his daughter die, rather than dish out some money. I wonder if the CEO of BCBS would be covered if he/she gave their daughter a kidney? BCBS, you are good for nothing corporate snakes!!!!!!!!!!!
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