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steve1

Convicts have better health care than I do!

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I was diagnosed with prostate cancer many months ago. There are some terrible treatment options for that, so I read everything I could find on the subject.

I decided that Proton Radiation was by far the best way to go. I figured it would have the best quality of life after treatment. I didn't want the terrible side effects and complications that go along with the other treatments.

So, I signed up for treatment at Loma Linda Hospital in California. Over the years, my place of employment has paid in hundreds of thousands of dollars for health insurance. I figured I was well covered, if disaster ever struck.

A week before the wife and I went down to Loma Linda, the insurance company notified us that they weren't paying because Proton Radiation costs more than the other brand-X treatments.

We're on the third appeal in this mess, and things still don't look good. We decided to go on down to Loma Linda and meet with our Doctor. The hospital said they would help us fight the insurance company if we did that.

I was truly impressed with what they have to offer down there. I would love to have their treatment. We were standing outside the hospital enjoying the warm weather, when a van pulled up, with a cage in the back. Out of the cage steps a very large black man, dressed in orange jump suit and shackles. With his jailer in tow, he shuffled into the hospital where he was able to receive the best, most expensive cancer treatment in the world.

There I stand, someone who has worked hard all his life, trying to do the right thing, just to find out his insurance isn't worth crap.

I struggle with the concept that life isn't fair!

Does this piss anyone else off, or is it just me!>:(

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Hi steve,

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Does this piss anyone else off, or is it just me!



Me!!!!

But if you are going to stickup a 7-11, do it in California and not Montana.

Many years ago the California Supreme Court ruled that convicts are req'd to be provided health care. And there does not seem to be any limit to it.

JerryBaumchen

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he shuffled into the hospital where he was able to receive the best, most expensive cancer treatment in the world.



While it may have looked like this to you as an outsider, you really don't know why he was there or what "expensive cancer treatment" he was there to receive.

As an employee of a large NCI, my experience is that people without private insurance do not get the latest and greatest treatments. So try to take comfort in knowing that he was likely not there to receive the same treatment you were denied for. Good luck, I know the insurance companies are frustrating. :)

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he shuffled into the hospital where he was able to receive the best, most expensive cancer treatment in the world.



While it may have looked like this to you as an outsider, you really don't know why he was there or what "expensive cancer treatment" he was there to receive.

As an employee of a large NCI, my experience is that people without private insurance do not get the latest and greatest treatments. So try to take comfort in knowing that he was likely not there to receive the same treatment you were denied for. Good luck, I know the insurance companies are frustrating. :)


That is a good point. It seemed like everyone I met there, was getting proton radiation cancer treatment. It's one of ten places in the U.S. that offers this. Possibly it was something else, that this scum-bag came for.

I know that even Medi-care will pay for Proton Radiation treatment. I wouldn't be too surprised if convicts are getting it too. My insurance company figures the cost is too great.

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he shuffled into the hospital where he was able to receive the best, most expensive cancer treatment in the world.



While it may have looked like this to you as an outsider, you really don't know why he was there or what "expensive cancer treatment" he was there to receive.

As an employee of a large NCI, my experience is that people without private insurance do not get the latest and greatest treatments. So try to take comfort in knowing that he was likely not there to receive the same treatment you were denied for. Good luck, I know the insurance companies are frustrating. :)


That is a good point. It seemed like everyone I met there, was getting proton radiation cancer treatment. It's one of ten places in the U.S. that offers this. Possibly it was something else, that this scum-bag came for.

I know that even Medi-care will pay for Proton Radiation treatment. I wouldn't be too surprised if convicts are getting it too. My insurance company figures the cost is too great.


Maybe, he was there for a long-overdue vasectomy. ;)
lisa
WSCR 594
FB 1023
CBDB 9

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Though not as serious as your situation,I was exposed to just how unfair the system is.
I broke my ankle catching my shoe on a rough piece of ground on landing about 15 years ago.
2 weeks later back at the hospital I find that my insurance will not cover the cost because it was an extreme activity injury.
What really got me though,was as I was waiting to find this out,I could not help but overhear the immigrant workers interpreter talking to the billing agent.
The guy had a broken wrist,and the hospital simply ate the bill and then even went so far as to get him some financial aid until he could go back to work.
So you can imagine my surprise when I'm told that my insurance will not pay,and that the hospital wants $22,000,no if,ands,or buts.
My jaw drops and the guy tells me basically that it is so expensive because so many people do not pay,and that means I have to pay, because basically I'm well to do compared to others(I'm a professional skydiver living on turkey chilli and ramen).
I then find that the surgeons bill is not included,but fortunately he only wants $1800.
What is going on with you is by far worse,but I can kinda relate.

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When it comes to skydiving injuries like a broken ankle or wrist or something like that, it's just best to tell the fuckers you fell off the ladder or down the stairs or something. Just saying... :P

"Mediocre people don't like high achievers, and high achievers don't like mediocre people." - SIX TIME National Champion coach Nick Saban

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Though not as serious as your situation,I was exposed to just how unfair the system is.
I broke my ankle catching my shoe on a rough piece of ground on landing about 15 years ago.
2 weeks later back at the hospital I find that my insurance will not cover the cost because it was an extreme activity injury.
What really got me though,was as I was waiting to find this out,I could not help but overhear the immigrant workers interpreter talking to the billing agent.
The guy had a broken wrist,and the hospital simply ate the bill and then even went so far as to get him some financial aid until he could go back to work.
So you can imagine my surprise when I'm told that my insurance will not pay,and that the hospital wants $22,000,no if,ands,or buts.
My jaw drops and the guy tells me basically that it is so expensive because so many people do not pay,and that means I have to pay, because basically I'm well to do compared to others(I'm a professional skydiver living on turkey chilli and ramen).
I then find that the surgeons bill is not included,but fortunately he only wants $1800.
What is going on with you is by far worse,but I can kinda relate.



I am thinking that Dante had some of the lower levels in mind for insurance execs and lawyers >:(

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The insurance company's probable justification is a study published on December 14, 2012 in the Journal of the National Cancer Institute. Abstract:

http://jnci.oxfordjournals.org/content/105/1/25.short

The study says, bottom line, that proton-beam therapy is no better than radiation (re outcome). Short term, it appears to confer better results with respect to side effects, but a couple of years down the line, lingering side effects are comparable.

Proton-beam therapy costs about $32K and IMRT is $19K.

I don't know much about prostate cancer and its treatment, but I have seen similar insurance company behavior towards breast cancer patients, and very often, the treating institutions are able to persuade them to reverse their decision. It will help that there appear to be studies since which lean the other way (although I don't know if they're good studies).

If you're really determined to have the proton-beam therapy no matter what the insurance company ultimately decides, you might want to consider crowd-sourced funding. Three good sites for medical funding are:

http://www.gofundme.com/
http://www.youcaring.com/ (this one has no fees)
http://www.giveforward.com/

Keep fighting, but know that even if you lose, it's not a survival issue. (I didn't find radiation (6 weeks) to be horrible, and I highly recommend calendula after each treatment to mitigate radiation damage.) Good luck to you.

P.S. I'm pretty sure that prisoners are not getting cutting edge treatments. There's no doubt they get the so-called "standard of care" but they don't have the same options as those of us who are walking around free.
If you don't know where you're going, you should know where you came from. Gullah Proverb

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Maybe your wife could accuse you of a crime so you could spend a little time in jail? You could refuse to post bond. Once you've gotten the primo healthcare, she could recant and say it was a case of misidentification?

Just spitballing here. I got nothin'.
I know it just wouldnt be right to kill all the stupid people that we meet..

But do you think it would be appropriate to just remove all of the warning labels and let nature take its course.

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Thanks, RhondaLea, for a specific and actively helpful post. I got nuttin', but you went out and found a lot of good information.

Wendy P.
There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

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The insurance company's probable justification is a study published on December 14, 2012 in the Journal of the National Cancer Institute. Abstract:

http://jnci.oxfordjournals.org/content/105/1/25.short

The study says, bottom line, that proton-beam therapy is no better than radiation (re outcome). Short term, it appears to confer better results with respect to side effects, but a couple of years down the line, lingering side effects are comparable.

Proton-beam therapy costs about $32K and IMRT is $19K.
.



The bottom line is that randomized clinical trials have never been done to determine which prostate cancer treatment is better. So, it's impossible to say which treatment is best. There is a ton of research that shows that Proton Radiation is at least as good as any treatment out there for killing the cancer.

Where Proton Radiation is clearly superior is in terms of side effects. 99% of men treated with proton radiation for prostate cancer are happy with their treatment. This comes from a recent study done this year. Compare that to other treatments. Most men, that I've met, who had other treatments, are depressed as hell. Most are impotent. Many have huge problems with incontinence. Not to mention other side effects.

Almost 100,000 men have been treated with Proton Radiation. Most state that their life after treatment is as good or better than it was before. The treatment is painless, non-evasive, and no recovery time is needed.

The radiation is safe enough to even use on children. Yet exact enough for brain cancer. I truly believe that once the cost comes down, it will make the other forms of radiation obsolete.

Twenty years ago, there was one treatment place for Proton Radiation, Loma Linda. Now there are ten in the U.S. Each one costs 200 million to build. Ten more are under construction,with ten more in the planning stages. Soon there will be thirty in the U.S. There are 23 in other countries. Why would investors spend that kind of money if it was no better than IMRT?

IMRT is new. It's only been around for ten or fifteen years. Noone really knows all the side effects from that. The bottom line is that X-ray radiation (also called photon radiation) is dangerous. You're being exposed to thousands of times the radiation you might get from a dental x-ray. It is destroying healthy tissues on it's entire path through your body.

Comare that to Proton Radiation. With Proton, the radiation activates when it hits the tumor and then stops. It's like comparing a smart bomb to a cluster blomb.

Radiation can cause secondary cancers. The chance of secondary cancers is twice as great when comparing IMRT to Proton Radiation. The chance of secondary cancers from Proton is almost zero.

X-ray radiation also makes you tired and sick. I just talked with a lady who had x-ray radiation for her cancer. She said it was worse than chemo. I'm not sure if you glow in the dark after IMRT, but I don't want it.

There have been a ton of studies stating the absence of side effects from Proton Radiation. That includes short term or long term side effects.

There is even a following of hundreds of men who have had proton radiation for prostate cancer. They are called "Brotherhood of the Balloon". These men are willing to tell anyone how superior Proton Radiation is. Name another treatment that has a fan club like that?

I was told that if I paid cash, Loma Linda would settle for $80,000. Most places charge closer to $125,000.

I've read that IMRT is about $8,000 less that Proton Radiation. I'd gladly pay the difference but the insurance company is saying either pick another treatment or get little or nothing.

Yep, I agree....Insurance companies are a racket!

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I've decided that I might opt for a prostate transplant. I'm not sure how much that will cost. I was thinking of getting one out of a black stallion. I know they can transplant pig hearts, and that sort of thing, so a horse prostate shouldn't be that much harder???:S

After that they may have to keep me away from good looking women. I might start snorting, and squealing, and go galloping after one of them.

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I've decided that I might opt for a prostate transplant. I'm not sure how much that will cost. I was thinking of getting one out of a black stallion. I know they can transplant pig hearts, and that sort of thing, so a horse prostate shouldn't be that much harder???:S

After that they may have to keep me away from good looking women. I might start snorting, and squealing, and go galloping after one of them.



https://www.youtube.com/watch?v=RWyl8IHIea8

:D:D:D
"Mediocre people don't like high achievers, and high achievers don't like mediocre people." - SIX TIME National Champion coach Nick Saban

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What is your insurance company?



That's a good question.....Maybe I better wait til this last appeal is over with. Then I plan to tell the world what I really think of them. Maybe I'll even get a law suit for slander. At this point I hate their guts.:( If they pay for my treatment, I'll say that I love them....

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I hope your insurance company can be made to see the light of reason, but as a treatment for prostate cancer, proton beam is the controversy of the day (more so than I realized, actually).

http://curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/1976

I'll add that if I had had a choice between five months of chemo (plus an additional year of targeted infusions) and radiation, I'd have picked radiation. (As it was, I had it all--slashed, burned and poisoned--and it was still 100% better than walking around with an active, aggressive tumor. The last thing I want to be is metastatic.)

Please look into the crowdfunding. It's extremely effective (from what I've seen based on the results of people I know), and you feel strongly enough about this that it's worth asking for help to do it the way you want it done.
If you don't know where you're going, you should know where you came from. Gullah Proverb

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