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Old 11-23-2005, 12:00 PM
DVaut1 DVaut1 is offline
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Join Date: Nov 2004
Location: Ann Arbor, MI
Posts: 27
Default Re: Did the system fail this man?

One thing I missed in the details of this story (and I never saw a detailed explanation on the website linked to by VR in his OP, although I gave the website only a cursory glance) is this: why did the insurance company/Medicaid deny him coverage for the transplant? This seems vitally important to the discussion here. I saw a rather vague answer on the website, which claimed that the insurance company/Medicaid refused to cover the transplant because "it's all about money" -- which I don't doubt is true. However, I'm curious as to why the insurance company/Medicaid specifically denied coverage, and what kind of insurance policy the now-deceased man/his family had -- while I feel like my liberal heart should bleed for this guy (and it's certainly a tragic story which ought to raise serious questions regardless of who's to blame), I think these are not-so-inconsequential details.

Perhaps vulturesrow (or someone else) can provide more information, if they have any? I like to criticize insurance companies and heartless bureaucratic organizations as much as the next guy, but I'm genuinely curious as to why this man was specifically denied coverage. I'm wondering, especially -- why didn't the man/his family ever take legal action against the insurance company if they thought the insurance company wasn't providing services they were obligated to provide, as specified in the policy? Certainly, such legal recourses were/are still available, even after the man died.
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