Scott Eveland: DENIED

Yesterday I wrote a blog about a young man with a serious brain injury who is slowly recovering at Palomar Medical Center.
Blue Cross California wanted to terminate his treatment and shunt him off to a nursing home, or send him home.

That diary sank without a trace, buried in a flood of opinion pieces about candidates, and that is sad. I was hoping that enough people would read it to make a noise that would cause Blue Cross to reverse its decision.

Well, so much for the power of the internet. Apparently Hillary and Obama are just so much more of a vital topic that everyone and their brother had to chip in their two cents.

Hardly anyone read it, and that is too bad, because this case pretty much outlines what we have to look forward to if certain pols get elected. Medicine by bureaucrats flying a desk, determining what course to take. I am disgusted, both by the lack of attention Scott Eveland's story got, and the treatment he's getting from Blue Cross California.

Original diary here:
http://www.dailykos.com/...

Here we go, "ESCONDIDO – Rejecting an appeal from his family, Blue Cross of California is discontinuing payments that would allow injured high school football player Scott Eveland to remain in the hospital."

Scott was responding well, but slowly, to therapy. He was in a coma for a month, and is gradually regaining his ability to move and talk again.

"Blue Cross, however, decided that Eveland's progress was not dramatic enough, and is recommending that he be transferred either to a nursing home or Eveland's home in San Marcos."

In other words, he isn't recovering fast enough to suit the suits at Blue Cross. You could have made a difference.
Alas, Hillary's latest bon mot was more important.

•  If your diary isn't getting enough attention

  it's my fault?

  This is a large community advocating a lot of causes. Maybe you should take a look at your approach before you blame others.

  by ord avg guy on Thu Jan 10, 2008 at 05:53:27 AM PDT

  •  xenubarb is correct, this is a major catastrophe

    I was with a CEO of a hospital yesterday who described these insurance industry practices with TBI (traumatic brain injusy).

    The United States is in freefall. The healthcare situation is spiraling out of control.

    by nyceve on Thu Jan 10, 2008 at 05:59:01 AM PDT

    •  Makes you wonder how many promising young

      people will never get past injuries that could be treated.  I hope that the insurance has to pay for his care forever if they get to pull that nonsense.

      by maybeeso in michigan on Thu Jan 10, 2008 at 06:29:30 AM PDT

    •  Yep

      But is that really the fault of kossacks who aren't reccing xenubarb's diary?

      I have issues I care about too. I don't diary them because I am not a very good writer. If i did do an action diary, and it didn't get the attention I thought it deserved, I sure wouldn't come back the next day and blame the community.

      Just saying.

      by ord avg guy on Thu Jan 10, 2008 at 07:48:15 AM PDT

    •  Eve, interesting article on Amgen marketing....

      FYI: http://www.latimes.com/...

      "Two former Amgen salespeople allege improper drug marketing"

      Yet another way millions are taken from the health care system without really helping people...

      Immoral denial of real claims, kicking off the sick and injured when they need care, sales of unnecessary expensive drugs while being legally unable to negotiate pricing for billions of needed drugs worth under Part D, etc., etc., etc.

      I still support Edwards, but I'm leaning towards Hill as a second choice just because her health care plan is so similar to JRE's.

      Stories like this just keep coming and coming and coming...

      by bewert on Thu Jan 10, 2008 at 08:12:28 AM PDT

  •  Your fault?

    I think you missed the point.

    Lets not forget the reason - we're supposed to be supporting the democrats.

    If they're not going to SOLVE the healthcare crisis then why should we care if they get elected or not.

    The amount of pre-primary, pre-election 'news' coverage has been very inappropriate and on scale with the Britney Spears coverage.

    by reasonanyone on Thu Jan 10, 2008 at 06:06:36 AM PDT

    •  Maybe i missed the point.

      It sure looked to me like the point was the diarist wrote about a young guy in CA who's getting screwed by  BC but I cared more about some stupid primary.

      My point was that maybe the original diary could have been better written, and that's why it didn't get the attention it should have.

      If they're not going to SOLVE the healthcare crisis then why should we care if they get elected or not.

      I don't know what this has to do with yesterday's diary and. health care is not the only issue.

      by ord avg guy on Thu Jan 10, 2008 at 07:57:32 AM PDT

•  Um...

  That diary sank without a trace, buried in a flood of opinion pieces about candidates, and that is sad.

  What is sad is that the quality of most of those hit and puff pieces was so poor.  The fact that there were so many of them wasn't a problem as this is a political website. There's nothing wrong with using a personal story to make a larger point about health care coverage but scolding us for not responding with sufficient fervor in the midst of primary season is kinda clueless.  Perhaps you could time your publications better.

  Alas, Hillary's latest bon mot was more important.

  Got passive-agressive.

  by MajorFlaw on Thu Jan 10, 2008 at 05:54:34 AM PDT

•  typical

  The legalized scam business (insurance companies) operate on a business model based on accepting premiums and denying claims.  I am assuming that the facility BCBS wants to utilize for Mr. Eveland is not a rehabilitation hospital.  As you are probably aware, there are hospitals that specialize in rehab for patients in coma or having suffered serious trauma.  Is BCBS offering to pay for the long term care facility?  You don't have any links to sources in your diary that would be helpful to those of us interested in this story.

  by strength to strength on Thu Jan 10, 2008 at 05:57:22 AM PDT

•  What other real news are we not hearing?

  What other real news are we not seeing covered because of the super critically important 18 month pre-election 24 hour non stop coverage?

  It would be a great idea if one of you tech people made a website where - if you were denied coverage by one of these criminal insurance companies - a patient could post certain details and information about who to contact at the criminal company and how to contact them - CEO - Claims reps, I don't know.

  I'd like to see hundreds/thousand of people call the company and ask for them to explain the method/process of deciding who should be allowed to die in order to return the appropriate profit margin for it's shareholders.  

  Or - how do you decide which Patients to allow to die in order for the CEO to earn that multimillion dollar bonus?  Is it 10 kids, 8 adults and 14 elderly - is that how many people you need to deny coverage each month and allow to die for you to make your bonus?  

  If  your CEO bonus is tied to profit and profit is tied to denying care and if denying care causes the deaths of a Patient who would have lived if provided care  - then please explain - how many people you need to allow to die annually for you to earn your bonus?

  by reasonanyone on Thu Jan 10, 2008 at 06:02:35 AM PDT

  •  I've wondered now and again if pay for

    misbehavior was running for some of the stars/starlets---anyway, famous.  Or maybe some of their handlers.   Things get tough, suddenly there's a "Britney" in trouble.   During primary season they would save a bundle becausethe pundrity spends so sickening an overabundance of time on minor bits and quibbles.      

    Just a thought, but watch and see how they march together.

    by maybeeso in michigan on Thu Jan 10, 2008 at 06:27:21 AM PDT

•  I hope you are right

  It's my understanding that they are moving the young man to a rehabilitation facility. He is in an intensive rehab center at the hospital and doesn't appear to be making enough progress to justify satying there.

  This has been a tragedy for his family and the community. I drive by the high school several times a week and see the signs and the concern expressed by his classmates. It is understandable that his family wants him to stay in the most aggressive treatment possible. I can see how sending him home or to a rehab facility seems like admitting defeat and saying Scott won't get better, but I really wonder how much of this is a permanent condition for the young man. Sometimes people don't recover from tragedy. I hope with all my heart that this is a case of the Big Bad Insurance Company and not a case of his family and friends holding on to hope that simply isn't there.

  by SeekCa on Thu Jan 10, 2008 at 07:37:20 AM PDT