HMO abuses are the single largest health problem in America today," said New York State's Lieutenant Governor Betsy McCaughy Ross. New York recently became the first state in the nation to ban "drive-through mastectomies," when it approved legislation outlawing the "outrageous" policy held by some health-care plans.
Requiring women to leave the hospital hours after undergoing a modified radical mastectomy is only one example of HMO abuse, noted Lt. Governor Ross, who spoke last month at the annual meeting of the Huntington Breast Cancer Action Coalition in New York.
Also unfair are laws that allow health insurance plans to refuse payment for treatment considered experimental, remarked Lt. Governor Ross, when such treatment might be a patient's only chance to stay alive.
Requiring insurance companies to pay for experimental treatment will benefit future generations, too, she added, because "today's experiment often does become tomorrow's proven cure."
Results demonstrated by once "experimental" treatment proved that lumpectomy is effective therapy for breast cancer, avoiding the need for many women to endure a radical mastectomy. Further, the cure rate for childhood leukemia now approaches 90%, because most children with cancer are treated with "state-of-the-art" therapy provided in clinical trials, said Lt. Governor Ross.
Although no one plans to become ill, 4 of 10 Americans will develop cancer. "If you have cancer, high-dose chemotherapy, bone marrow transplants, and other such treatments still classified as experimental could be your only chance of extending your life," the Lt. Governor urged, adding "your health insurance plan should be there to support you."
She emphasized that "delay can be as deadly as denial" and addressed patients' rights to a fair and timely right of appeal outside of their health-care plans should they be refused coverage for necessary treatment.
New York's mandate against drive-through mastectomies is an important first step, according to Lt. Governor Ross, but more action is needed to protect against unfair insurance company practices.
The Lt. Governor also recently announced legislation to require insurance companies to pay for care in clinical trials if a doctor deems it a seriously ill patient's best chance for survival.
"Putting profit ahead of patients must be stopped," said the Lt. Governor, who added, "We need to rewrite insurance company regulations so that they are fairer to the patient and the patient's family."
The Huntington Breast Cancer Action Coalition is a grassroots organization on Long Island committed to intervention and prevention of breast cancer.
A 52-year-old man presented with an erythematous lesion in the axilla of unknown duration. Surgical excision was performed. What is your diagnosis?
