Medical Insurance Industry - Evil or just Uncaring?


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This is a complete and total vent.

See, a friend of mine down in California has been fighting for well over two years with her insurance carrier (GPA, AMM, and Regence BlueShield of California) to treat pressure and swelling in the cranium, as well as a large ovarian cyst. She was a programmer making good money, but is now on disability due to her conditions and is scrambling to support herself and her daughter.

The go around has been this:

Doctor prescribes and recommends a particular type of treatment, does referral to neurologist.

She makes appointment with neurologist.

Neurologist confirms treatment needed, makes arrangements to have surgery done.

Insurance company REJECTS claim, demands she goes to another neurologist.

Second neurologist punts, passes it back to original doctor.

Insurance company denies surgery.

Friend goes back to doctor, whole process starts over.

In late May the State of California ruled AGAINST her insurance carrier and told them they HAD to authorize the treatments the doctors recommended for her. The insurance carrier actually ignored the state and denied her again.

To make matters worse, the pressure in her skull has put pressure on her optic nerves, causing her to lose her vision. Yesterday she saw a neuro-ophthalmologist. She's lost 85% and 87% of her vision since April, meaning they're going to have to do surgery to relieve the pressure on the optic nerve to save what's left. There's less than a 5% chance she'll ever regain the vision she lost - and the neuro-ophthalmologist said if the insurance carrier had allowed her to come to him earlier, he could have saved her vision completely.

So, thanks to the utter incompedence, greed, and banality of GPA, AMM, and Regence BlueShield of California, my friend is in constant pain, unable to work, worried she won't be around to raise her daughter, and has now lost most of her vision. While the bean-counters openly flout the State of California in denial of services.

Personally, I hope she sues the asshats so their next five incarnations are paying restitution