Last month I was diagnosed with melanoma in my right eye. I had some blurry vision so I went to my eye doctor right away. He noticed what he called a “freckle” in my eye and gave me an emergency referral to an ophthalmologist.
The ophthalmologist diagnosed me with a “large melanoma” in my right eye. Dr. Google told my wife that survival with a large melanoma in the eye is less than 50% after five years. Fell apart. I was referred to an eye oncologist and was seen the next day. She diagnosed the melanoma as “small” – a function of thickness and said I had a much better chance of long-term survival than we thought.
The recommended treatment was a radiation plate that is sewn directly to the eyeball. Everyone moved quickly. Two weeks after the diagnosis, I was in the operating room. Things had to happen fast because every day the risk of metastases grew, and when that happens, a bad outcome is much more likely.
But the fact that insurance companies are involved also increases my risk of a bad outcome.
Other developed countries have trouble understanding our US health care system. Here we decided it would be a good idea to put a for-profit entity between us and our medical care – health insurance. As expected, this creates a huge conflict of interest for insurance companies. They make money by collecting your premiums and then denying you coverage.
Here are two situations that have already happened with my current health scare. When I was diagnosed with melanoma, all the doctors said, “Everything will be covered.” I soon received letters from the insurance company assuring me of coverage. (By the way, this is the largest health insurance company in the US)
Treatment involved installing a radiation plaque in my eye and removing it a week later. The installation went without any problems. The day before she was to be removed, the hospital called and said, “The insurance company did not approve the move.” I said “Uh, what?”
So we called the insurance company. They told us that they need three weeks for such an approval. The hospital said I would have to sign a waiver to have the surgery, indicating that I was financially responsible if insurance didn’t pay. The insurance company told me that if we signed a waiver then they would not pay because I stated that I would.
The doctor told me, “This source must come out immediately, because if you leave it too long, it will destroy your eyesight.” And this was a regulated nuclear source in my eye that prohibited me from being around other people. So I had no choice but to sign it. And right before the surgery – like literally an hour before, when we were in the waiting room – the insurance company denied the surgery to remove it. If it seems crazy, it is. So we have to fight them. Just more stress on the matter.
Second thing. My oncologist said the most important thing now is to determine if the cancer has spread. That’s really the biggest factor in whether I have a good or bad result. He ordered a full body PET scan. The insurance company refused. They said, “This melanoma was in his eye. We don’t see a need to check the rest of his body.” Crazy again.
In fact, the woman who booked me in for plaque removal surgery was originally from Canada. She said: “I just don’t understand this system. I pay my health insurance every month but I still have to pay contributions and co-payments? What is this?”
I hate this system with a burning passion. And I’m lucky. At least I have insurance. It’s hard to imagine someone without insurance going through this.
I have lived in Germany, Scotland and the Netherlands. I have experienced firsthand universal health care in these countries. What we have in the US is an abomination.