Sunday, August 05, 2007

Maddening myeloma article

This was in the Kansas City Star this morning. It makes me crazy. As much as I want to see Sicko, I don't know if I'd be able to make it through it, knowing what I already had to go through just to get my Revlimid approved by the insurance company. I know what I had to deal with was much, much easier than what other people have to face, and, man, it was still so stressful. It took weeks of fighting and a nasty letter from my doctor before the insurance company said, okay, we'll do you a big favor and"let" you have this lifesaving drug. Everyone should get mad about stuff like this.



Posted on Sat, Aug. 04, 2007
Lokeman: Fighting for health care, fighting for her life

It took two viewings before Julia Slaven could laugh with others in theaters showing Michael Moore’s latest film.

“Sicko” opens with a guy who, for lack of affordable health care, stitches up his own gaping wound. According to Moore, you’re better off getting sick in Cuba, France and Great Britain than in the USA.

Some people in Moore’s film died while their appeals on denied claims were pending. Moore’s film featured a St. Joseph Medical Center employee whose husband had cancer and died while the family appealed an insurance denial.

Julia Slaven of Kansas City watched “Sicko” through a been-there-done-that lens. A nurse at University of Kansas Medical Center, Slaven has multiple myeloma, an aggressive form of cancer. She’s not your typical cancer survivor: She ought to have the letter “S” sewn on her shirts and walk around wearing a cape.

Earlier this year, her health provider, Coventry Health Care of Kansas, denied as not “evidence-based” a second round of autologous stem-cell treatments at KU Medical Center. Coventry claimed the transplant procedure was “not supported by medical literature.” She appealed.
As she waited, Slaven, family and friends held a one-day protest in March on Ward Parkway near Coventry’s Kansas City headquarters.

Supportive letters were faxed to Coventry. Motorists honked in support. TV crews from KMBC and Fox-4 News interviewed her. By the end of the day, Coventry had contacted Slaven to explain that the denial had been overturned. Just like that.

The stories that Moore tells are stories that people like Slaven live.

Slaven couldn’t understand how her insurer had approved the workup to this second round of treatment, denied it as experimental and within hours of a protest changed its mind. Variations of this theme are found in “Sicko.”

“First time I saw the movie, it made me mad. It stirred things up,” Slaven said. “The second time, I thought it was sarcastic and funny. You do have to have some humor about this or else you would go crazy.”

While fighting cancer, Slaven kept her sense of humor but lost her hair. She lost her appetite, but not her life.

“It’s heartbreaking what happened to that woman and her husband at St. Joe,” Slaven said. “But there are a lot of stories like that out there.”

Had Coventry not come through, the Slavens would have had to pay out $250,000 on their own. The family already pays more than $14,000 in premiums annually. And these were Julia’s stem cells, not the controversial embryonic stem cells.

“I have stem cells saved from the year before,” Slaven said. What happened to her was like putting money in the vault and having the bank charge you $250,000 to claim it.

Coventry claims it overturned its denial based on a review of her case by a panel of independent physicians called upon to consider her appeal.

A Coventry representative on Friday identified the physicians who gave the green light as A. Robert Thiessen, Keith Hansen and Matthew Sacks. The original denial was made by Dr. William R. Rooney, medical director of Coventry.

Last March, the second round of stem-cell treatments began.

“I open the newspaper first thing to the obituaries,” Slaven said. “The other day I read one about a woman who died of multiple myeloma. The way I feel right now is I will live for a long time.”

Julia Slaven turns 55 on Tuesday. Michael Moore will miss her blowing out the candles surrounded by her loving family. Despite her happiness, she worries about other cancer patients who also see life through a been-there-done-that lens and may run out of time while waiting for the coverage they have paid for and been denied. You ought to worry, too.

Rhonda Chriss Lokeman is a nationally syndicated columnist for Creators Syndicate.

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