Insurance company denies covering cost of life-saving medicine for metro woman

[UpInArms]

Source: Fox4KC

KANSAS CITY, Mo. — Blue Cross and Blue Shield of Kansas City denied covering the cost of one metro woman’s medicine that she says could save her life, leaving her with an over $8,000 monthly bill.

“I was at risk for spontaneous internal bleeding that could kill me,” Kaitlyn Sy said.

Sy, a KU Medical student, said she’s fighting back just weeks after a near death experience.

… snip …

Just weeks ago, this scenario played itself out, Sy was forced to go to the ER to treat internal bleeding. Her hematologist had one more option, a pill called ‘Promacta,’ that could stabilize this issue. Things changed when Sy got to the pharmacy.

“The pharmacy tech – her eyebrows go up – and I said this can’t be good and she says this medication is going to cost you over $8,000,” Sy said.

Sy said she can’t afford to pay the bill every month. She called her insurance company, and they stood by the denial.

Read more: https://fox4kc.com/news/insurance-company-denies-covering-cost-of-life-saving-medicine-for-metro-woman/

[Blues Heron]

1. multiply this by millions of individuals and its easy to see how people might be... miffed at the sytem.

[onecaliberal]

22. But but but murder is bad.

Oh wait, it’s okay when rich whites kill you.

[Bengus81]

2. Rake in as much CASH as possible until their "customer" really get's sick

Then tell em to fuck off,we're denying this drug that could save your life. They don't care,they made thousands off of this person and now they are not about to lose it over an expensive drug.

BTW,these drug companies couldn't give a rats ass about the high price of drugs. It just gives them an excuse to deny coverage on the sickest people.

[speak easy]

27. "Rake in as much CASH as possible"

That cuts two ways: The real issue across the board is price gouging by big pharma.

[GiqueCee]

3. How is denying life-saving care simply to increase profits...

... NOT classified as homicide? Premeditation, malicious intent, and ruthless execution are documented daily by greedy psychopaths, and they are paid bonuses.
Explain it to me like I'm 5.

[ReRe]

4. There is no explanation for it

and if they were honest, they would have to say "...but Greed is Good."

I think they read it as "Greed is God."

[BattleRow]

5. Is there a RICO somewhere in this ?

[summer_in_TX]

7. Interesting question.

A Fani Willis is needed to find out.

[IronLionZion]

8. They classify it as good for their investors

human sacrifices must be made so rich people can get richer.

[GiqueCee]

19. The phrase I hate most in the world is...

... "Our first obligation is to our stockholders." To which I reply, your first obligation should be to act as a decent human being, a task at which you have, thus far, failed miserably.
The proverbial substance is about to hit your fan with a resounding splat. As they say, FAFO, motherfuckers.

[WalkerinSC]

25. A start is to reclassify

by statue that all insurance 'providers' are classified as non profit entities and delist from stock market. Remove all denial authority from them. They are merely the vessel to pass through payments. Allow them to set up small boutique for profit entities for private insurance that they have full control over but cannot be taken full public. Open up Medicare/Medicaid with some restrictions to make it competitive. Basically create something akin to the German system. Multi-payer with competition. It's also time to put some of our resources to use for the people of this country. I am not a fan of nationalization per se, but there is oil, timber, and other resources on federal land that can be monetized in a wise manner to create a sovereign wealth fund to pay for the citizens of this country to have a way to pay for healthcare.

[IronLionZion]

30. Trump and the GOP congress want to do the opposite

and privatize Medicare/Medicaid and everything else so executives can get wealthy from death.

[GiqueCee]

31. Privatization...

... benefits no one but the Wall Street Weasels that told their pet Republicans to shove it down our throats, whether we like it or not, just like Trump's promise to "protect women, whether they like it or not."
So the burning question is, how much of this evil treachery will we tolerate before shit gets real. If we let these traitors get too far down this path, there may be no turning it around.
If Garland had grown a pair when it really mattered, we wouldn't be in this mess, and the Orange shitstain would be in prison where he belongs, but nooo... Maybe his right leg is shorter than the other one, because right seems to be direction he leans when the winds of change start to blow.

[ShazzieB]

37. And more people will die from treatable causes than ever before!

But that is naturally of no concern to those ghouls.

[TexasBushwhacker]

35. Other countries also regulate the cost of drugs

With everyone else on the planet regulating drug prices, drug manufacturers get all their profits in the US.

[IronLionZion]

29. For government, it's the taxpayers, citizens, and anyone else using the programs

no stockholders to demand more profits. It's a direct conflict when health insurance companies have a profit motive for people to die faster.

[BattleRow]

33. Are their stockholders ever denied coverage?

[Bettie]

24. Because rich people make the rules

and they hide behind "shareholder value is the most important thing in the world" to justify it.

[Attilatheblond]

36. 'gotta protect shareholder value' but never admit they ARE the primary shareholders

IOW, screw the women & children and LET ME INTO THE LIFEBOAT!

[idahoblue]

6. Medicare rx plan cover this drug.

You just have to live long enough to qualify.
MEDICARE FOR ALL!

[TBF]

9. Insurance companies are parasites. Tm - Luigi. nt

[Seinan Sensei]

16. And Pharma is guilty of extortion

… in the name of Research/Development

And I’ll betcha there’s Fed money (and a university’s research) baked into that high-dollar pill

[TBF]

20. Sure - plenty of guilt to go around. Pharma cos. will do their best

to kill the Kennedy nomination. It will be entertaining to watch.

[Bettie]

26. Most pharmaceutical breakthroughs

come from government funded university research.

They usually reap the profits from research done by others and paid for by others.

[GiqueCee]

34. Reaping profits from the work done by others...

... defines Elon Musk's business model. That motherfucker is poised to do incomprehensible damage if he's not reined in somehow.

[msfiddlestix]

10. What is a "Metro Woman" ? Do you mean as opposed to a "Rural" Woman?

[UpInArms]

18. It is a term used

locally for a Kansas City resident

[msfiddlestix]

38. Thank you. I wondered if it, the term, was specifically related to that specific location.

I never hear that usage in any context relating to people in the Bay Area.
I was beginning to wonder if "Metro" was now a new reference term for Women or People in any city around the country. thank you .

[IronLionZion]

32. A city's metro area covers suburbs across state lines

so for Kansas City, it includes areas of Missouri and Kansas.

[xocetaceans]

11. It seems that the leadership of that company is also in hiding....

https://www.bluekc.com/consumer/blue-kc/leadership/

and possibly that they don't think that Google works....

https://www.bluekc.com/static/consumer/blue-kc/leadership.html

They still even have PDFs on their backgrounds up. It is insanely poor security for a group whose "business model" objectively acts to the detriment of the general public. Maybe, they actually think that they are "respectable business people" instead of what they actually are? Who knows?

[C0RI0LANUS]

15. The death panel can run but they can't hide.

[GiqueCee]

21. Interesting...

... click on your link and it's: ERROR 404 Page not found.

[orleans]

12. and this time: blue cross blue shield, ok about killing their "members" one "member" at a time

and $8,000 a month?
wtf?

Novartis Pharmaceuticals Corporation manufactures Promacta (eltrombopag).
GlaxoSmithKline (GSK) and Ligand Pharmaceuticals discovered eltrombopag through a research collaboration. Ligand sold its Promacta assets and royalty to Royalty Pharma for $827 million.

-google search ("AI overview)

[Fla Dem]

13. Pharmaceutical companies are just as bad. Charging extreme amounts for life saving medications.

I understand there are enormous expenses that go into the research and development of drugs. But many of these companies make enormous profits and pay their top executives enormous salaries.

[Farmer-Rick]

14. If this woman dies

We can trace the death back to Blue Cross and Blue Shield of Kansas City. We can then follow the chain of blame from the nurse who reviewed the claim to the doctor hired to rubber stamp those decisions. Then to division supervisors and department heads to the top of food chain President and Chief Executive Officer of Blue KC, for authorizing this policy. Her name is easily obtainable. She needs to be held to account.

I think these CEOs hide behind their deadly organizations. Trying to pretend they don't murder people for a living. They hope we will blame the $30,000 a year Blue KC nurse or the $160,000 a year Blue KC doctor. But really at the top are the people who really pull the levers of death. The $24 million a year CEO is really the one who would be responsible for the girls death. She makes $24 million a year and can't spare $8,000 to keep a person alive.

[Jacson6]

17. The real problem is prescription drug pricing.

Unless Congress creates regulations to rein in pharma this will be a continuing problem.

[Nigrum Cattus]

23. The real question is how much does it cost to make ?

It might only cost a $100 or less to make. They know it's a
drug someone would need & so they stick it to em.

[Sibelius Fan]

28. Novartis offers a patient assistance program for this drug.

I have been on Cosentyx for over a decade. List cost is over $7000 a month. My cost thru the Novartis Patient Assistance Program is $0. It’s based on financial need. In my case, that means having a yearly income under $103,000 for a 3-person household. I imagine their program for Promacta is similar.