A recent New York Times article helps highlight just how far behind insurance companies are to innovations of modernity and innovation. Highlighting the cases of several cancer patients who were forced to go out-of-pocket to receive convenient oral treatments rather than in-house intravenous, etc., care, the NYT highlights how insurance companies rely on redtape and a lack of federal demand to innovate to demonstrate how the average citizen who, until they fall into crisis, believe they are fully covered suddenly are required to provide their own money for reasonable remedy:
Pills and capsules are the new wave in cancer treatment, expected to account for 25 percent of all cancer medicines in a few years, up from less than 10 percent now.
The oral drugs can free patients from frequent trips to a clinic to be hooked to an intravenous line for hours. Fewer visits might save the health system money as well as time. And the pills are a step toward making cancer a manageable chronic condition, like diabetes.
But for many patients, exchanging an I.V. bag for a pill is a lopsided trade because the economics and practice of cancer medicine have not caught up with the convenience of oral drugs.
Too often individuals appealing to their insurance company for help when necessary are finding that there is little to no interest on the part of these companies to modernize or “go the extra step” to provide the care they should provide. Through governmental complacence and a lack of oversight to the processes occurring in coverage, insurance companies have consistently red flagged and prevented proper restitution or remedy to claimants who have a full right to proper care. This practice extends beyond pharmaceuticals and the healthcare industry and into various other insurance industries, including property and homeowners.
By refusing to accept low-end bargaining from insurance companies and seeking legal advise on the rights provided by the contractual arrangement between policy holder and provider, citizens can protect themselves from needing to pay out-of-pocket for the results they deserve. While necessary governmental oversight over the insurance companies may be too far into the future to rely upon, everyday people can make sure that, should a form of tragedy befall on them that they believe their insurance provider is bound to provide, they have the legal support they deserve.