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View Full Version : UK, Cancer Surviror Refused Breast Surgery!!!



Sev
03-31-2010, 06:18 PM
So you think National Health Care is a good thing???
This is now what is coming to America.
Congratulations people.

http://www.dailymail.co.uk/news/article-...ic-surgery.html (http://www.dailymail.co.uk/news/article-1262483/Cancer-survivor-refused-breast-reconstruction-operation-NHS-officials-dismiss-cosmetic-surgery.html)

<span style="color: #000099">
Cancer survivor refused breast reconstruction operation after NHS officials dismiss it as 'cosmetic surgery'

By Liz Hull
Last updated at 12:57 AM on 01st April 2010
Comments (34)
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Patsy Parsons was denied a breast augmentation operation on the NHS after surviving cancer

A cancer sufferer has condemned the NHS ' postcode lottery' after health chiefs refused to fund her breast reconstruction.

Mother-of-four Patsy Parsons had a large section of her left breast removed when she was diagnosed two years ago and was told she was entitled to have it rebuilt free of charge.

But despite being recommended for a £5,000 bilateral breast augmentation operation - complex surgery which involves inserting implants and uplifting both breasts - by her consultant, the local primary care trust refused to fund it.

It said her operation is 'low priority, routine' cosmetic surgery, which is paid for by the NHS only in exceptional circumstances.

Last night Mrs Parsons - who has four children aged between two and 14 with her labourer husband, Robert, 35 - said she was the victim of a 'postcode lottery'.

Guidelines state all women who undergo a mastectomy - a complete breast removal - should be given reconstruction by the state.

However, it is at the discretion of PCTs whether to fund the surgery for women such as Mrs Parsons who have partial breast removals, or lumpectomies.

'I feel completely let down and insulted by the NHS,' said Mrs Parsons, a cafe owner.

'I'm not some celebrity model wanting a boob job to get more pictures in a glossy magazine - I need this to boost my self-esteem.

'Some PCTs are saying they will fund it and some are saying they won't. It's not fair, it should be one rule for everyone across the country. It's a postcode lottery.'


Mrs Parsons had been scheduled to have breast augmentation surgery at the University of North Staffordshire Hospital

Mrs Parsons, 33, was diagnosed with breast cancer after finding a lump in her breast in April 2008. Doctors told her the cancer was aggressive and she needed a partial lumpectomy to remove the tumour and 16 lymph nodes to stop the disease spreading.

They reassured her that after her treatment, which included ten months of chemotherapy and radiotherapy, she would be entitled to reconstructive surgery.

She also had a hysterectomy in June to improve her chances of beating the cancer for good.

Three months later Mrs Parsons, of Stoke- on-Trent, discussed reconstructive surgery at University of Staffordshire Hospital. A consultant recommended she undergo a bilateral breast augmentation and advised it would be paid for by the NHS.

So she was devastated when, in December, Stoke-on-Trent PCT refused to fund her operation.

Mrs Parsons said her breasts are disfigured and she has been depressed since learning the operation would not happen. Although she appealed, the request was denied twice more.

Dr Zafar Iqbal, of Stoke- on-Trent PCT, said he was unable to comment on individual cases, but stressed they would be reconsidering Mrs Parsons' plight. </span>

<span style='font-size: 26pt'><span style="color: #FF0000">'The NHS is not in a position to meet all the demands placed upon it,' he said.</span></span>

And just think the population of the UK is so much smaller than ours. Just imagine the resource pool we are going to need compared to theirs.

Check please. /forums/images/%%GRAEMLIN_URL%%/sick.gif

Qtec
03-31-2010, 10:55 PM
<div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body">Last summer, while working on my ranch in the Southern Sierra mountains, I was attacked and badly mauled by a predatory black bear. Although my face was ripped off, and I was blinded, I was able to make my way back to my vehicle and drive myself down a rutted mountain road to a fire station for help. From there I was airlifted to UCLA Medical Center where a team of nearly a hundred people put me back together in a grueling seven-hour emergency surgery.

That was the easy part...

Although I’ve maintained a private individual health insurance policy with Blue Cross of California for thirty (30) years, they have, at every turn of my ordeal, tried to waffle, obfuscate, or outright deny me benefits for medical care. Because my injuries were mostly to my eyes, my facial structure (including my nose and most of my teeth,) and obviously, cosmetic appearance, my policy “does not cover services,” for putting me back together, and demands 30% co-pays before they will pay for the hugely expensive ($300,000 and counting,) reconstructive surgeries I need to regain a degree of functionality.

I am, not surprisingly, disabled and unable to work. My assets and savings were exhausted long ago, (their deductable and co-pays reset every calendar year and my reassembly is a multi-year project.)

I always thought having a "good" insurance policy was not only my civic responsibility, but would cover my medical expenses should I ever face a catastrophic illness. But it turns out that Blue Cross's $2,500 deductable is actually more in the order of an $11,500 deductable before they kick in for 100% of what they deem "reasonable and customary" care. Even that determination is subjective and skewered in their favor.

All this is on top of Blue Cross's insanely expensive monthly premiums -a difficult proposition for me given that SSI disability only pays me $654-oops, just reduced to $625-- a month on which to live.

Twice in the last month, Blue Cross denied payment for ophthalmologic consults I had arranged to see if some of my eyesight can be retained. Then there is the $600+ per month Blue Cross doesn’t cover in specialized prescription eyedrops I need to save what is left. My other medications are similarly extortionate and not covered. </div></div>

link (http://www.bobcesca.com/blog-archives/2009/06/health_insuranc_2.html)

cushioncrawler
03-31-2010, 11:31 PM
Hi. I did have reconstruction after a very large excisional biopsy. I was a AA cup prior to the removal of the breast mass which was a full 7 cm. The mass extended from the nipple to the chest wall. I had it removed and opted for reconstruction, as my breast surgeon said I would be severely deformed after removal. I consulted a well-known plastic surgeon (he has invented a special adjustable implant to be used in reconstruction) who agreed that reconstruction would be necessary for any normal appearance, and insurance would surely cover it. I had adjustable implants done at the time of the mass removal (the right for reconstruction and the left for symmetry). That was 3 months ago. The plastic surgeon is still stretching skin and fighting with scar tissue from a core needle biopsy that went horribly wrong. Right now, the right side is filled with 550cc in order to get the desired results. Once we are happy with the placement of the implant, the plastic surgeon will drain over 200cc. I can tell you honestly that I wasn't aware the process would take so long. However, I have confidence in my plastic surgeon and am sure the results will be well worth it. The bad news is, my insurance company has denied payment on the reconstruction. They said there is no "physiologic need for a specific size or shape of the breast" and my choice was purely cosmetic. I am still fighting for payment.

cushioncrawler
03-31-2010, 11:36 PM
Wondering if anyone out there has run into this: I went in for my annual mamo and to make a long story short I ended up having a MRI as the radiologist was not comfortable with the findings in the mamo and ultra sound. I have dense breasts and I guess it's like trying to find a needle in a haystack. Years ago I also had a biopsy because of microcalcifications. However, my insurance company does not feel this MRI was "medically necessary" and therefore will not cover it. My doctor ordered this MRI so I feel it was medically necessary and should be covered - I didn't have it just for the heck of it. I can't beleive this is going on when there is so much talk about finding breast cancer in the early stages. Does anyone know where I can go to get some help with this situation?

cushioncrawler
03-31-2010, 11:37 PM
Jan 29, 2009 08:40 am
hopefor30 wrote:

I just got a bill from the hospital for an MRI that was done almost one year ago -- for a whopping $5,600 -- there's no way I wil pay for that -- I was told by BCBS that it was coded as routine rather than as a result of a medical diagnosis -- what the heck! Routine? Having BC is routine? The hospital needs to review the code --so now I am waiting to see if it will be resubmitted and paid.

And, I have my next MRI (which I am supposed to get once a year) already scheduled for April -- hope this isn't going to be a problem.

cushioncrawler
03-31-2010, 11:39 PM
While calling attention to this in Washington may be a good idea, I urge anyone who has unresolved issues with their insurance company to consider contacting their State Insurance Commissioner. Most insurance policy coverage requirements are set at the state, not national, level. If you are covered by an employer, and that employer is self-insured, it becomes more difficult, but not impossible to get things turned around.

In Washington State we have a very consumer-oriented insurance commission. We have also pioneered requiring some medical treatments be provided by insurors offering group coverage in the state. Things such as mental health parity, alternative/complementary medicine, etc.

In many cases, if it looks like they company will continue to deny, deny, deny, one letter to the Ins Commissioner and cc'd to the insurance company (or vice versa) will do the trick.

My mother initially had her treatment for BC denied because the insurance co. decided it was a pre-existing condition (she changed companies about 3 months prior to her dx). It took her surgeon, PCP, and onc, along with a well-timed letter to the State to get the decision turned around.

cushioncrawler
03-31-2010, 11:41 PM
Jan 30, 2009 06:12 pm
OneBadBoob wrote:

Well guys, I sent an E-Mail to CareCore and Healthnet, demanding to know the particulars about Dr.J.Saxon, who denied my MRI pre-cert, demanded a copy of his CV, demanded to know whether he was licensed to practice medicine in the State of New York, demanded to know his board certifiations if any, and informing them that I was filing a complaint with the NYS Board of Education against him for (1) practicing medicine in NYS without a license (2) prescribing medical treatment for a patient without having first examined the patient.

Well, knock me over with a feather. My pre-cert request for a bi-lateral MRI was appoved this morning.

Keep fighting ladies!! These dirt bag insurance companies are counting on us letting it go!

cushioncrawler
03-31-2010, 11:45 PM
I kood go on forever just pasting similar breast storys from usofa.
Well, aktually i karnt, the storys will slow and perhaps even stop, once the Messiah gets into action -- i tell ya, its going to be a miracle for the usofa.
madMac.

Sev
04-01-2010, 06:25 AM
I doubt it.
Perhaps you missed the last line of the article that I so nicely highlighted for everybody.

There is a big difference between bureaucratic stupidity and a system that is overwhelmed. Not that I think the bureaucratic stupidity will diminish in the least.

Historically in this country Medicaid and Medicare are the largest deniers of care in the country. They are both run by the government and bankrupt.

eg8r
04-01-2010, 07:27 AM
What does this have to do with UK cancer victim being refused surgery?

eg8r

Sev
04-01-2010, 07:31 AM
His ending statement indicates that the system is overwhelmed.
The surest way to stop the bleeding is to refuse procedures.

Now with almost 50% of Americans not paying taxes and adding another "30,000,000" individuals to the system what do you think is going to happen??

sack316
04-01-2010, 07:43 AM
<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: eg8r</div><div class="ubbcode-body">What does this have to do with UK cancer victim being refused surgery?

eg8r </div></div>

Q's story is about Allena Hansen. Her story is true and tragic. BUT she also rallies for removing insurance companies out of the system completely... wonder what she thinks about the gov't (in a sense) growing their business?

We discussed a radical idea in a class the other night. About going back to the days where the churches ran hospitals. Was an interesting thought... kind of one of those old (IIRC) Will Rogers things "I don't know how, I'm just an idea man" /forums/images/%%GRAEMLIN_URL%%/wink.gif

Sack

Chilled
04-01-2010, 07:54 AM
<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: eg8r</div><div class="ubbcode-body">What does this have to do with UK cancer victim being refused surgery?

eg8r </div></div>

That's a good point and it could be equally asked what the unfortunate experience of one woman out of tens of thousand of similarly positioned breast cancer survivors who got perfectly acceptable treatment regarding reconstruction in Uk has to do with what can be expected in USA, without even considering the fact that the woman concerned is in any case almost certain to get the treatment on appeal.

Neither one anti-Obama policy poster picking one isolated example like this or one pro-Obama poster picking one example in the opposite direction is any way to conduct a sensible debate. It's just pointless sniping.

sack316
04-01-2010, 07:55 AM
Good post Chilled.

Sack

Qtec
04-01-2010, 08:18 AM
<div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body"> it could be equally asked what the unfortunate experience of one woman out of tens of thousand of similarly positioned breast cancer survivors who got perfectly acceptable treatment regarding reconstruction in Uk has to do with what can be expected in USA </div></div>

Exactly.

<div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body">Neither one anti-Obama policy poster picking one isolated example like this or one pro-Obama poster picking one example in the opposite direction is any sensible way to conduct a sensible debate. It's just pointless sniping. </div></div>

I wasn't sniping. In my own way I was trying to make the point the you so eloquently phrased. My point is, HC has always been rationed and always will. Public or private.

There is no bottomless pit filled with money.

The difference is that in the UK case the woman was refused because they had money problems and more urgent priorities.
In the US case , the woman who had her face ripped of by a bear got the shaft from her HC Ins.Co. after being a client for 30 years and the only reason they did it was to increase their profits.

Q

eg8r
04-01-2010, 01:04 PM
<div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body">There is no bottomless pit filled with money.

The difference is that in the UK case the woman was refused because they had money problems and more urgent priorities.
In the US case , the woman who had her face ripped of by a bear got the shaft from her HC Ins.Co. after being a client for 30 years and the only reason they did it was to increase their profits.</div></div>My point is that you like to change the subject and it would be nice for you to stick to one topic if you desire the same respect for your threads.

eg8r

Sev
04-01-2010, 05:16 PM
Pointless sniping???

Heaven forfend that ever occur on this board. /forums/images/%%GRAEMLIN_URL%%/whistle.gif