Denial is Not Just a River in Egypt

Most of us have heard that old line plenty of times, often attributed to Mark Twain. Whether you think it’s corny or not, it’s so brilliantly succinct and applies to so many situations in life that I am stealing it for today’s blog title.

We’ve also all heard the adage about insurance companies… that their strategy is “deny, deny, deny.” Some assessments are less generous than that, referring to the “three D’s of the insurance industry” as “delay, deny and defend.”

I’ve mentioned this many times before, but perhaps the dirtiest little secret behind cancer treatment is the pernicious financial effects on patients that come from treating the disease that is trying to kill them. I spent this past weekend sorting through a huge database of medical claims data that I downloaded from my insurer. From this, I was able to ascertain that the remaining balance owed to my health care providers – in the absence of any further processing and after the insurance company has processed claims and made payments - is $99,120.85. Dollars, not pesos.

I just did a video that we will release in the next day or so explaining how we got here, and I plan to do additional videos as I work my way through this process. I am an unabashed fiscal conservative and social liberal, so I operate under the (faulty) premise that insurance companies have a right to make a buck, but I also believe they should do the right thing with the money they earn, beyond just taking care of their shareholders. In my mind, they also have a fiduciary duty to return value to subscribers in exchange for the premium payments they willingly accept. You can’t fulfill that duty through a blanket denial of medical claims, ESPECIALLY when the claims you are denying are for people battling cancer.

The thing that frightens me is that I at least have the wherewithal to figure this stuff out. For better or for worse, I have spent my career managing databases and building financial models. As such, data doesn’t scare me (and I pretty much believe that anything worth doing is worth doing in Microsoft Excel). But what about those people that can’t sort this stuff out on their own? How do they even figure out what they really owe and how do they get help if their finances are crushed by the cost of treatment?

My experience underscores the reason why Cincinnati Cancer Advisors offers financial navigation services, and why we will have a renewed focus this year on helping patients with financial navigation services. I don’t know how to measure the negative effect on physical health that occurs when a patient is dealing with the new, crushing reality of insurmountable medical debt, but I know that it doesn’t help. After 8+ years of dealing with this stuff, I have learned how to roll with the punches, but I worry about those that are new to this game.

Until next time,