It's happening again. A Health Insurance Company has decided that a person's life isn't worth their time...and especially their money.
This time its Blue Cross of California that against the advice of doctors, nurses, and family members wants to kick Scotty Eveland, a young man seriously injured during a football game and now in a coma, out of the hospital.
Hospital spokesman Andy Hoang says, ""We've been advocating for him to stay since this whole negotiation process began. He's progressing well and responding quite well to the treatment plan."
The hospital's opinion, however, means squat to Blue Cross.
At a skilled nursing facility, doctor visits could plummet to as few as once a month and therapy could be cut back to a maximum of an hour or two a day with less sophisticated equipment, Keyvan Esmaeili, Eveland's primary doctor during his rehabilitation and medical director of the rehabilitation unit at Palomar Hospital where Scotty is being treated says.
But Blue Cross doesn't agree with the good doctor's assessment, or that of family members, friends. Blue Cross wants Scotty out of the hospital and warehoused as soon as possible.
Supporters are outraged as well they should be.
Wielding signs that read "Don't Stop the Progress" and chanting "Let Scotty Stay," nearly 50 friends, family members and neighbors of the injured Mission Hills High School linebacker marched in front of the Palomar Medical Center in Escondido Tuesday morning.
Eveland's girlfriend, Amanda Tucker, 17, told the North County Times she organized Tuesday's rally as an attempt to send a message to the insurance company.
"We feel Scott deserves as much rehabilitation as he can possibly get," said Tucker, resting on her sign. "It's like a broken leg -- they're sending him home without a cast."
Blue Cross of California says tough toenails to all that.
The Union Tribune of San Diego writes:
"The director of the Acute Rehabilitation Unit at Palomar Medical Center believes Scott's slow but encouraging recovery will continue if he remains on the hospital's ninth floor and keeps receiving intense physical therapy three hours a day."
Nevertheless, Blue Cross of California has decided to cut short the expensive hospital treatment. Twice, they've ordered Scott transferred to his own home or a nursing home, where his therapy would be much less rigorous and far cheaper."
The first Blue Cross ruling was temporarily reversed after an appeal. A second appeal was denied yesterday. As a last recourse, the family will petition a state oversight agency, said Diane Luth, Scott's mother."
'It's disappointing,' Luth said of the setback."
In a letter, Luth had implored Blue Cross not to write off her son. She has seen a growing light at the end of what four months ago seemed a caved-in tunnel. "
'I know that Scotty's recent progress has amazed and exceeded the expectations of several of his doctors, nurses and therapists,' she wrote. 'I also know that he has only just begun to scratch the surface of what he can and will accomplish if given the resources."'
The latest denail by Blue Cross likely means Scotty will be released from the hospital's acute rehabilitation unit on Friday, the last day the insurer has agreed to pay for the intensive, specialized care, and be transferred to a less-costly skilled nursing home.
But his family and supporters are trying to fight on. The family plans to appeal the decision to the state's Department of Managed Health Care on Thursday, said family friend Jeb Butler. Butler spoke for the family Wednesday, he said, because Eveland's mother, Diane Luth, was too distraught after the phone call, which came at about 4 p.m.
We pay these health insurance maggots our hard earned dollars and when we really need them, they tell us to take a hike.
Any American with any brains should be rising up now and demanding the total end of the this whole private heatlh insurance con. They are killing and maiming us and we're paying them to do it.
And yet every single Presidential candidate with a "new" health care plan but one still wants to work with the insurance industry on one level or another.
Only John Edwards has the guts to stand up and say it's nonsense to sit down and negotiate with these goons. He is straight up when he says they aren't about to be nice and diminish their profits. He is right on when he says that anyone who thinks we can fix this mess by sitting at the table with the health insurance industry or by keeping them in the system is out to lunch. For that reason alone I'd vote for Edwards and I'd encourage you to do the same (even if you, like I, don't have much hope in the electoral process). I'd add that Edwards is the only real candidate out there who understands that this is the case not only with the health insurance industry, but the oil industry, the defense industry...all of them. He's the only one who understands class (which is why his chances of ever getting nominated for anything is virtually nill).
It's way past time for hard working Americans to once and for all take on these corporate suits and send them packing. It's time to put an end to their huge saleries and bonuses and treat them like the criminals they really are.
In the past two days I've been writing about dealing with senseless violence and crime in the Oread Daily. Well, friends what Blue Cross of California is doing to this young man and his family is just that and needs to dealt with as such.
The following is from XETV in San Diego.
INSURER REJECTS APPEAL FOR INJURED FOOTBALL PLAYER
The family of injured high school football player Scotty Eveland is said to be devasted. Late Wednesday afternoon, they received final word that their insurance company, Blue Cross of California will not pay for Scotty to stay in the Acute Rehab Unit at Palomar Hospital.
On Tuesday, Scotty's family allowed him to be photographed by the media for the first time since he suffered a critical brain injury during a game last September.
The teen had spent weeks in a coma and on life support. He's now awake and breathing on his own.
His family and docters say he's making progress, thanks to the intensive therapy he gets at the hospital.
But Blue Cross doesn't share that assessment, saying Scotty's "insufficient progress" warrants his being moved to a skilled nursing facility.
His family and doctors fear that move will destroy any chance of further improvement and may even cause Scotty to regress.
They've pledged to appeal the matter the State Insurance Commissioner.
Supporters of Scotty protested outside his Escondido hospital Tuesday over Blue Cross of California's decision to suspend further acute rehabilitation care.
The insurance company wants to discharge Scott Eveland from the Palomar Medical Center's Acute Rehabilitation Unit to a less-costly skilled nursing facility, according to the linebacker's mother, Diane Luth.
In a statement, Blue Cross of California said on Tuesday that Eveland's family has the right to appeal the decision.
Internal and external medical specialists, including a neurological rehabilitation expert, will now review the case, according to Blue Cross.
"In the meantime, Scott Eveland will remain in Palomar Medical Center and Blue Cross continues to cover his medical care," the statement read. "We are committed to having him stay until the completion of the appeal process. Since this injury occurred to Scott Eveland in September, Blue Cross of California has been and remains committed to providing the most appropriate coverage towards his recovery."
In a letter to Blue Cross of California, Luth said her son has "shown leaps and bounds progress" in his treatment at the facility.
"I think it would be detrimental, if not tragic to my son if you didn't at least allow him four additional weeks to show his continued progress at Palomar acute rehabilitation," Luth wrote.
The 18-year-old has been at the Escondido hospital since he collapsed during a game in September, just after starting his senior year at the school.
Eveland suffered a subdural hematoma, which causes blood to collect around the surface of the brain and swelling of the brain, and was in a coma when he arrived at the hospital.
He has since emerged from the coma, is off life support and is undergoing daily therapy, according to his mother. She said he continues to make progress, including moving his legs, interacting with family and speaking.
About a dozen family members and friends protested outside the hospital, carrying signs in support of Eveland and chanting "Let Scotty Stay."