Column: His doctors ordered an emergency
flight by air ambulance. His insurerwouldn’t pay
Los Angeles Times,
by
David Lazarus
Original Article
Posted By: earlybird,
10/8/2019 6:41:33 PM
Rancho Palos Verdes resident Carrie Hassanzai contacted me the other day about her 18-year-old son, Ethan, who has cerebral palsy, autism, epilepsy and other serious ailments. He requires a shunt to drain fluid from his skull because of brain surgery.
“He is a severely, severely disabled child,” Hassanzai told me.
About a year ago, Ethan began vomiting and having what seemed like seizures. Hassanzai feared that her son’s shunt had become clogged — a potentially fatal complication.
She and her husband, Moe, a Los Angeles Police Department detective, rushed their son to the emergency room at Torrance Memorial Medical Center.
I'm sure Medicare-4-All would have covered the bill...maybe even transported him first class. Funny how these sob stories ALWAYS have more than one side.
2 people like this.
Reply 2 - Posted by:
earlybird 10/8/2019 6:56:37 PM (No. 201614)
Surface transport was warranted. Insurance would have paid for it. Helicopter was not. Those doctors who were with him at the time contend he was not an emergency case.
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Reply 3 - Posted by:
jalo1951 10/8/2019 7:04:19 PM (No. 201628)
There is no way I can comment medically on this patient's condition. For me that is not the issue. The world is full of sad medical stories. However, that is no reason to blow up our healthcare system again and completely screw us all over one more time. Do you really think the government would do a better job? Uh, no. Chances are they would look at his medical history, determine he had way too many complications and surely his quality of life sucks so he would be denied the air transport. Check out the stories from the UK and just see how many people are denied care for various reasons. One I remember was a young man who needed a liver transplant. But because he was overweight he was denied placement on their transplant list. He did die. Yes, not everyone who is on the list gets a transplant but at least you are hopefully getting the chance of one. This young man was ruled out completely. Yes changes need to be made by not by these nut job democrats "promising" free everything.
4 people like this.
Reply 4 - Posted by:
Jethro bo 10/8/2019 7:08:07 PM (No. 201630)
So we are expected to pay $2500+ a mile for a 20 mile trip because of some doctors 'feelings'. Thanks to Obambicare, I can now barely afford insurance. But if every transportation was $2500+ a mile, can anyone afford it? What is gonna happen to my cost when doctors 'feels' some desperate terminal patient needs a $250,000+ drug? More likely the amily demands it. Oh yes, there are plenty of those out there. Think expensive common things like dialysis. Or a $120,000+ drug a year? Will my near $20,000 a year in insurance cost got up 50%? 100%? 200%? When it comes to insurance, WE THE PEOPLE pay the bills, not an insurance company.
1 person likes this.
Reply 5 - Posted by:
dadofboys 10/8/2019 7:29:02 PM (No. 201640)
The Air Ambulance business is a huge racket. As is transporting patients between hospitals for procedures and convenience of the doctors. I am a hospital based physician and I see this abuse all the time.
8 people like this.
I just read the article. It doesn’t say “his doctors” did not order the helicopter. Where did you see that? Let’s not make things up. You don’t know the whole story.
1 person likes this.
Reply 7 - Posted by:
NHChemist 10/8/2019 7:50:32 PM (No. 201656)
This has gone on for many years. 20+ years ago a coworker called his doctor because his child was sick. The doctor said "Take your child to the Emergency Room" so he did. He then got hit with a large ER bill because the insurance company said the ER was not medically necessary. Maybe the doctors should have to pay when the insurance denies coverage. We are told to listen to our doctor's instructions to maintain our health, yet they do not shoulder the responsibility of bad decisions unless malpractice is charged. BTW My father was a physician with no malpractice awards.
2 people like this.
Reply 8 - Posted by:
earlybird 10/8/2019 8:00:18 PM (No. 201661)
Re #6, I do not make things up.
FTA:
The story from the Torrance ER (near where the patient Ethan Hassanzai and his family life) onward.
"Hassanzai said the ER doctor on duty felt unsuited to handle the scope of Ethan’s issues. She asked where he’d had his earlier brain surgery — UCLA — and immediately contacted the Westwood facility.
“There was a pediatric neurosurgeon at UCLA, and he said they’d send an ambulance for Ethan,” Hassanzai recalled. “We didn’t know it would be an air ambulance.”
Ethan was flown 20 miles north, treated and released after two nights in UCLA’s intensive care unit. (Snip)
Leslie Porras, an Anthem spokeswoman, acknowledged that “the need for transfer to another hospital and ground transportation was covered” by Ethan’s insurance.
“However, based on the review of the case and the hospital records, Mr. Hassanzai was stable in his vital signs and exam while he was in the emergency room, and when he was transported to the receiving hospital,” she said.
“In accordance with our medical necessity criteria outlined in our policy, air ambulance transportation was not medically necessary in this case and ground transportation was appropriate for his care.”
All of the doctors on either end, from the initial ER through the UCLA hospital (none of them “his doctors”) said he was stable. The doctor who ordered the air ambulance was not “his doctor”. "
Nowhere in the article are “his doctors” mentioned except by the LA Times.
3 people like this.
Look all I’m saying is be careful when extrapolating. I’m on the same side and agree with your policies. If patient was a prior patient at UCLA, could it be that he already had “his doctor” there and that “his” doctor gave the order. That’s all I’m saying. You nor I know the entire story.
1 person likes this.
Reply 10 - Posted by:
earlybird 10/8/2019 8:34:48 PM (No. 201683)
Some more FTA:
Hassanzai says the family pays $97 a month in health insurance premiums. And to be sure, Anthem covers most claims for a teen with very serious medical issues.
Read this young man’s conditions again. Dad is an LA police detective, hence the excellent insurance they have at a very, very low premium. It’s also worth knowing that they live in a $1.250 million house in Rancho Palos Verdes.. I imagine each has a car that cost more than $51,000.
2 people like this.
Reply 11 - Posted by:
jimincalif 10/8/2019 8:38:04 PM (No. 201687)
Prayers for Ethan and family, what a difficult situation. I have no idea if air transport was medically warranted, but for those of you not familiar with SoCal traffic, a weekday 20 mile surface trip anywhere around the west side of LA is a 1 to 2 hour ordeal. Doesn't matter if it is on the freeway or side streets. Velocity made good is rarely more than 15 miles in an hour and can be much slower. Weekends are only slightly better.
5 people like this.
Where they live and what kind of car they drive has nothing to do with this. How on earth did you discover where they live? It’s kind of creepy, eh?
1 person likes this.
Reply 13 - Posted by:
earlybird 10/8/2019 9:24:18 PM (No. 201702)
I know Rancho Palos Verdes. The Hassanzais could have afforded it. With that very ill son, they still pay less than $100 per month for insurance. They obviously would not have ordered a helicopter for their son had they known it would cost $51,000. An ambulance would have been just fine with them. There was no emergency. Just a complex patient who needed observation at an appropriate facility not that far away.
Lazarus decided to turn this into a sob story. It didn’t work.
Now I will follow advice given to me nearly 20 years ago by a wise fellow LDotter: “Sometimes you just let the puppy have the sock…"
4 people like this.
Reply 14 - Posted by:
zephyrgirl 10/8/2019 9:26:27 PM (No. 201704)
So because of this case and a few others, everyone else's health insurance must be abolished and the government take over???? #3 is correct - he probably would have languished in a corridor for hours under the United Kingdom's NHS, once they determined he wasn't in critical condition (and maybe even if he was).
2 people like this.
Reply 15 - Posted by:
Jsb405 10/8/2019 11:11:11 PM (No. 201763)
The city/county is either self insured or such a large client that one word from the plan administrator and this bill is paid. Second, the ćounty and or the insurer is breaking rule number one which is never freak with a child’s health. Messing with children is always a losing proposition and expensive and a PR loser. How stupid.
0 people like this.
I am surprised they did not pay after the appeal. She can always take it to the insurance commissioner. it's not like the mother ordered the air ambulance herself. Let's not be so hard hearted. Her child was very ill and all of this was in the heat of the moment. Keep in mind most ER physicians are not on any plan, just like anesthesiologist. You have to fight to get the bills paid.
The physician who ordered the air ambulance has nothing to say ?
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“His doctors” did not order the helicopter. The ER doctor at Torrance did not feel “suited” to Ethan’s multiple problems Asked where his brain surgery was done, the parents said UCLA Medical Center. A call was placed and a neurosurgeon there said they would send an ambulance. It turned out to be an air ambulance. Tab $51,000. Insurance rejected claim as unwarranted. Lazarus is taking position that insurance should have paid. But the ER at Torrance is saying there was no emergency, that the young man was stable. The distance: 20 miles. One wonders how long it would have taken to transport him there by surface ambulance, with some use of sirens if necesssry (though he was not considered to be an emergency at that point). A compromise is apparently in the works, though Lazarus had to pretty much bury that as it would have spoiled another of his “ain’t it awful” SJW narratives…. It’s also pretty clear that neither of these facilities - one that had seen him but believed his conditions were not their forte and another who hadn’t seen him that day - had to protect themselves from the lawsuits the Lazaruses feed with their reporting.