Crown says cancer patients denied treatment

‘Uneven’ access to treatment for some patients depending on their health insurance

Prof John Crown:  said a patient battling malignant melanoma had been deemed appropriate for the drug, Ipilimumab, but the insurance company, GloHealth, had informed him that it would not cover its members for the treatment.

Prof John Crown: said a patient battling malignant melanoma had been deemed appropriate for the drug, Ipilimumab, but the insurance company, GloHealth, had informed him that it would not cover its members for the treatment.

Wed, Jun 19, 2013, 01:00

MICHAEL O’REGAN

Some cancer patients with private health insurance were being denied treatment they assumed they were covered for, Prof John Crown (Ind) claimed.

He said there was “uneven access’’ to treatment, depending on the insurance company. People paid a premium all their lives in the expectation of legally approved treatment available in the public system.

“Their doctors, after a process of appeal to the company fails, have to discharge them from the private system and bring them to the public system where the treatment is given at taxpayers’ expense,’’ Prof Crown added.

He said a patient battling malignant melanoma had been deemed appropriate for the drug, Ipilimumab, but the insurance company, GloHealth, had informed him that it would not cover its members for the treatment.

“One could understand if there had been some failure of approval of this drug,’’ Prof Crown added. “However, it has been approved for routine use.’’

He said that Minister for Health Dr James Reilly had courageously and correctly decided, at a time of mounting financial pressure, that the treatment would be available to public patients. He did not know what pressure the Minister could bring to bear in terms of insurance company approvals.

John Kelly (Lab) said it was a major concern that people changing health insurance companies did not real the small print.

Catherine Noone (FG) said she had worked for many insurance companies in previous employment.

“Their practice is generally to avoid paying when they can; that is just how they operate,’’ she added. “People should be warned that they should read the small print.’’

Ms Noone said that, in many instances, people only found out about problems with their health insurance cover when they were unwell and vulnerable. The House should debate the issue, not least because of the serious rise in the cost of health insurance.