One of the worst abuses of the private health insurance industry is its practice of denying claims to pay for necessary care for patients. This practice has become so rampant in the industry that a recent study by the California Nurses Association found that a whopping 21 percent of all insurance claims filed in the first half of 2009 in the state of California were denied by insurers.
As the story of six-year-old Madison Leuchtmann of Franklin County, MO, demonstrates, even children are victims of this insurance company abuse. Madison was born with bilateral atresia, which means she lacks ear canals in both ears. In order to hear, she wears a special device on a headband that allows her to make out sounds. Despite her disability, Madison is at the top of her kindergarten class and is slowly learning to read.
Yet Madison, due to her growth, will soon require a new hearing implant to be able to recognize sounds. Her hearing and speech therapist warns that “if she doesn’t get her implants by age seven, she’s not going to be able to blend her words. … She won’t be able to hear herself [talk].” Madison’s pediatrician, Dr. Randall Clary, also insists that without the implant, the girl may never be able to hear again.
Unfortunately, the Leuchtmann’s family insurer, Cigna, has issued “one denial after another,” flatly refusing to cover the $20,000 bill for the implant. In a written statement to the local news station Fox 2, Cigna explained, “It is not unusual for commercial benefit plans to exclude hearing assisted devices,” prompting Dr. Clary to angrily respond, “This is obviously medically necessary. You have a child that has no ear canals!” Dr. Clary also told Fox 2 that he sees these sort of denials “on a weekly basis.” Watch Fox 2’s report:
The United States is the only developed country without a universal, cradle-to-the-grave health care system. In no other developed country would a girl be on “the verge of never hearing again” because a for-profit insurance company decided that its bottom line was more important than keeping a child from going deaf.