The Cutting Edge

Here in the United States we have some of the best surgeons, specialists, and some of the best, most innovative treatments in the world. 

But when the company that runs your health plan refuses to authorize these treatments, what does this mean for the very progress of medicine in this country?

In this episode of ERISA Watch, host Elizabeth Hopkins speaks with Aaron Monheim, a 34 year old husband and father of a three year old daughter. Aaron lives with Relapsing- remitting Multiple Sclerosis.  

Aaron tells Liz the story of his diagnosis of  and its affect on his life.  All of Aaron's signs showed that he was the perfect candidate for a certain  type of stem cell transplant that would give him the best long-term outcome. Unfortunately for Aaron, the decision makers at Kaiser did not agree. The treatment was deemed experimental and Kaiser refused to authorize these treatment. 

Elizabeth and Aaron discuss the irony of the fact that even though this stem cell treatment would likely work, and is considerably less expensive than the pharmaceutical counterpart, insurance companies would rather we all use treatment options that are repeatable, and are something we would pay for for years and years.

Although in some cases when refusing to authorize treatments, insurance companies have a legitimate foot to stand on. But the problem of standing on one foot is balance.

Please enjoy, and be on the lookout for our next episode on June 4