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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2007HMO Blue Denies Clinical Trial - Cancer Claims Firefighter
Houston Firefighter Dies after Insurance Battle HOUSTON, Texas Thursday, August 16, 2007 11:24 CDT A 35-year veteran Houston firefighter who led a courageous fight to get insurance companies to cover clinical trials has died. Local 2 investigates first introduced you to Steve Jahnke earlier this year as he battled cancer and the city's insurance company. All he wanted was a chance, but his insurance company would not cover a clinical trial that he hoped would save his life. Now his death marks the end of the long-running Jahnke era at the Houston Fire Department. "You either fight them or your give up," he said earlier this year. Jahnke is no stranger to fighting. For 35 years, he battled blazes as a Houston firefighter. But 10 months ago, Jahnke began a new fight against Stage 4 skin cancer. He and his wife Renee soon found out the cancer was not the only battle ahead. "Steve needs this chance, that opportunity to save his life," Renee Jahnke said. You see, chemotherapy didn't work, so MD Anderson Cancer Center approved Jahnke for a clinical trial -- a study testing two drugs sponsored by the National Cancer Institute. But a small clause in the city's health insurance plan, HMO Blue, allowed the company not to pay for potentially life-saving treatments because clinical trials are considered experimental or investigational. "They're being denied clinical trials that could save their lives," Renee Jahnke said. The Jahnke's appealed to HMO Blue, but in the months it took for a final decision to be made, Jahnke's cancer spread and he was no longer eligible to participate in the trial. Jahnke and his family still fought for others -- trying to convince both the city and state lawmakers to require insurance companies to cover clinical trials for patients fighting life-threatening diseases. Fighting for others has been a long-standing Jahnke family tradition. Jahnke's father, uncles and cousins all worked as Houston firefighters. Steve Jahnke was the last family member to work at HFD -- a proud tradition remembered now as an honored legacy. Steve Jahnke will be remembered for taking on courageous battles both in and out of uniform. His family hopes his final fight leads to long-standing change. Several city council members vowed to take up Jahnke's fight, but so far, there have been no changes to the city's insurance policy. We'll keep following it to see what happens. I've never heard of any insurance company paying for clinical trials. Typically grants and/or government dollars pay all expenses including travel to and from the trial site. The NIH for instance does this and there is usually no expense to the patient. I'm not often on the side of insurance companies but I can see their reluctance to pay for experimental trials especially when it is so easy to promote bogus shark cartilage and eye of newt "trials" by the less than reputable. As a payer of insurance premiums I have to side with the insurers on this one. Dave Perry On Aug 16, 10:31 am, "california_chief" <Fire_Chief@Jamacha_Junction_FD.ca.us> wrote: > Houston Firefighter Dies after Insurance Battle > HOUSTON, Texas [quoted text clipped - 58 lines] > there have been no changes to the city's insurance policy. We'll keep > following it to see what happens. Dave, as someone who has participated in a Phase II Clinical Trial, first at Baylor College of Medicine and now after its divorce, Methodist Hospital Research Institute, my insurance carrier pays. Insrance carrier payments is not unheard of at all and quite common based on my conversations with other trial participants. In fact, if my insurance carrier would not pay, I would still be able to participate. I can understand MD Anderson's position to not treat. I live in Houston. Something is not right. My best guess is that his cancer was too advanced to really have any hope. BTW, the Jahnke family is well known as a family of firefighter throughout the city's history. Gourd Dancer > I've never heard of any insurance company paying for clinical trials. > Typically grants and/or government dollars pay all expenses including [quoted text clipped - 78 lines] >> there have been no changes to the city's insurance policy. We'll keep >> following it to see what happens. > Dave, as someone who has participated in a Phase II Clinical Trial, first at > Baylor College of Medicine and now after its divorce, Methodist Hospital [quoted text clipped - 100 lines] > > - Show quoted text - Dave, it's obvious you've never lost anyone to illness. FYI, the company who owns BCBS actually does cover clinical trials in other states, Texas just happens to be one that slipped through the cracks. If this was some random clinical trial from some random hole in the wall clinic nobody has ever heard of, I'd understand insurance not wanting to cover it for fear of shark cartilage and crap like that. But this was MD Anderson Cancer Center. People come from all around the world to get treated at MD Anderson. Do you really think they're going to shoot someone up with eye of newt? AND, Steve Jahnke was a firefighter for the City of Houston for 35 years. He was a District Chief. As a City of Houston firefighter, he didn't earn a huge salary, so in order to provide for his family, he always had at least two jobs (and yes, DAVE, Steve Jahnke also paid his insurance premiums). He dedicated his life to helping and serving people, saving the lives of countless numbers of both friend and stranger. How did the City of Houston repay him? Oh wait, they didn't... Gourd Dancer, you said maybe Steve's cancer was too far advanced to have hope? It wasn't. It was bad, but there was hope. Steve's doctor (from MD Anderson) wrote a letter to BCBS telling them how aggresive melanoma is, and how urgent it was that Steve get proper treatment right away. In the letter, the doctor stated that he felt this clinical trial might be the only way to save Steve's life. For some reason, nobody at BCBS understood the meaning of the words "aggressive" and "urgent." After TWO MONTHS of Steve's wife calling BCBS daily, she was finally able to speak with a woman called Theria Malone. Their conversation has led many to believe that THERIA MALONE and those who work with her, are complete idiots. Theria said that she didn't understand what that letter meant. She actually told Steve's wife, that the letter was unclear and that she needed more time to do further research. I will again state that this was after TWO MONTHS of endless phone calls and getting the run around. Gourd Dancer, you also stated that "Something is not right." The only something not right with this situation is that the system is jacked up! The story is long and complicated, but my understanding is that MD Anderson would have let Steve participate in the clinical trial anyway (paying through a grant or out of pocket), but Steve's insurance basically threatened not to cover any further tests or treatments if he participated in the clinical trial without their approval (no matter how it was paid for). The letter BCBS sent said something about if he participated in the clinical trial, even paying out of pocket, then BCBS would not cover any more tests or treatments having to do with his cancer. Steve didn't want to leave his family in debt trying to pay the bills for future treatments, and so he chose to go through the appeals process with BCBS. That appeals process took two months. Two months is all it took for Steve's melanoma to spread to his brain. TWO MONTHS is the something that isn't right in this situation!!! In case anyone reads this and decides it's a great story to use for supporting national health coverage, please don't. Steve and his family all feel that yes, the health insurance system in America is jacked up, but Steve NEVER supported national health coverage! It would be a terrible act of disrespect and dishonesty to use his story in that way. > Dave, it's obvious you've never lost anyone to illness. Actually I have and I don't think it was obvious. I retract my blanket statement regarding insurance companies not paying for clinical trials. Apparently they often do and as policy too inspite of Mr. Jahnke's experience. My original response was triggered partly by my 89 year-old mother's experience fighting breast cancer which has caused me to be quite cynical of many aspects of medical care in this country. Her private doctors think nothing of sending her off for every test under the sun whether there's any medical value in it or not. How about a breast ultrasound to detect cancer - ridiculous. Of course you and I paid $750 for that plus what the doctor squeezed out of the same insurances (medicare and blue cross) by simply checking off a box on a form requesting the ultrasound. Last year she developed a weakness in both legs after a minor outpatient surgery from which she was slow to recover. What she needed, which was obvious to me and to some medically knowledgeable friends, a doctor and a nurse, was some physical therapy to get things going again. Mom's doctor insisted on a return to the hospital "just to be sure." What she got was a six night stay in the hospital where she was given an array of tests including brain scan, cardiac ultrasound, blood work, x-rays, etc., etc., again "just to be sure" according to her doctor. Final diagnosis: Minor stroke which is bull**** and which left the medically knowledgeable shaking their heads. Who ever heard of any stroke, major or minor, affecting the lower half of your body and not the upper half. It's always one side or the other. The little bit of physical therapy she received in the hospital - doctor's comment, "We might as well give her some physical therapy too, it won't hurt," - is what got her back on her feet and which was all that was needed in the first place. By the way, the last test, the cardiac ultrasound, was scheduled for the morning of her last day (after four nights) and then she could go home. At about 2PM, the nurse came in and said it would not be done that day but the next morning, first thing. The nurse said mom might as well stay another night since it was already paid for - if you're not checked out by 11AM medicare pays for the next night anyway, no sense in going home and returning the next morning, she said. The next morning no technician but she finally arrived at 1PM. Guess what, you and I ended up paying for yet another night since mom wasn't checked out until after 11AM. So, a four night stay which wasn't required in the first place turned into a six night stay for the insurances to say nothing of the tests that were run. Of course her doctor stopped in every morning for a couple of minutes to see how mom was doing - a $200 charge each day for the insurances, another $1200. So, while I'm no fan of insurance companies, they (meaning you and I) are getting screwed royally by our existing medical system so when someone comes along boo hooing about no coverage for this or that, I have to look with a jaundiced eye. It appears Mr. Jahnke was not one of these and that he indeed got screwed. But, I hope you can see where I'm coming from. When doctors say they are practicing preventive medicine, what they are preventing is malpractice lawsuits. Ah, now we can attack the lawyers. It never ends. Dave Perry Thanks. I read a rather lengthy article after the post. I did have a typo, though... can should have been can't in reference to MD Anderson decsion to not treating... As the article read, when final approval by the insurance to cover came, two months after the denial, it was too late to participate in the trial at MD Anderson as the cancer had spread too far. I am surprised, and hope that I never experience a threat by an insurer to drop if treatment occurred. I wonder if Bill White is aware of the situation...... Gourd Dancer >> Dave, as someone who has participated in a Phase II Clinical Trial, first >> at [quoted text clipped - 178 lines] > would be a terrible act of disrespect and dishonesty to use his story > in that way. |
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