Tuesday, August 13, 2013

Man Denied Lifesaving Treatment Over 26 Cent Payment Error

A New Jersey man's life is apparently not worth 26 cents.

Especially if that life affects the bottom line of his former employer and an insurance company, it seems to me.
Sergio Branco in this image from
The New Jersey Star Ledger. Insurance
snafus almost killed him.  

According to the New Jersey Star Ledger, Sergio Branco came down with leukemia and needed a bone marrow transplant. They found a good match for him, but it's an expensive treatment, costing maybe $500,000.

He took a leave from work, then was canned after Branco's illness left him unable to do his job. He could still get insurance through COBRA and the family was informed on how to make payments and for how much.

A May bill came to $518.26.  Branco's wife wrote a check for $518, accidentally leaving off the 26 cents.

For that mistake, the former employer and Paychex, a third party benefits administrator basically imposed the death penalty on Branco. They would not cover the transplant, according to the Star Ledger. 

You'd think the matter would be handled simply. Paychex, or whoever is running the show could have contacted the Brancos and said, "Hey Dufus! You forgot the 26 cents. Pay up now." If they wanted to be mean, they could have imposed some sort of $10 stupid charge on the Brancos or something.

I'm sure they would have gladly paid up. Nobody would let them, though.

Nope, despite the pleadings of the family, his doctors, it was no go. It was only after the New Jersey Department of Labor, the lawyers and media outlets like the Star Ledger began "meddling" in this situation did it appear Branco's transplant will be covered.

Yes, yes, the parties involved are blaming the whole thing on administrative errors, strict governance rules and that kind of thing.

To be honest, I don't buy it. I smell a big, fat rat.

I have no proof and I could well be wrong. (Please set me straight if I am missing some information here), but here's what my conspiracy-addled mind thinks what happened.  And to be fair, some of the parties might be innocent. Paychex might be under orders from an insurance carrier. Branco's former employer might have their hands tied by an insurance company. Or the employer might have mucked things up with the insurer.

But somebody's to blame.

And somebody would have had to pay for Branco's transplant. Maybe his former employer, or some insurance company thought the price was too steep, that it would cut into profits. Maybe piss off a shareholder or two.

If Branco had the common courtesy and just die of his leukemia and not make a big stink about it, everybody would be happy, goes the logic. Branco's family excepted, of course.

Once again, we have one of those cases where some bureaucrat trying to impress his or her boss with his budget consciousness to save the bottom line was willing to kill somebody with a pen or a stroke of a computer key to do it.

This seems to happen a lot. Often, the cases get media attention. Bad PR is even more expensive than high medical bills, or whatever, so once the journalists start to poke around, things get "resolved."

Have we come down to this? The only way to save an innocent man's life is to threaten somebody with bad press?

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