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Medicine

Anger at Health Insurance Prompts the Public to Fund a 9-Year-Old's Bionic Arm (yahoo.com) 236

A 9-year-old girl born without a left hand had "started asking for a robotic arm to help her feel more confident," her mother told the Washington Post. So her parents met with a consultant from Open Bionics, which fits people with lightweight, 3D-printed prostheses that function more like a natural arm and hand — known as Hero Arms. The bionic arms are manufactured in Britain and cost about $24,000, but the Batemans were hopeful that their health insurance company, Select Health, would pay for one for [their 9-year-old daughter] Remi. Remi said she tried using one of the robotic arms for a few days in Colorado and was thrilled to cut her food with a knife and fork for the first time and carry plates with two hands. "I loved it so much — I could function like a full human," she said. "I was able to steal my dad's hat. When they fit me for my arm, I told them I wanted it to be pink."

On Oct. 1, the Batemans sent a prescription for the robotic arm and office notes from Remi's pediatrician to Select Health for approval. One week later, their request was denied, Jami Bateman said. "They sent us a letter saying it was not medically necessary for Remi to have a Hero Arm and that it was for cosmetic use only," she said. "We appealed twice and were again denied."

"It was very upsetting, and Remi cried when I told her, because we'd all been so hopeful," Bateman added. "It broke our hearts." In mid-December, a frustrated Jami Bateman tried an approach she'd seen other people use when their health insurance failed them: She started a GoFundMe for her daughter, hoping to purchase a robotic arm through the kindness of strangers.... Bateman was stunned when friends and strangers chipped in more than $30,000 in just a few days, surpassing the family's $24,000 goal. People who donated understood the Batemans' predicament, and many were furious on their behalf.

As donations poured in, the Batemans received a call from somebody else who wanted to help. Andy Schoonover is the CEO of CrowdHealth, a subscriber-based resource that helps people negotiate lower costs for medical bills. He told the family on Dec. 16 that his company wanted to pay the entire cost of Remi's bionic arm. "We were looking for some ways to help people during the holiday season, and I stumbled upon Remi's story on social media," Schoonover said. "We were honored to help her out...."

Remi quickly came up with an idea. "She came to me and said, 'Mom, I know how it feels to have one hand. Is there someone else we can help?" Bateman recalled. She said she contacted Open Bionics and learned there was a long list of children who had been turned down for Hero Arms by their health insurance companies for the same reason Remi was denied...

Somewhere in Maryland, the mother of a 9-year-old boy born without a left hand suddenly got a surprise phone call explaining Remi's decision. "I was so proud of Remi that I immediately started crying," she said. "She wanted to give my son an opportunity that I was unable to give him. It just touched my heart."

They had been trying to raise money by running a lemonade stand. But yesterday Remi's GoFundMe page posted an update. The 9-year-old boy's arm had now been paid for.

"And maybe, if more donations roll in we can help a third child!"

Anger at Health Insurance Prompts the Public to Fund a 9-Year-Old's Bionic Arm

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  • by LordofWinterfell ( 90845 ) on Sunday December 29, 2024 @07:41AM (#65047253)

    Because they still donâ(TM)t have to pay for the damn arms.

    We need to raise GoFundMe funds to lobby Congress to pass universal healthcare.

    • Hmm, children grow very fast. These prosthetics will be too small pretty soon.
      • That's why you give them the cheapest, most generic prosthetics that are still useful to them. Maybe with expandable bits, maybe able to hand 'em down to the next kid when the current owner outgrows them.

        Of course, "useful" is already an almost impossible barrier to overcome. A natural healthy human arm is a damn amazing tool, and can't really be replaced by strapping on a dead weight with a slow grasping device triggered by a muscle twitch sensor on a stump.

        • by mysidia ( 191772 )

          They will need to be replaced with larger ones, eventually. Once the kid grows to a point where they are less effective than a new set would be or cannot be used.

          They are in fact medically necessary to provide high-quality care for their condition.
          And no you don't restrict them to generic inexpensive prosthetics, because that is a low quality of care.

          And I would say the insurance company should have to pay for them -- that is their job.
          The insurance company just doesn't want to pay money.

          Skimping on necess

          • Just because the US spends 2x as much on healthcare for similar outcomes as comparable countries doesn't mean the available money is infinite.

            Somebody has to sit down and do the analysis to decide how the funds are best allocated based on cultural values, and ultimately nobody's going to get all the money to themselves. Somebody will be 'shortchanged', probably everybody to some degree.

            Unless a prosthetic is 99.9% reusable and can serve multiple children in turn, it makes no sense to give a kid a top of th

        • by taustin ( 171655 )

          Of course, "useful" is already an almost impossible barrier to overcome. A natural healthy human arm is a damn amazing tool, and can't really be replaced by strapping on a dead weight with a slow grasping device triggered by a muscle twitch sensor on a stump.

          I know a guy (now in his 60s) who was born with no left hand. I knew him about a year before I realized it, because that was his natural state. He was so well adapted to it, that it wasn't obvious until he was trying to do something that really requires two sets of fingers (buttoning a shirt cuff, IIRC).

          When he was young, he was fitted with what was then a state of the art artificial hand. He tried it, and it's been sitting in a drawer since. He told me once that the only thing he could imaging using it for

          • >I agree that this rewards the insurance company for denying coverage.

            I really don't get these 'GoFundMe' stories as 'feel-good' stories. Each and every one is about a massive failure. Sometimes it's a societal one, sometimes a personal one, but rarely is it just some random bad luck for which there were no reasonable financial precautions to be taken.

            Every time you see a donation campaign for someone with a health issue, you should be ashamed of your healthcare system and angry at the people who keep

      • Hmm, children grow very fast. These prosthetics will be too small pretty soon.

        I was thinking the same.

        Was the insurance company wiling to buy a lower cost but less "cosmetic" prosthesis? If so then I can understand why a claim for a custom 3D printed prosthesis that cost $24,000 would get denied. There would likely be a claim like this every year until the patient matures in 10 years or so. That's a lot of money.

        Wasn't there some news recently on hearing aids? The issue was that hearing aids cost a lot of money because they were regulated as medical devices versus something else.

        • If so then I can understand why a claim for a custom 3D printed prosthesis that cost $24,000 would get denied.

          If it doesn't get denied, somebody will go into business making a $50,000 arm that's just a little bit better and then stir outrage when that is determined "not medically necessary." We simply haven't accepted any rational basis for what medical expenses are justified given cheaper alternatives etc.

      • My god, how will a company like United Healthcare ever survive? https://www.macrotrends.net/st... [macrotrends.net]

    • by mysidia ( 191772 )

      Not universal healthcare.. We need a law that Penalizes all improper denials by insurance companies with Treble damages plus all litigation costs and additional penalties and sets the default legal presumption that all Denials by an insurer of procedures prescribed by qualified medical professionals are both improper + in bad faith, and if the denial was actually merited they can try to prove its legitimacy.
      .

    • Because they still donâ(TM)t have to pay for the damn arms.

      We need to raise GoFundMe funds to lobby Congress to pass universal healthcare.

      I've said this for a long time. Given that the government runs on baksheesh, the people can band together and buy some politicians. Once you own enough politicians, they will obey.

    • That's how much the private insurance companies spent on lobbying The last time we did significant health care reform.

      Universal healthcare would require a fundamental change in our culture. The idea that you shouldn't have to pay for somebody else to have something would need to go. The argument that universal healthcare makes doctors slaves would have to be seen as ridiculous by the majority of the population.

      It's tough to do that because there's an animal instinct for fairness that can be exploite
      • by ac22 ( 7754550 )

        Insurers spent $117M on lobbying last year. If they kept that up for 1000 years, they would still not have reached your improbable "half a trillion" claim.

    • Can someone please explain what "Select Health" is? Did they mean "SelectHealth"? Yes, these sorts of things matter, they managed to get the spacing on that CrowdWhatever company correct...

    • Maybe you could have got the Funny mod you deserved if you remembered that Slashdot is font crippled?

      You also touched on a couple of serious issues, but I don't think you got anywhere close to insight, but perhaps that was FP haste and brevity?

      For-profit healthcare is sick and "earns" larger profits in all the wrong ways. By letting sick people get sicker. By not curing "profitable" diseases. But mostly by favoring long-term treatment over accurate diagnoses that lead to short-term cures. Killing patients w

  • by sinkskinkshrieks ( 6952954 ) on Sunday December 29, 2024 @07:43AM (#65047259)
    It's like a random lottery windfall by happenstance than care for all of the desperation of millions of people who don't win big on social media pity/outrage. That isn't fair, good, ethical, or moral and a shame that more isn't done consistently for those in need. It's a sign that the over $50 trillion stolen by the billionaires needs to be returned and reinvested in the needs of the people so they aren't left homeless or impoverished to where they have to beg for help from strangers who also don't have much wealth either.
    • by alvinrod ( 889928 ) on Sunday December 29, 2024 @08:37AM (#65047347)
      Sorry to get in the way of your screed, but the ACA mandates that a percentage of premiums be spend on medical care (this is referred to as the Medical Loss Ratio within the law) so any approval made and paid is money that doesn't go towards some other approval. If this girl received her arm then there would only be someone (or even multiple people) who would be in the same situation.

      I am not aware of the particulars beyond the summary, but perhaps I could try to reason out why this claim was denied. One immediate possibility that jumps out is that the patient was is only nine and will continue outgrowing any robotic limb. I'm assuming that doesn't require replacing the entire device at full cost each time, but it's not something that grows with the individual.

      Regardless of that, there's no perfect system that will produce infinite medical care on demand in the manner which you want. This may be upsetting to you or others, but it's simple reality. The U.S. cost more, but has some of the shortest waiting times for seeing specialists and for major surgeries. It's typical for wealthier Canadians, for example, to get treatment in the U.S. simply because it's quicker. There are also too many people who mistake the absence of a bill to be paid for the notion of "free" healthcare as though taxes don't exist.

      I'm sure some will also mistake my post as a defense or an endorsement of the U.S. system, which it isn't. Like too many other systems (e.g. education) it has become overrun with administrators and bureaucrats that only get in the way of the actual providers. Worse still those parasites have become so imbedded that making change has become difficult as they lobby government for rules and regulations that enable them to remain in place so they can keep funneling money to politicians who function similarly.
      • Re: (Score:3, Informative)

        by mysidia ( 191772 )

        but the ACA mandates that a percentage of premiums be spend on medical care (this is referred to as the Medical Loss Ratio within the law) so any approval made and paid is money that doesn't go towards some other approval.

        Incorrect. The ACA sets a MINIMUM of 80% of premiums must be spent on care not a maximum. If they aren't meeting that ratio they would be forced to lower premiums or find a way to spend more money on their policyholders' care. The mandated ratio is nothing more than a cap on their maxi

        • "The mandated ratio is nothing more than a cap on their maximum profit "

          It's not even that, it just a limit on the profit than can be taken directly from the premium overages because THAT'S NOT HOW YOU MAKE MONEY UNDERWRITING INSURANCE.

          Pooling risk means you are converting random expenses to systematic cash flow. You can then reinvest the float. You just need a little bit of overage to cover some of the variation and then you buy reinsurance yourself for the outlier events.

      • I am going to blow your mind. Insurance companies get to use the pre-discount amount when they claim their government regulated medical loss ratio is within 80% to 85%. And yes, those discounts are dynamically chosen every quarter or so so they exactly meet this rate.

      • "This may be upsetting to you or others, but it's simple reality. The U.S. cost more, but has some of the shortest waiting times for seeing specialists and for major surgeries. It's typical for wealthier Canadians, for example, to get treatment in the U.S. simply because it's quicker."

        When calculating wait times, how to you weight the patient that was denied the procedure by their insurance company?

  • Insurance Companies: "Yeah, screw your mental health"
  • by Khyber ( 864651 ) <techkitsune@gmail.com> on Sunday December 29, 2024 @08:28AM (#65047323) Homepage Journal

    The welfare of the people is tasked specifically to the Government, not private entities.

    End this scam and hang every healthcare C*O, every major shareholder, the lawyers behind it all, the lobbyists making it happen, and maybe we'll start seeing real change in this country.

    Oh, and if you have Kaiser Permanente as your insurance provider - they're blatantly committing prescription billing fraud, and I have financial documentation via my bank to prove it.

    Kill 'em all.

    • Re: (Score:3, Insightful)

      by piojo ( 995934 )

      Kill 'em all.

      I'm not sure that's a precedent you want to set. First it's insurance CEOs. Next it's people that work in oil and energy. Next it's people that sell pesticides or operate LLMs or high frequency traders or right wingers or that guy that threw you under the bus in workplace politics. And certainly OB/GYNs, leaders of the wrong religion, vocal atheists, etc.

    • Thank you for limiting that to 'major' shareholders. I have a fair amount of evil in my portfolio, on the grounds that "if I don't, someone else will, and I like making money". A variation of the tragedy of the commons, I suppose.

      Anyway, I'd be happy to have those investments disappear as options (I'll simultaneously vote for politicians who promise legislation that counters my personal financial interest), but as long as they exist and are among the better investments, I'm going to keep investing in evi

  • by Pollux ( 102520 ) <speter&tedata,net,eg> on Sunday December 29, 2024 @08:45AM (#65047349) Journal

    There's a lot of problems in the American health care system, but this story exemplifies a particularly important one: everyone gets to move the goalposts.

    Companies invent a new medical device (Goalpost gets moved). Insurance company denies claim for treatment (Goalpost gets moved). Groundswell of parent and public complaints [potentially] pressures company to approve payment (Goalpost gets moved).

    But we have to do it, because "think of the children", right?

    And all the while, insurance gets more expensive for everyone. Because, who really pays when we give bionic arms to everyone who has a need for one? Everybody, because everybody pays for insurance.

    Ladies and gentlemen, America's health care system is the Titanic, and we all know where it's headed. I started negotiating with a union 20 years ago, and our biggest concern at the time was back-to-back 15% increases in health insurance premium rates. Back in 2004, our premium was $300 a month. Doing some quick math, I predicted a continued 15% increases in premiums set against 2.5% increases in salaries would lead to premium costs that were half our salary in 2037 and our whole salary in 2044. If a fresh-out-of-college math teacher could see that catastrophe on the horizon, I thought, surely someone would fix the problem before it's too late. Nope.

    Unlimited exponential growth is unsustainable. Eventually, people will be priced out of paradise.

    Until we have strict controls that put limits on what medical devices will be covered by insurance, and limit industries from setting ridiculous profit margins on devices because those costs are covered by insurance, industries will keep inventing more of them, and we'll all have to keep paying for them, and costs will keep going up.

    Because "think of the children". And think of the insurance bills we'll be burdening them all with by continuing this unsustainable game of moving the goalposts.

    • by mysidia ( 191772 )

      And all the while, insurance gets more expensive for everyone. Because, who really pays when we give bionic arms to everyone who has a need for one?

      This is not why insurance is expensive. Bionic arms are not new, and 30K is not a high priced medical procedure. $30,000 is about equivalent in cost to a one-day hospital stay with any common surgical procedure.

      • It's expensive, because nobody sets any limits.

        $30,000 is not expensive for one person. But we're not limiting this to one person, nor are we limiting the cost. Why not add more features and options and raise the cost to $300,000, or three million?

        With no limits to prices, prices know no limits.

    • You seem to be arguing that if something doesn't exist, it isn't needed. [wikipedia.org]

      I think the real problem is that the increased productivity from innovation mainly benefits the people at the top and doesn't trickle down. In other words, health insurance isn't good enough, we need something non-regressive like Single Payer.

      • I'm arguing that industries exist to invent things, not for the benefit of prolonging life or increasing quality of life, but for making ridiculous profit margins and getting insurance to agree to pay for it.

        Why do I need to pay $300 for an epinephrine auto-injector when its medicine only costs $1 [wtvm.com]? Why the hell does this exist [visualcapitalist.com]? Because nobody limits the cost. My government forces me to buy insurance that allows for that price to exist, because my premiums have to pay for it. And it also pays the insuran

    • And all the while, insurance gets more expensive for everyone. Because, who really pays when we give bionic arms to everyone who has a need for one? Everybody, because everybody pays for insurance.

      What a crock of shit. https://www.macrotrends.net/st... [macrotrends.net]

      They could pay for a 100,000 bionic arms and still turn a profit. Hell at that rate you'd get a better volume discount.

    • People hate the heartless math, but you sit down and figure out what an average human life is worth, then you figure out the costs of having them continue without help. Medical care up should be funded up to that calculated cost without question. It's just sound financial planning at the society level.

      Sure, sometimes you're spending money on somebody who will never be productive enough to make it back, but you'll also be spending money on people who would have made it back regardless. It evens out.

      Now, o

      • Calculating car insurance rates are easy, because every car has a defined value that depreciates in value over time (usually, COVID-irregularities aside). Calculating health insurance rates are ridiculously difficult, because costs are not defined. (Obamacare removed practically all limits to annual insurance payouts, which had existed previously. Now that they don't.)

        What is the price of a human? While it's impossible to settle a debate on how invaluable a human life is, we don't have to. There's a si

        • >There's a similar measurement where we calculate how much humans are willing to spend to reduce our risk of death.

          Since there's no perfect answer, I like this one as a potential 'good enough' or 'best we can likely manage'.

          Still... people are really bad at risk assessment and will spend a lot on incredibly unlikely things that frighten them, while not spending on things that are almost certainly going to bite them in the ass at some point.

  • by sinij ( 911942 ) on Sunday December 29, 2024 @09:00AM (#65047367)
    Healthcare insurance in US no longer operates as insurance - where risk is distributed across a large pool of people. Instead, it is aimed at minimizing payouts by all means possible and in doing so clearly crosses moral red lines and likely legal red lines. Personal risks to decision makers is one way to reintroduce accountability into the system. If I were on Luigi Mangione jury, I would push for jury nullification. [wikipedia.org]
    • And why is health care system the *"insurance"* in USA? Health is not something I can (decide to) live without like my crashed car or burned house. I do not pay for Police Department insurance or Fire Department use insurance or "need to use public road" insurance.

      • I've never heard of a place where the cops are optional, but fire I have. Don't pay your insurance, fire will respond only to protect your insured neighbors if your fire spreads too far.

        Since fire doesn't care about property lines, I consider that absolutely insane, but it is the reality in some places.

    • by taustin ( 171655 )

      If I were on Luigi Mangione jury, I would push for jury nullification. [wikipedia.org]

      If I were his lawyer, I certainly would. Not the right answer, but the jury may decide it's less wrong than any other option.

    • > If I were on Luigi Mangione jury, I would push for jury nullification.

      The problem is that Luigi didn't have insurance issues, and even if he had, he didn't go after the CEO of the company that he did business with. He just got angry about his medical outcome (which sucked, medicine is not magic) and picked a target.

      Now... he picked a good target. I shed not a single tear over that guy's death, he was an amoral bastard presiding over a company causing a lot of harm well over the acceptable line for a

  • Cheaper (Score:5, Funny)

    by rossdee ( 243626 ) on Sunday December 29, 2024 @09:03AM (#65047377)

    "The bionic arms are manufactured in Britain and cost about $24,000"

    The cost of bionics have come down a lot since Steve Austin's day.

  • Not sure about the funding, but wasn't this bionic arm created by a high school kid with help from Meta's LLama 3 AI? I saw it on the TV commercial: a fully functional exo-skeletal prosthetic arm and hand, sort of a web of lit-up smart material, perfectly articulated and controlled by your natural brainwaves (picked up and read at the the stump attach point). Just stick it on a stump and you're good to go! It looks like fucking sci-fi and is about 60-100 years more advanced than what we had before Meta ca

  • "...but the Batemans were hopeful that their health insurance company, Select Health, would pay for one for [their 9-year-old daughter] Remi."

    Wow, the Batemans were dumb as fuck. They actually thought insurance would pay for this without a fight to the death.

  • by gavron ( 1300111 ) on Sunday December 29, 2024 @09:37AM (#65047421)

    Please put these CEOs, COOs, and CFOs out of the collective misery.

    The US has the worst healthcare of any industrialized nation, but worse than that, there's no HEALTH and no CARE in healthcare.
    It's about maximizing the profit of the shareholders.

    You know what? How about healthcare companies not being allowed to be a public shareholder owned company. Make [legislate]
    them all to be public trusts... like utilities.

    Revoke the publicly traded company status.
    Remove the shareholders.
    Kill the C-suite leeches.

  • Would it be not cheaper to create GoFound to open source this and have it been build-able on demand? There would be tons of people wanted to help beyond money.

  • $24,000 is over twice as expensive as a traditional split hook prosthetic arm. She needs to learn how to use a split hook before she grows up and has to provide for herself. I knew a gid growing up that had a split hook and he had no problem using scissors or tying his shoes.

    • I believe there's a variant of the Hero Arm that can be had for around $6000... and for some reason 2x that in the US. Still, if you find a more complex prosthetic useful, maybe a flight to the UK for the purchase and fitting is in order if that's in your price range.

      I'd love to have a chat with a prosthetics designer about the current technology, because it seems to me if we'd just give up on the 'it must look realistic' part (which, if you look around, we have - obvious prosthetics can be 'cool' now), yo

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