A Doctor's Problem With Our Health Insurance System

My doctor, Dr. Richard Goldberg, is one of the best doctors in Manhattan and has written to me about a problem that has touched all of our lives in one way or another--but in his family, it has hit hard in a very deep and profoundly painful way. This is his personal, heart-wrenching story about his travails with our nation's health insurance system. Here is Dr. Goldberg:

"Thank you for taking the time to hear about my son's crisis with corporate America. As you are aware, Dylan lost his leg in a motor vehicle accident five and a half years ago. He was in a new Saab, belt on, no drugs/alcohol/cell phone and swerved to avoid a deer.....He lost his leg (high above the knee), and was in need of a prosthesis."

"At the time, the servicemen who were losing limbs in Iraq were shown on television running with their new computerized knees. I told Oxford, our insurance carrier, that he deserved one also. We were told it was not a 'covered item' After two appeals and being told that legal action was doomed to fail, I appealed to the NY State Insurance Commission who agreed that Dylan and all clients are entitled to this wonderful proven technology."

"Well, Dylan is now graduating from Johns Hopkins, majoring in Public Health, and attending the Bloomberg School of Public Health next year. This wonderful prosthesis has enabled him to walk with his classmates and dance with his friends. However, it has worn out....as all computer devices do. Oxford, however, has decided on approving 'one leg per lifetime--and according to the Connecticut Healthcare Advocates office, they have 'lived up to their 'bargain.' They informed me that no legal action could be taken."

"However, if we were New Jersey residents this item would be covered, because their legislature stated that if a physician feels a certain prosthetic or orthotic device was needed by a patient it would be covered. The Connecticut. Advocate's office recommended going to the 'court of public opinion.'""The reason for this letter is not truly one of need for health care reform, but I feel one of corporate greed. How much is enough? It appears to be the same theme in much of corporate America. Division heads seem pressed to go beyond sane thinking for profit. If you win at blackjack you are paid in chips at the moment. The casinos and the insurance industry are structured in a similar matter. The odds are on their side. But the insurance industry does not have to have pay out--using our laws and hoping you will go away. But enough is enough. This is my son's leg...."