Thread by @IsTrumpCareDead

Four years ago tonight, I put my baby on a helicopter and prayed I’d see her on the other end of the journey.

She got very sick at home and we rushed her to the local ER who immediately contacted her cardiac team and arranged transport.

What we didn’t know at that moment is that she was having a major and rare complication from her previous open heart surgery that would result in not only an air lift to Cincinnati but a medical jet to Boston and an urgent open heart surgery.

When we walked out that door, we didn’t know we wouldn’t see our house again for 2 months. We had NO idea what we were headed in to.

We didn’t have to worry about seeking care at our local ER. Emergency room visits must be covered under the ACA.

We DID have to worry about them covering the air lift to Cincinnati. We didn’t seek preapproval because Savannah was gravely ill. We asked forgiveness instead of permission and thankfully it was approved.

However, Cincinnati determined she needed HER surgeon. Her surgeon is in Boston. She needed a medical jet flight. We had to have pre-approval for this.

This was a ridiculous battle.

Cincinnati’s surgeons stated flat out they refused to touch her. She needed HER surgeon. The one who had pieced together her very broken heart in a complex surgery no one else was doing.

They still initially denied the flight.

I finally had to shout at the person taking our appeal to the insurance executives.

“If you drag this out and screw this up and you kill my baby, I will be your worst nightmare. I will make sure everyone knows. She needs this. Every doctor says she needs this. Let’s go.”

Roughly 45 minutes after that, we had approval for her airlift. They called the flight team, her surgeon cleared an OR, and we were the first case Monday morning.

Pre-authorizations can be dangerous and life threatening. In Savannah’s case, zero medical professionals were against the flight. Insurance was the only obstacle.

Insurance red tape prevents a patient, their advocate(s) and their medical team from making the best decisions for a patient.

Sometimes that lowers someone’s quality of life.

Sometimes that leaves a person in more pain than necessary.

And sometimes it kills people.

Savannah made it to Boston. Her amazing surgeon took her to the OR, cut into her tiny heart, and repaired the issues. Recovery was rough. Medical bills topped $1,000,000. Thanks to the ACA, it didn’t bankrupt us.

But denial of that PA could have led to a different outcome.

When we are discussing universal coverage or single payer, situations like ours must be taken in to account.

Preauthorizations are dangerous. Restricting the ability to travel for care, especially to a patient’s established team, is dangerous. Refusing to take the opinion of medical professionals who know the patient is dangerous.

We can’t let that be part of our UC/SP solution.