Word: colorado
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...deMeurerses, committed now to getting the transplant by any means necessary, launched a two-pronged attack: they authorized Hiepler to pursue an injunction to compel Health Net to pay for the treatment: and they began fund raising in earnest. Christy's sister organized a formal dinner in Boulder, Colorado; friends and colleagues arranged a school talent show. The deMeurerses' daughter Michelle, then eight years old, took a piece of loose-leaf paper and with shaky precision wrote her own advertisement for a yard sale. The sign said, MONEY GOES TO A MOTHER WITH BREAST CANCER...
...think this system is robbing physicians of their essential goodness," says Dr. Roy B. Jones, a University of Colorado bone-marrow-transplant specialist who saw Christy deMeurers during her journey. "I think physicians are slanting the opinions they give based upon monetary considerations that in many cases they wouldn't have allowed to influence them before." Vincent Riccardi, a neurologist and expert on "Elephant Man" disease, says the issue of trust in California is already moot. He has gone so far as to establish a company, American Medical Consumers, that plans one day to dispatch "personal medical advocates" to negotiate...
...recommended she consider a bone-marrow transplant and, in a breach of Health Net procedure, skipped the usual channels for making referrals and arranged a consultation with a physician he knew, Dr. Robert McMillan, an oncologist at the Scripps Clinic in La Jolla. Christy's sister, living in Colorado, had urged her to see a leading bone-marrow transplanter at the University of Colorado, Roy B. Jones, but the deMeurerses decided to play by the book. They drove to La Jolla the following Monday...
Under the old medicine, research hospitals paid for clinical research through billing surpluses; grants from the National Institutes of Health tended to pay only for big-ticket basic science. Colorado's Dr. Jones accuses HMOs of placing medicine in a double bind. "Is it reasonable," he asks, "for an insurer to demand the gold standard of proof and simultaneously refuse to pay for patients to enter a trial to get that level of proof?" Dr. Jones is convinced that women who once would have come to him for a transplant aren't coming because their doctors, operating under tight managed...
Roger Greaves, Health Net's chief executive, was fighting a battle of his own against what he calls the "cancer" of a tactical lawsuit. His company had drawn the attention of Dr. Malik M. Hasan, founder and chief executive officer of QualMed, a Pueblo, Colorado, managed-care company that owned an HMO that competed against Health Net in Northern California. To best grasp Hasan's delight in bold business maneuvers, one need only know that as a young medical student in Pakistan in the late 1950s he made roughly $10 million selling land along the anticipated rights...