Christy deMeurers, a 32 year-old Los Angeles school teacher, experienced like what other severely ill members of HMOs had experienced. She found out that a lump in her breast was malignant and sooner, turned into a cancer. Two months earlier, she had signed up to become a member of Health Net, a health maintenance organization that provides medical care for its members. Because of such membership, Christy received a radical mastectomy as well as radiation therapy and chemotherapy treatments. However, such treatment didn’t cause the cancer to cease. In May 1993, the cancer recurred and as one doctor puts it, Christy needs to undergo a bone-marrow transplant.
When Christy met another doctor, she was already declined even just to be explained on what the operation was. She thought that the doctors’ decisions were already influenced by Health Net. She realized that Health Net wouldn’t want to spend at least $100,000 for such operation, thus, intimidating the involved doctors. As an HMO, Health Net collects from its members monthly premiums from employers in return for providing their employees with medical care. In 1995 Health Net collected a total of $2billion from employers. However, even acquiring such a huge amount, Health Net still refused to answer for the operation costs of Christy.
On the other hand, Christy and her family did not surrender in finding the doctor that would look after for Christy’s welfare. They found Dr. Roy B. Jones, a leading bone marrow transplant specialist, who recommended a bone marrow transplant for Christy. However, Health Net determines that it wouldn’t pay for such transplant because it is classified “investigational” or “experimental.”
Now, after an endless campaign to sustain her life, Christy finally was allowed to see another cancer specialist. Dr. Schinke, recommended for her to be evaluated for a transplant at UCLA Medical Center. Having the fear of rejection, Christy concealed her membership in Health Net. That is...