Posts Tagged ‘insurance’




Someone reminded me that most stem cell treatments and immunotherapies aren’t FDA approved or covered by insurance in the USA.
This is true, but…
we’ve known about the rampant capacity for stem cells regenerating/regrowing finger tips since the work of Dr Illingsworth in the early 70’s. Children under 8 regrew their fingertips unassisted. That was their natural stem cells in their own bodies regenerating the distal phalanx, blood vessels, skin, nail, etc. but our natural healing system is not FDA approved.
We’ve known about bone marrow derived stem cell treatments in the form of bone marrow transplants for Leukemia/blood cancers. They regrow the patients immune system and are approved and have been used successfully in the USA for 60 years.
We know of stem cell treatments recovering patients from many chronic and terminal diseases successfully around the world for over 2-3 decades but that is only outside of our country and medical system for what I think are probably obvious reasons.
We know immunotherapy, like the 2 bubble babies cured and out of bubbles in 2001 and the Cuban originated lung cancer vaccine has been working for decades and treated thousands successfully but that is years from getting approvals here.
Sadly, as you said, many of these treatments – which merely expand on and accentuate the natural regenerative capacity and natural immune response capacity of the human body – are not covered by insurance or FDA approved.
I guess the only question I have is:
If these treatments have worked years to decades everywhere else they are used…
Is this a failing of the treatments or of the FDA and insurance…

Only you can decide.

“Many of life’s failures are people who did not realize how close they were to success when they gave up.” – Edison

“All that was great in the past was ridiculed, condemned, combated, suppressed — only to emerge all the more powerfully, all the more triumphantly from the struggle.” – Tesla

“Success is not final, failure is not fatal: it is the courage to continue that counts.” – Winston Churchill

“The scientific man does not aim at an immediate result. He does not expect that his advanced ideas will be readily taken up. His work is like that of the planter—for the future. His duty is to lay the foundation for those who are to come, and point the way.” – Tesla

Medical News: What’s in the Healthcare Reform Law – in Washington-Watch, Reform from MedPage Today

In OFF THE BEATEN PATH on September 12, 2010 at 10:25 am

What’s in the Healthcare Reform Law

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: April 01, 2010

WASHINGTON — When President Barack Obama signed the “add-on” bill this week, he completed the process of sweeping healthcare reform that is projected to provide insurance coverage to an additional 32 million people and cost $938 billion.

Here’s a summary of the key provisions dealing with coverage, quality improvement, and tax changes in the new law and its add-on bill.

Effective This Year

Starting immediately, HHS will set up an annual review process to make sure insurance companies aren’t raising premiums excessively. Insurers will also have to justify any major premium increases.

The law also gives the FDA the immediate authority to approve generic versions of biologic drugs. Biologic manufacturers are granted 12 years of exclusive use before follow-on generics can be developed.

The law directs the immediate formation of task forces to develop, update, and disseminate recommendations on the use of clinical and community prevention services.

Within 60 days of passage, the Secretary of Health and Human Services (HHS) must create uniform language that clearly describes health insurance benefits. That language must be used by all insurance companies, so patients can easily understand and compare benefits. The agency will also immediately begin awarding grants to states to set up insurance information centers, which will answer consumer questions about health insurance options.

Within 90 days, HHS will create a high-risk insurance pool for those with preexisting conditions. The pool will operate through 2013. Eligible participants include those with preexisting medical conditions who have not had insurance for the previous six months.

Each state is required, by July 1, to create a Web site where residents can easily see what insurance options are available to them.

Within six months, health insurers must eliminate lifetime dollar limits on policy benefits and “unreasonable annual limits.”

The law also prohibits a health insurer from rescinding a plan once an enrollee is covered, except if he or she has knowingly committed fraud, such as lying about a preexisting condition on an insurance application. Even then, the insurance company would have to notify the enrollee prior to terminating coverage.

Other restrictions on health insurers that take effect within six months include:

  • A ban on discrimination against lower-wage workers
  • Prohibition against preexisting condition exclusions for children
  • Allow dependents who are unmarried to stay on their parent’s health insurance until they are 26

Also within six months, hospitals must publish a list of their standard charges for items and services.

By Jan. 1, 2011, insurers must eliminate copays for certain preventive health services, including those that the U.S. Preventive Services Task Force (USPSTF) considers the most likely to improve health; immunizations recommended by the CDC; screenings and preventive care for women that are recommended by the Health Resources and Services Administration, including annual mammograms.

The law specifically prohibits use of the USPSTF’s most recent recommendations on mammograms to determine coverage decisions.

Within a year, the Secretary of HHS must create a new reporting system, and health insurers will be required to report how their plans improve health outcomes, prevent hospital readmissions, improve patient safety and reduce medical errors, and implement wellness activities.

Within two years, health insurers will be required to submit an annual report to HHS breaking down what percentage of premium revenue is spent on paying for clinical services, for activities that improve healthcare quality, and other non-claims costs.

Those reports will be made public on the HHS Web site. The provision is intended to help cut healthcare costs.

Coverage Requirements for Individuals

Starting in 2014, most individuals will be required to have health insurance or else pay a penalty of $95.

That penalty will rise to $325 in 2015 and to $695 in 2016. In the years thereafter, the penalty will be indexed to the cost of living.

The penalty for minors who don’t have insurance will be one-half the penalty for adults.

Certain exceptions are allowed for those who object to health insurance on religious grounds, those who cannot afford coverage and receive a hardship waiver, those for whom the lowest cost plan option exceeds 8% of annual income, Indian tribe members, and those who are incarcerated.

New Insurance Options

The law creates new state-based insurance exchanges called American Health Benefit Exchanges, through which individuals can purchase coverage. The Exchanges must be established by 2014.

All the plans in the Exchanges must meet certain quality and coverage benchmarks, but insurers can offer one of four types of plans: bronze, silver, gold, and platinum, which provide increasing levels of coverage and out-of-pocket spending.

Each state exchange will be required to operate a toll-free hotline and a calculator so consumers can figure out what the costs would be for various plans.

Members of Congress and their staffs will purchase plans through the Exchanges.

The Government Accountability Office will conduct an ongoing assessment of the progress of the exchanges, and whether physicians are accepting patients enrolled in government health programs, including the Exchanges.

The law will also create Small Business Health Options Program (SHOP) Exchanges, through which small businesses with up to 100 employees can purchase coverage, beginning in 2017.

States will have the option to create a basic health plan, which will be open to uninsured individuals with incomes between 133% and 200% of the federal poverty level who are eligible to receive premium subsidies in the Exchanges.

States choosing to create their own plans must offer basic coverage and ensure that enrollees won’t pay more in premiums than they would have in the Exchanges. The federal government will pay states 95% of the funds that would have otherwise gone toward subsidies for purchase of an Exchange plan.

The law also creates a federal program to assist with the operation of nonprofit, member-run health insurance companies known as Consumer Operated and Oriented Plans (CO-OP). Although co-ops were, at one time, touted as a major component of heatlhcare reform, in the end, the government will appropriate just $6 billion for the program.

Also part of the reform law is a temporary $5 billion reinsurance program for employer-sponsored health plans to provide coverage for retirees ages 55 to 64 and their families. It will reimburse plans for 80% of retiree claims between $15,000 and $90,000….

(to read more click link below)

via Medical News: What’s in the Healthcare Reform Law – in Washington-Watch, Reform from MedPage Today.


In ALL ARTICLES on March 8, 2010 at 3:40 pm
Obama appeals for public support on health care


President Barack Obama speaks about health care reform, at Arcadia University in AP – President Barack Obama speaks about health care reform, at Arcadia University in Glenside, Pa., Monday, …

By JULIE PACE, Associated Press Writer Julie Pace, Associated Press Writer 2 hrs 37 mins ago

GLENSIDE, Pa. – President Barack Obama accused insurance companies of placing profits over people and said Republicans ignored long-festering problems when they held power as he sought to build support Monday for swift passage of legislation stalled in Congress.

“How much higher do premiums have to rise before we do something about it?” said Obama, making the first in an expected string of out-of-town trips to pitch his plan to remake the health care system…

Spinal Cord Injury Patient Wins…and Loses

In VICTORIES & SUCCESS STORIES on February 8, 2010 at 1:39 pm

Spinal Cord Injury Patient Wins With Stem Cell Therapy, But Loses In Court

Are you or a loved one interested in receiving stem cell treatment? For free treatment information, please fill out our treatment form

Stem Cells Helps Spinal Cord Injury Patient, but Michigan Court Does Not

A spinal cord injury (SCI) patient who improved after stem cell treatment in Portugal has lost a court decision in Michigan declaring that insurance did not have to pay for the therapy despite the success of it. Kevin Krohn, who regained feelings in his lower body after the adult stem cells from his nose were implanted into his spinal cord, lost in the Michigan Court of Appeals when the judges reversed a jury decision earlier which had awarded Kevin $51,000 for the treatment and stem cell research which improved his quality of life.

The panel reversed the jury verdict ordering Home-Owners Insurance Co. to pay a $51,400 claim by Krohn for an experimental stem cell procedure.

The case went to court after the insurance company denied the claim, arguing the procedure was not reasonable nor necessary. (Not necessary? What if they were in Kevin’s unfortunate condition? -DM)

Krohn suffered a severe spinal injury in a 2001 traffic crash, leaving him with no feeling below his chest. A stem cell treatment in 2005 restored some nerve connections, giving Krohn control of his bowels and bladder and allowing some movement of his hips.

The fact the treatment was successful in improving Krohn’s condition is irrelevant, the panel ruled. The majority opinion stated the case should have been dismissed by the trial court for lack of evidence of the “scientific reliability” of the the surgery.

Before allowing the jury to decide the case, the opinion said, Lenawee County Circuit Judge Timothy Pickard should have required evidence the procedure had “gained general acceptance in the medical community.”

The procedure was done at a government hospital in Portugal’s capital of Lisbon.

A dissenting opinion by Judge Karen Fort Hood said the panel was overstepping its authority in ruling on the scientific reliability of the procedure when no hearing on that issue was held.

The insurance company did not challenge admission of the surgeon’s testimony, said Hood, so there was no opportunity at the trial level for Krohn to present evidence of scientific reliability. The Appeals Court panel erroneously made its own analysis based on a limited record, said Hood.

Michigan’s no-fault auto insurance statute does not require medical procedures to be approved by the federal Food & Drug Administration and performed in the United States, as the majority opinion indicates, she said.

Hood also rejected the insurance company’s argument that the Lenawee County jury’s decision would cause a flood of claims for experimental procedures.

The Fact The Treatment Was Successful Is Irrelevant?

“The fact the treatment was successful in improving Krohn’s condition is irrelevant.”   What a terrible statment that is.  I see a man in distress and doing what was best for him under the circumstances– going to Dr. Carlos Lima for stem cells which improved his quality of life.  If he had left it up to the insurance company, he would NOT have anything now- no feeling in his bowels, no feelings in his legs, no movement at all in his hips.

This is the problem with Obama’s proposed healthcare reform and socialized medicine in general.  It takes the individual’s personal choice or preference for medical treatment out of the equation.  If Kevin had left his fate up to a insurance commission or a “medical commission” appointed by the state,  he would not have any of the improvements in his quality of life that he has today thanks to the adult stem cell research.


Bill Moyers Journal: Health Care Reform + Wendell Potter

In ALL ARTICLES on September 23, 2009 at 11:33 pm

Bill Moyer’s take on the health care reform: With almost 20 years inside the health insurance industry, Wendell Potter saw for-profit insurers hijack our health care system and put profits before patients. Now, he speaks with Bill Moyers about how those companies are standing in the way of health care reform.

Health Care Reform

Vodpod videos no longer available. more about “Bill Moyers Journal: Health Care Refo…“, posted with vodpod

LifeCell Int’l inks pact with Max New York Life Insurance

In BUSINESS OF STEM CELLS on September 7, 2009 at 7:17 pm

LifeCell International inks pact with Max New York Life Insurance

Submitted by Harish Dhawan on Sun, 09/06/2009 – 11:42.

LifeCell InternatiMAXonal, India’s first and the largest stem cell banking service provider, has entered into an arrangement with Max New York Life Insurance.

Under the arrangement, Max New York will reach out to LifeCell’s customers who are expectant parents and create awareness on the importance of securing a child’s future against unseen health and financial needs.

LifeCell ensures biological insurance for children by banking their umbilical cord blood stem cells for future therapeutic use, Max New York will offer life insurance options to LifeCell customers helping them meet the future financial needs of their children.

According to an official release, every LifeCell customer will get the opportunity to analyze their future financial needs and explore various insurance and savings options available with Max New York Life Insurance.

via LifeCell International inks pact with Max New York Life Insurance | Top News.



A 3 year old boy is getting a repair stem cell transplant!

This is not an historic medical event…this barely registers as news.  Doctors have been using repair stem cells in order to prepare patient’s bodies for the ravages of high-dose chemotherapy for decades.

What is a miracle is that an insurance company is actually willing to pay for SOME of it!


Feb 8 2009 1:40PM -KXNewsTeam -AP-SDInsurance Stalemate,0160

SIOUX FALLS, S.D. (AP) A 3-year-old South Dakota boy whose brain tumor treatment had been in question because of an insurance dispute is to begin chemotherapy in Minnesota on Tuesday.

Cooper Urbaniak (ur-BAN’-ee-ak) is to be admitted to the University of Minnesota Medical Center to begin high-dose chemotherapy and a stem cell transplant.

The family’s insurance provider initially declared the procedure experimental and refused to pay for it. But under an agreement reached last month between Sanford Health Plan and the university, Sanford will pay for the chemotherapy and pay a discounted rate on the stem cell transplant.

The boy’s father, Joe Urbaniak, says his son will undergo eight days of chemotherapy treatments followed by a day of rest. Doctors then will give him back the stem cells they harvested earlier this fall.

The family is from Hereford, which is near Sturgis in western South Dakota.

By AP Writer Dirk Lammers (Copyright 2009 by The Associated Press. All Rights Reserved.) APNP 02-08-09 1330CST |

via 3yearold boy to begin chemo, stem cell treatment | KXNet.com North Dakota News.

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