Make insurers accountable for denying care

initially thought, meaning he would require subsequent radiation and chemotherapy.

It was determined that proton radiation — a highly targeted form of radiation treatment—was Brent’s best option. Brent was regarded as an excellent candidate for proton therapy due to his age, the previous resection of his tumor, and his general prognosis.

However, Brent’s fight with cancer was undermined by an additional battle with our health insurance company.

Our health insurer disagreed with the physician’s expert medical opinion and flatly rejected Brent access to proton therapy. This decision to withhold optimal treatment, which could impair future quality of life, was a blow to my family on so many levels. My brother was denied treatment because an insurance bureaucrat decided traditional radiation would suffice.

What my family has learned is that proton therapy can be a significantly more effective option for some patients in substitution of traditional radiation and is especially successful in treating hard-to-reach tumors as well as those near vital organs. Because it utilizes protons, as opposed to conventional radiation, it can precisely target tumors without harming healthy parts of the body near the cancer site. Given that my brother’s cancer was in his brain, we were very concerned with ensuring that healthy tissue around the tumor went unharmed.

Though our family appealed the insurer’s initial decision to deny proton therapy, the company did not waver and Brent’s small window of time to benefit from proton therapy was closing. Their staunch resistance baffled us, especially since we were told it would only cost one and a half times as much as traditional radiation. It didn’t make sense that a large insurer would refuse to make a relatively small investment in the best treatment for a 23-year-old man in the prime of his life.

Despite our insurance company’s refusal, we moved forward with the proton plan Brent’s doctors assured us was the best course of care that would also protect Brent’s quality of life for the many years of life he has ahead of him. We were grateful that Brent’s dedicated medical team stepped in with a payment plan.

Today, my brother has completed his treatment and is doing well. We try to focus on the positives: Brent received a prompt diagnosis, excellent care and the expertise of specialists who not only prescribed lifesaving treatment but helped our family finance it.

Though we are grateful for our family’s good fortune, I fear for the patients who don’t have the same options. Cancer patients shouldn’t have to depend on luck; they should be able to depend on their health insurers to appropriately approve the care they need, when they need it. That’s why I’m advocating with other cancer patients and their family members for fair and timely payment decisions from health insurers.

But calling out insurers isn’t enough — they need to be held accountable. We’re urging Ohio Department of Insurance Director Jillian Froment and commissioners nationwide to step up and protect health-care consumers by adopting and enforcing principles of the Cancer Patients’ Timely Treatment Bill of Rights, a set of common-sense practices that can help ensure cancer patients receive the timely access to care they deserve.

No cancer patient fighting for life should be at the mercy of an insurer’s whims when it comes to receiving a medically prescribed treatment. One battle is more than enough.