get another opinion? Her life was at stake. Raising
$212,000throughcharitabledonations,shepaidthecosts
of therapy herself, but it wasdelayed. Shedied eight
monthsafterthetreatment.HerhusbandsuedHealthNet
forbadfaith,breachofcontract,intentionalinflictionof
emotionaldamage,andpunitivedamagesandwon.The
jury awarded her estate $89 million. The HMO
executiveswerebrandedkillers.Tenstatesenactedlaws
requiringinsurerstopayforbonemarrowtransplantation
for breast cancer.
Never mind that Health Net was right. Research
ultimatelyshowedthetreatment tohaveno benefitfor
breastcancerpatientsandtoactuallyworsentheirlives.
But the jury verdict shook the American insurance
industry.Raisingquestionsaboutdoctors’and patients’
treatment decisions in terminal illness was judged
political suicide.
In2004,executivesatanotherinsurancecompany,Aetna,
decidedtotry adifferentapproach.Insteadofreducing
aggressive treatment options for their terminally ill
policyholders, they decided to try increasing hospice
options.Aetnahadnotedthatonlyaminorityofpatients
everhaltedeffortsatcurativetreatmentand enrolledin
hospice.Evenwhentheydid,itwasusuallynotuntilthe
very end. So the company decided to experiment:
policyholderswithalifeexpectancyoflessthanayear
wereallowedtoreceivehospiceserviceswithouthaving
toforgoothertreatments.ApatientlikeSaraMonopoli
couldcontinuetotrychemotherapyandradiationandgo
tothehospitalwhenshewished,butshecouldalsohave
ahospiceteamathomefocusingonwhatsheneededfor