One More Stinkin' Example of Why We Need Universal Healthcare

Yes, I know that national health programs have their drawbacks (a Canadian reader wrote me with a bunch of horror stories just this week) but removing the profit motive should take care of many of the problems we have now:

Eric Simpson was strangely calm when the insurance company called last week, saying it was sending a man for his right arm.

The woman on the phone told him he should have known he had only $2,000 of coverage through Aetna for artificial limbs. And the arm, which he'd just received that week, cost more like $37,000.

But, he protested, he'd been preapproved.

Angelo Russello had the job of taking Simpson's arm. He works for Allied Orthotics & Prosthetics in Northeast Philadelphia.

All week he'd been visiting Simpson at Moss Rehab in Elkins Park, fitting the device, teaching the 32-year-old Germantown man how to flex his muscles to move the thumb and fingers.

"I felt like a fool," says Russello. "I've got to tell you, this has never happened before."

Simpson read his face and said, "Just take it."

And yet, in that odd way that often happens when major media calls an insurance company, it was all a big mistake!

"A miscommunication," Aetna spokesman Walt Cherniak said yesterday.

Aetna officials had mistakenly considered his new arm medical equipment rather than a prosthetic, which is covered in full. They called Simpson to apologize.

And the next day, Friday, Russello returned the arm.

"Honestly, I didn't think it would be back so soon," Simpson said Tuesday in his room. The new arm will make it easier to dress himself, to support his weight, as he tries to recover from his spinal injury. Doctors give him hope he'll walk again.

As we spoke, it was hard not to hear the man in the next bed talking with a rehab specialist.

"The wife just gave me the bad news," he said. "The insurance company just called and said we don't have approval for the procedure."

Sounds like it's going around.