Monday, November 29, 2010

Keep Your Eye on the Prize

     Talk about Must See TV!  A blind woman gets her vision back thanks to a miraculous new surgery involving a tooth.  No kidding!  It's a rare chance for the health care industry to shine.  Instead, this feel good story turns into a needless PR hit for a company that should have seen this one coming.

     Kay Thornton lost her vision 10 years ago, the result of a rare disease.  Doctors in Miami removed one of Thornton's teeth and implanted it in her eye, as an anchor for a tiny lens.  Get this- the 61-year-old woman now sees well enough to drive a car again.  Amazing!  But the response from Thornton's insurer was anything but...

     Instead of being the hero, Thornton's shortsighted insurance company (Humana) played the villain.  That's because Humana initially refused to pay for the procedure.  According to NBC's Kerry Saunders, Humana told him that "medical records did not show that the eye surgery... was medically necessary and reasonable."  So there's Saunders on network TV wondering why Humana didn't think restoring a person's vision was necessary or reasonable.  At first, Humana said it would investigate.  And then in a reversal, Humana said it would "pay the outstanding physician claim."  Humana was smart enough to change course, but this should never have happened.

     I'd think health insurance companies would be especially sensitive to PR but that's not always the case.  Earlier this year, an insurance company refused to cover a baby because he was considered too fat.  Now, it doesn't take a genius to know this kind of rigid posture is going to generate negative PR.  And what about Kay Thornton's case?  Instead of playing a supporting role in a medical miracle- Humana comes off looking like the mean machine of medicine.

     We all understand that insurance companies don't like to pay for procedures in general- much less operations that could be considered experimental.  But someone at Humana knew or should have known this was a poor decision.  I've said it before- negative PR is frequently self-inflicted.  And once your reputation is injured there's not much the spin doctors can do for you.  So remember, by doing the right thing you can get the right result- positive publicity.  By taking a position that looks wrong (even when you may be in the right) you can get a black eye.

Here's a link to NBC's report.
Woman loses tooth- regains her vision!

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