How an insurance company denied a cancer-stricken mother a chemotherapy regimen



Contributing Writer

Danni Gilbert with her daughter


About a year and a half ago, Danni Gilbert was diagnosed with stage four metastatic colon cancer.  What was different about Danni than the majority of people receiving this diagnosis is that she was in her mid-30s, a mother of two young kids and a teacher.  In the midst of her third chemotherapy treatment. a study was presented at the American Society of Clinical Oncology showing that the addition of Bevacizumab, a drug used in early stage chemotherapy had positive effects on patient survival.  Danni’s oncologist recommended this treatment for her, and her insurance company denied her the treatment calling it “experimental.” (the study incidentally was conducted over the course of two years from 2006-2008).  When Danni and her family tried to negotiate that they would pay for a portion of the treatment, Blue Cross of Idaho (her insurer) further cut her treatment benefits, increasing the monthly cost of her therapy to over $22,000 per month (Thankfully, through diligent advocacy this decision to rescind all benefits was reversed yesterday).

This isn’t a unique story, but it’s important for me because Danni Gilbert is my cousin.

Blue Cross ironically was formed as a plan for teachers guaranteeing them 21 days of hospitalization for $6 per year.  It has morphed into a loose umbrella of for-profit and non-profit medical plans at state and regional levels.  Fitch estimates that Danni’s insurer, Blue Cross of Idaho’s statutory net earnings last year were $57 million.  Danni’s treatments cost $6,000 per month out-of-pocket – so for each treatment that Blue Cross of Idaho denies, they profit .005% of last year’s earnings.  The average teacher in Mountain Home, Idaho makes a little shy of $50,000 a year, so presumably Danni and her husband James (also a teacher) could pay for twenty treatments a year if they didn’t have the burden of having to pay for their home, food and other usual expenses for a family of four.

Forget for a moment the cruelty of denying a person cancer treatment when keeping a surplus of $57 million.  Forget the fact that Danni’s age is a very positive indicator for survival.  Forget the fact that Blue Cross of Idaho has donated over $150,000 in the last few years to political campaigns, and has spent hundreds of thousands of dollars in philanthropic giving.  Simply consider the impact to Danni’s family.

If my wife were diagnosed with cancer, I would spend every resource that we had available to help her survive.  If an insurance company put me in the position where I had to determine when to give up, I couldn’t.  How could I look in my kid’s eyes and tell them that I didn’t do everything I could for their mother to live?  How could I say that I love my wife more than anything in the world and then make a cold, pragmatic decision based upon finances?  It’s sickening to even consider, yet this is the position that James and Danni are in (Danni wrote a heartbreaking journal entry entitled “How much is a month worth?” which discusses the turmoil with the insurance company and her perspective of the experience).

There are many conflicting beliefs about what happens when we die, and I don’t purport to have any truth to share about them.  But one thing that I believe to be true is our legacy on this earth is the love that we share with other people.  By that standard, Danni Gilbert has lived a rich life.  I’m confident that Danni has a lot more life to live and love to share.  Danni’s kids deserve every opportunity to experience their mother’s love for as long as possible.  Danni’s husband James deserves the opportunity to spend the lifetime that he promised her with her.  Danni’s story resonates because it exposes how vulnerable we are to outlying events, and how out of touch our priorities lie when an insurance company can make record profits while denying patients prescribed treatment to live.

I’m not big on asking for stuff, but if you’ve read this far  I would ask you consider sharing Danni’s story with your network of connections, sending a tweet to Blue Cross Idaho (Danni’s insurance company) and/or Genentech the manufacturer of the chemotherapy drug that Danni and her husband are being asked to pay for out of pocket, signing the online petition that Danni’s friend set-up on change.org, or all of the above if the spirit moves you.  I sincerely thank you for everything you do to tell her story, and to help give her the best opportunity to survive her cancer.

Danni Gilbert and her kids

Danni Gilbert and her kids

Tweet to Blue Cross Idaho:


Tweet to Genentech (manufacturers of the chemotherapy drug that Danni’s oncologist prescribed her)

Sign the petition for Danni on change.org

Jim Dougherty

Jim Dougherty

Writer and chief of miscellany at leaderswest.com

I aspire to give people something to think about rather than tell them what to do. My favorite Google Alert is “social media research,” I am increasingly compelled by Gen Z, and I appreciate good writers agnostic of where they write. At one time I was Kred’s 12th most influential social media blogger and Klout’s most influential person on the topic of David Hasselhoff. Transplant from Seattle living in Cincinnati. Haven’t entirely adopted the local sports teams yet.

Jim Dougherty

@jimdougherty

Writer about social media and tech at Leaders West, I also tweet as @leaderswest.

Twelve Must-Have Tools for Twitter http://t.co/P6DtZFp31u – 28 mins ago

Jim Dougherty

Jim Dougherty

  • http://www.krusecontrolinc.com Kathi Kruse

    Just signed the petition, Jim. Happy to support.

  • http://leaderswest.com Jim Dougherty

    Thank you so much, Kathi! You are awesome!

  • http://ellenbremen.com Ellen Bremen

    I’ve signed the petition and posted this on Facebook. I’ve got the mommy mafia going and it’s a mighty force. Putting out healing light for your family. I’ve watched two fellow young mothers lose their lives to cancer already. Danni’s kids deserve every minute. Ellen

  • http://www.team-roxy.com Roxanne Martinez

    I will definitely support Danni and get this message out to my network. Thanks for sharing! It shouldn’t take all of this to make something happen but unfortunately it does. I hope it all works out and I’ll be praying and rooting for Danni.

  • http://leaderswest.com Jim Dougherty

    Thank you so much for reading, commenting, sharing and taking action Roxanne! I’m so grateful for your generosity and thankful for everyone’s kindness and advocacy for Danni. Cheers!

  • http://leaderswest.com Jim Dougherty

    Thank you so much Ellen! Reminds me I have something that has been simmering since we met – you are all kinds of awesome and I’m so grateful for your outreach and advocacy for Danni (added to the list of millions of other things I am grateful to you for!) Thank you thank you thank you!

  • http://ellenbremen.com Ellen Bremen

    Well, I feel exactly the same way about you, Jim–magnified :-) . I saw that the petition was nearly at the 1500 signatures yesterday. Do you know if they reached the mark? I bet they did… and then some. This has to have a more positive ending, at least as positive as it can be. Will you update about Danni and how she is doing from time to time?

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  • Terr

    Thank you for sharing this. Blue Cross has already notified my brother-in-law that they will be dropping him from their insurance due to Obamacare. That’s the only reason. And truth be told they can do whatever they want however they want whenever they want. Contracts mean nothing. Care means nothing. The bottom line is what’s important and that’s all. They are mirroring our government knowing that they can get away with whatever government is getting away with.

  • Luc Patry

    Sorry for your predicament. I am a foreigner (one of those white male canadian) and cannot sign this petition. Do not give up! Humanist (people who respect human) will win.

    luc

  • http://cricketkissner.scentsy.us Cricket Kissner

    This breaks my heart! As a mother of four kids, this totally touched my heart! I also this year have lost both parents to cancer. So this story has really hit home with me. It’s a sad world that we live in, when a insurance company can decide what our future holds. When to stop, or not give their customers the BEST treatments, and HOPE for living. What if this were their family, wife, or mother! Keep the faith, and hold your head up high. Believe in the true physician!! Prayers for great results and change of heart!! Praying for this beautiful family, and above All more time!!!! Thank you for your time! Cricket Kissner supports you, as does N. Carolina <3

  • Wanda O

    We are in the very same predicament with my sister Dani. I don’t quite know where to begin, but you can bet we aren’t going down without a fight. The only thing she wanted to do gor her Birthday this year was to drive down the shore to volunteer to assist those affected by Sandy, and that’s exactly what we did. I will not allow an insurance company deem her life unworthy of saving. Without the recommended chemo treatment, she’ll be lucky to have six months of life left to live.

  • jimdougherty

    I’m sorry to hear that Wanda. My cousin died last month and it was really heartbreaking to know a good portion of her final time on earth was spent squabbling with an insurance company. My heart goes out to you and your family – thank you for sharing.

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