File under "only in America"

After a busy day yesterday and falling asleep early on the couch, I only have time for a quick take today. So file this under "only in America":

A 23-year-old Metro Detroit man robbed a South Lyon credit union earlier this month for his daughter, he told investigators according to South Lyon Police Lt. Chris Sovik.

Brian Randolph, who is currently jailed on a $500,000 bond and facing up to life in prison for robbery of a banking institution, told detectives he recently lost insurance coverage necessary to pay for cancer treatment his daughter required, Sovic said.

Randolph said his daughter had a tumor behind her eye.


Randolph told police that his insurance company was no longer paying for his daughter's chemotherapy treatments and that he robbed the credit union in a last-ditch attempt to find a way to pay for her treatments, according to South Lyon Public Information Officer Lieutenant Christopher Sovik.

Randolph's family, including the mother of his 1-year-old daughter, told local ABC affiliate WXYZ-TV that they think he was desperately trying to get money before his daughter's upcoming chemotherapy treatment. Asia Dupree, Randolph's girlfriend and mother of their 1-year-old daughter, told WXYZ-TV that their daughter Brialynn has retinoblastoma, a cancer that forms in the eye.

"I guess it was desperation. Time was ticking right before her appointment came up," Dupree told WXYZ-TV.

See also:

I did a freeze frame when the story briefly showed a shot of the insurance denial letter, which states the reason for suspending insurance was that Randolph didn't return the determination form asking for documentation. Listed on the form are the BAM 105, 130, and 210 forms. These are State of Michigan forms, which makes me think that the child was almost certainly receiving Medicaid or be on the Children’s Health Insurance Program (CHIP). Medicaid and CHIP in Michigan requires a redetermination of eligibility every year. Of course, given the complexity of the applications, it's not too hard to imagine someone not understanding a request, filling it out wrong, or other "snafus," as described in the news reports. It also makes me wonder which hospital his daughter was being treated at. The pediatric hospitals in this area are usually quite good at working with parents to help them apply for Medicaid or CHIP and to make sure their children stay insured.

There was one story that cast doubt on the father's stated motive, noting that the police found a "Gucci bag, several high-end clothing items and a pair of shoes, most of which were newly purchased." However, his story was also corroborated by family members; so it remains unclear. Whether the father's motive really was to pay for chemotherapy for his daughter or not (and I suspect that it was a prime factor), what does remain clear is the plausibility of the story. People believe that a father would rob a bank to pay for chemotherapy for his daughter because they want to believe it, because they know about government paperwork and how easy it is for a person to miss a form or to fail to dot every "i" and cross every "t," and, above all, because they know that in the U.S., even after Obamacare, there are still too many people without health insurance for whom cancer treatment can result in financial catastrophe. Even if Randolph's motivation turns out not to have been what he is claiming now, this story strikes a chord precisely because it is so damned easy to believe.

In one story, a police officer blithely says, "But there are lots of fathers whose daughters have cancer as well, and you don’t see them out there robbing banks all the time." True enough, but putting it that way dismisses the desperation that having a child with cancer whose treatment you can no longer pay for can produce.

More like this

Filed as requested. And to think some folks thought I was being cruel.

OTOH, this foolish father could just have had a homeochiroquackter scoop out her eyeball with a rusty teaspoon on religious grounds, and the fundies and the Randites and half the states' legislatures would've been totally cool with that. Remarkable priorities.

It is not only in America. We have sort of State-financed healthcare, except that patients cover about half of the costs and many simple do not get any treatment at all. Including children. So, if you do not have money, wait, maybe waiting will have no consequences but maybe it will.
As to the insurance -most cannot afford even one for ambulatory treatmen of basic diseases and insurers do their best not ot pay.

By Ieva Zagante (not verified) on 27 Aug 2015 #permalink

I smell a dead fish, although I admit not to be familiar with the specific forms you cite. In my state, the Medicaid process, and the forms associated with it, are excruciatingly simplified--so much so that I find them insulting. Anyone who cannot understand them seriously needs remedial education. There are bold type, large sized, phone numbers to call for help and locations easy to get to for personal help. It would take a lot to convince me that there is any remotely plausible reason this child not being covered.

By darwinslapdog (not verified) on 27 Aug 2015 #permalink

Eek! Serious grammar issues and no "edit". Must learn to proofread--got interrupted by urgent text message. So embarrassing when speaking of remedial education!

By darwinslapdog (not verified) on 27 Aug 2015 #permalink

I've been helping out in case mgt in undeserved. While the forms may be straight forward, the process is convoluted as hell to actually get from point A to point B.

Dr. Javert will pursue the patient and father through the ruins of Detroit intent on denying treatment.

By Tom Hutchinson (not verified) on 27 Aug 2015 #permalink

In my state the forms aren't too difficult, but having them not be lost and actually getting the state financial worker to call you back if there is a problem before the deadline is pretty much impossible. I'm autistic and do have some trouble filing my yearly papers for insurance, so often spend a month without my seizure meds.( i have a worker from a not state agency that helps me now) They used to have a four month waiting period if your paperwork didn't go through correctly before you could reapply for the low income insurance program, at least with Obamacare there isn't that.Someone I knew from school died from cancer while trying to get the paperwork together, that was seventeen or so years ago. I could see someone getting desperate.

By obscurefox (not verified) on 27 Aug 2015 #permalink

Just wondering,how did the police know the Gucci bag and other "high-end clothing items" were actually purchased? Did they find receipts?My first assumption,in a case like this,would be that Mr. Randolph stole these items to resell for some quick cash.If Mr. Randolph's story is indeed true,we all know what the solution would be,even if we don't want to admit it.

By Roger Kulp (not verified) on 27 Aug 2015 #permalink

Surely a public hospital would have treated this child without payment up-front. Wouldn't they?

By Krebiozen (not verified) on 27 Aug 2015 #permalink

I am not surprised by this at all. My mother's insurance company denied her prosthesis because they said she had a single mastectomy for "cosmetic reasons" rather than the well documented cancer.
And I've never had an insurance company cover my hearing aids. Those are also considered "cosmetic." I'm still puzzling over that one. Silly me for thinking being able to hear was important.

"Surely a public hospital would have treated this child without payment up-front. Wouldn’t they?"

That might be the case for an emergency surgery, not for the inevitable follow-up care.

It's in days like this that I'm glad to live in Canada. This whole story reminds me of the movie "John Q" with Denzel Washington.

"I smell a dead fish, although I admit not to be familiar with the specific forms you cite. In my state, the Medicaid process, and the forms associated with it, are excruciatingly simplified–so much so that I find them insulting. "

Michigan is run by lunatic tea party types, so it wouldn't surprise me if they intentionally caused the forms to be difficult in order to reduce spending on those horrible poor people.

Alas, care ceases to become "world class," when there is no access to care... Welcome to America!

By Beverly Benmoussa (not verified) on 27 Aug 2015 #permalink

Garou, yeah, I am also glad I live in Canada, though I think we do not appreciate how expensive it can be here due to limitations in our government health care coverage. It can be quite pricey here, and varies quite a bit by province. Drugs received in hospital settings are free, but outside of that setting you may have to pay, and how much depends on what province you are in, as what treatments are covered, and how much of it is covered by provincial plans varies. It is often chump change compared what one would see in the US, but can still be pretty devastating.
Also, if you have to travel to receive treatment one has to factor in lost wages, and the cost of travel, eating, residence, etc and those can really add up.

“But there are lots of fathers whose daughters have cancer as well, and you don’t see them out there robbing banks all the time.”

Ya, and there are lots of countries where the idea of a childs life saving treatment not be covered by the government is unthinkable.

Only in America. Indeed.

By NewcoasterMD (not verified) on 27 Aug 2015 #permalink

My late father qualified for low cost drugs in his final years in Pennysylvania, where the program was administered by Medicaid. It is the single worst medical bureaucracy I have ever dealt with. Someone in the county Medicaid office entered my father's birth year as '1901' instead of the correct '1921'. It took me 11 months to figure out what the problem was, and then another 2 months to get the Medicaid office to fix it. All this time, they refused to cover his medicines, because their records didn't match his Medicare records (due to the faulty birth year). The worst part was trying to reach someone by phone at the Medicaid office about the matter. No one ever picked up; instead there was a recording that said they were too busy to answer the phone, and to try again later. No voice mail, no fax number, no email, nothing. It was the seven circles of hell, medical plan style. Even three years after my father passed away, I was still sorting through the last pieces of this mess.
I can understand how a family can get overwhelmed by the Medicaid bureaucracy, and also temporarily lose their coverage. It happened to us.

Slightly on/off-topic, a decent tool you can use to price compare general costs of meds is an app called GoodRx.

As someone who lives in a 'socialist paradise' as far as medicine goes (well my USAian relatives refer to it as socialist, if not a paradise), I fail to understand the backlash among ordinary people in the US over 'Obamacare'. It may not be perfect, but strikes me as a hell of a lot better than the current system with all its gold-plating if the insurance companies are willing to pay and complete failure if you don't have insurance.

As to the story, I have this sneaking suspicion there is more to this than we are currently being told.

“Surely a public hospital would have treated this child without payment up-front. Wouldn’t they?”

A faith-based not for profit, maybe. Note I say "maybe."

Police found a “Gucci bag, several high-end clothing items and an unwatched Breaking Bad DVD boxed set, most of which were newly purchased.”

By Esther Knight (not verified) on 27 Aug 2015 #permalink

It is this sort of story which makes me very angry at our right-wing politicians and media who are determined to do away with the NHS and replace it with some class of insurance-based health system.

As I write this, I am sitting in the hospital, waiting for my 5 year old daughters operation to end.

This is her 4th time being operated on in her short life. She has been to neurologists, eye specialists, ear specialists, had mri on her brain, and been to a geneticist and had her genome looked at.
The cost to us had been some otc stuff, paracetamol, antibiotic sales and the like, perhaps 100 usd over 5 years.

The health care system in Denmark is far from perfect, but it is rare in the extreme that medical costs ruin people

And not to forget. We have not experienced any red tape. No need to fill out forms to get treatments covered.

There is waiting time it took us 6 months to get an appointment with the head neurologist in the pediatric ward, two months before she could get polyps removed and a drain in her ear

Chris Hickie@11

As far as travel from Detroit (Where Mr. Randolph and his family are.)to Memphis (Where St. Jude is),this is something I can speak with some authority on.Childhood cancers can sometimes be rare diseases.I have some rare and unusual metabolic and mitochondrial disorders.I could never have gotten these diagnosed or treated had I simply sat back here in New Mexico.I see doctors in two different states,both hundreds of miles from where I live.One is at a top children's hospital.

There are three factors at work here.While care itself at the hospital costs me nothing travel does not.The same could be said of Mr. Randolph and his daughter going to St. Jude.Someone who is clearly very low income,like Mr. Randolph,would not have the money on his own to travel from Detroit to Memphis,either by plane,by train.or by bus.I can only do it because I have family who are willing to help me.

You would be surprised how any parents,or patients,are simply unwilling to see a doctor in another state.Even if doing so could save their,or their child's,life.I have encountered this time and again.Too many people simply sit back and complain about how awful their,or their child's doctor is.How little the doctor knows about their,or their child's,condition,because this is the easy and lazy thing to do.When you suggest going out of state,they will only make excuses.Finding the proper answers and medical care,takes a lot of time and hard work.

Many people simply do not have the ingenuity,intelligence,or persistence to find the right doctor.Even with the internet at their disposal.

This is one part of the story of access to health care in America that nobody talks about,outside of the very insular rare disease community.

By Roger Kulp (not verified) on 28 Aug 2015 #permalink

Yes I know about organizations like Angel Flight,but this gets back to point number three here.

By Roger Kulp (not verified) on 28 Aug 2015 #permalink

I worked for my state's medicaid program and it is very easy to apply for benefits and to fill out the yearly four page recertification forms. Even if a child's medicaid lapses if the recert form is turned in within a month the benefits are back dated so there is usually not a break in benefits.I'm sure in more metropolitan areas the red tape grows more difficult to wade through. However, if I had a child with cancer I would be jumping through every hoop to keep that child's medical care covered.
Also having spent several years in my career as an investigator and then a probation officer it is often incredible what criminals with come up with when caught.

By Sandy Penrod (not verified) on 28 Aug 2015 #permalink

Since we're all sharing our "insurance companies being stupid" stories, why not share mine.

Earlier this year I finally gave up fighting my insurance company over treatment of a badly infected toe. Since my podiatrist clipped back the nail during the course of treatment, the entire thing was classified as a nail clipping, which is not covered. Who the $%#@ goes to a podiatrist to get their nails clipped anyway? Didn't matter that I received a referral from my covered GP, or that my podiatrist was covered. Nail was clipped, nothing is covered. I'm just glad the bill wasn't so outrageous I couldn't pay out of pocket.

OK, rant aside, I'm really offended by that cop who said, "But there are lots of fathers whose daughters have cancer as well, and you don’t see them out there robbing banks all the time." If I had a daughter with cancer, and had exhausted all means of paying for treatment...if I feared treatment would actually be withheld for failure to pay, you can bet I'd be doing anything I could to save her, legality be damned.

There can be a reasonable argument about what the father should have or could have done, but if that was his state of mind...

Having been on Medicaid at one point, I can state that if you have a commonly accepted dx such as cancer, especially in a child, everything is paid for with no deductible. There is a one to three dollar nominal payment for prescriptions, and the patient can waive that. The hospital has staff to push Medicaid paperwork through.
If you have something uncommon or have an illness that causes cognitive deficits (say, you got radiation on the brain, or an autoimmune condition), then Medicaid is a nightmare. If you get on the wrong side of the bureaucracy, it's going to hurt.

And yet:
It is about 1000x more likely that this man robbed a bank because robbery was his go-to method of getting what he wants, rather than it being the act of decent person with no other alternative. I hope our generally insightful author will not be taken in by the "poor, dear felon" meme which has lately returned.

By Spectator (not verified) on 28 Aug 2015 #permalink

I'm from Michigan, and the Medicaid application process can get absurd if you're doing it without assistance. DHS workers are hit or miss in terms of helpfulness, which makes it all the worse - though to be fair, they are very overworked. People are directed to use the Michigan Bridges website rather than submit their application in paper, and the website is slow and not intuitive in design (A paper copy of the application can be obtained and it is lengthy). People may not receive letters from the state requesting documentation with enough time to respond, if at all. I can see how easy it would be to lose coverage.

That said, the Medicaid application process is faster and more efficient for kids. And medical providers either have someone on staff (medical social worker) or know where to send someone to help with the application process, especially if the person is a child. As much as people grumble about "socialized" health care here, they seem to mentally make an exception for children (Thank God). A ball was dropped somewhere, at least in regards to her medical coverage.

One has to wonder if private insurers would cover more essential care if they stopped covering sham "medicine". Luckily I have health insurance through my employer, but I'm always surprised to see that while it covers a whole load of fake medicine it barely covers the essentials like eye care, dental surgery, psychological therapy, etc. I'd love to see a health insurance company come out with a "science based medicine only approach". I'm sure such a company would have very low premiums and deductibles.

I thought it was more common practice in these cases for the hospital to provide care now and worry about the bills later ?
Perhaps I'm wrong.