Experimental medical treatments: who should decide coverage?

Imagine you or your wife, your sister, your mother, your aunt, or your best friend, has just been diagnosed with breast cancer. Treatment is expensive. What if you or your loved one does not have medical insurance? Worse yet, what if you or your loved one has medical insurance, but it does not cover the treatment you need to survive? What are you going to do? Can you pay for the treatment out of pocket? What if it costs anywhere from $100,000-$300,000? If you do not have that kind of money sitting in the bank, can you raise the money? Will friends and family and the community donate their hard earned dollars to save a life? In the case of Nelene Fox, her family and community did just that.1 Unfortunately, the efforts of family and community were too late. By the time Nelene raised enough money to afford the High Dose Chemotherapy and Bone Marrow Transplant (HDC-ABMT) her doctor recommended, the cancer had advanced and her body had deteriorated to such a degree that the procedure could not help her.' Nelene Fox had health insurance coverage through her employer, but was denied coverage for the treatment by her health maintenance organization, HealthNet, because HealthNet deemed the coverage to be experimental. What caused the death of Nelene Fox: the cancer or the inability to get the treatment that she so desperately needed when she needed