Insurance vs. Kyler

To deny Kyler coverage is to prescribe his death.

Last week, CHOP agreed to proceed with Kyler's first MIBG procedure, assuming that Medi-caid will pick up the tab. He withstood the procedure well and is back at school, happy to be among his playmates again.

If Medicaid doesn't come through, the VanNockers have no savings to pay for additional MIBG procedures that Kyler might need to stay alive, because the out-of-pocket costs associated with Kyler's illness have left them bankrupt. Paul estimates that he and Maria have spent "well over $60,000" of their own money - exhausting cash savings, IRAs and almost every asset but their home to pay expenses not covered by insurance.

"If Kyler can't have MIBG, he will have to enter hospice care," says Paul. "He'll have a good month, and then he will lose the ability to walk. Then he will become bedridden. And then he will die a slow, agonizing death."

MIBG is the only option to postpone that terrible possibility for as long as possible.

But the death panel's decision, it seems, is final.

E-mail polaner@phillynews.com or call 215-854-2217. For recent columns:

http://go.philly.com/polaneczky. Read Ronnie's blog at http://go.philly. com/ronnieblog.