Pendleton man denied life-saving operation by insurance company

PENDLETON, Oreg. -- A Pendleton man is in the fight of his life. His body is holding him hostage as his insurance company turns a blind eye.

Meet Scot Jacobson, a father, husband and social worker. Now meet 'Wilson,' a 70lb tumor that is quickly killing him.

"I just feel like Tom Hanks on Cast Away, this is Wilson, the only one that gets me," he said pointing to the uncomfortable mass. Jacobson says he feels deserted by his insurance company. They rejected his claim for gastric bypass surgery, a procedure that needs to happen before 'Wilson' can be removed.

"The insurance company said 'no' because that's weight loss and cosmetic even though it's not," he explained. Jacobson's surgeon, hospital and primary care physicians all wrote to the insurance company, explaining the gravity of the 550lb man's situation.

"With this tumor the fluid pools and gets infected, so eventually you would die from sepsis," said Jacobson. Asked if it's life or death, he said frankly, "It is."

Scot Jacobson's problems started five years ago. He knew he was overweight and that a gastric bypass was the best option. His insurance company denied the claim the first time, which meant the Jacobson's had to come up with $45,000 in cash up front.

"I had cashed in my retirement accounts, sold property and stocks, we had cashed in everything."

But in return, Scot Jacobson got nothing. Partway through, the surgeon aborted the procedure, fearful Scot would bleed out.

Four years later and still gaining weight, Jacobson saw a specialist. "She discovered I had thyroid cancer and it was making my metabolism go like a slug," he said. With his thyroid removed, Scot thought he was cured, but then came Wilson.

"After surgery, they put you on a synthetic thyroid drug," he explained, "well, something happened there, the tumor I had...suddenly shot up like miracle grow on a plant."

A tumor that's equivalent to seven 10lb bags of potatoes is situated between his legs and under his stomach. Doctors need to see a 100lb weight loss in four months to operate on the tumor, which means Scot needs another gastric bypass.
Hopeful he can come up with the funds, Scot scheduled his surgery for Friday, February 21, 2013.

"The cost is only around $17,000, but it might as well be $170,000 for that matter because I'm broke from the first time," he said.

The Jacobson's cashed in again for this upcoming surgery, getting around $8,000, family and friends raised another $6,000, which still leaves $3,500 to be raised before doctors will lift their scalpel.

Scot Jacobson does have a full-time job, working 40 hours a week. In fact, it's his job as a social worker that is keeping him from getting both surgeries done for free. He said if he left work and went on disability, which he qualifies for, Medicaid would pay for both operations.

But, Jacobson said as long as he is able to work, he won't take advantage of your tax dollars.

If you would like to donate, friends of the family started a collection at US Bank.
Donations are being accepted under "Friends of Scot Jacobson."

KEPR Action News contacted Jacobson's insurance company PacificSource.

They released this statement to us: "While we cannot, under federal health privacy laws, discuss information about this or any patient, I can tell you that one of our Nurse Case Managers is following up to see what can be done to help with this case. "