Ken Jones spent 17 years running toward the danger everyone else was running from. When the danger finally came for him, the people who were supposed to have his back are the ones who turned away.
Jones, a retired San Francisco firefighter, died Saturday at 70, roughly 14 months after he was diagnosed with stage four metastatic lung cancer. The diagnosis alone would have been a brutal fight. What made his final year so much harder was that he had to spend it battling his own insurance company at the same time he was battling the disease.Blue Shield of California, the insurer the city provides to its employees and retirees, denied coverage for treatments his oncologist recommended. Dr. Matthew Gubens, who leads the thoracic oncology clinic at UCSF, requested a combination of chemotherapy and immunotherapy for Jones. Blue Shield denied it, saying its medical guidelines did not support that combination. Gubens appealed in writing and was denied again. He has said the time lost fighting for approval cost Jones real ground, with tumors growing, pain increasing, and his appetite fading while the paperwork dragged on. A spot once the size of a pea in his neck had grown to the size of an egg.
That delay is the part his loved ones cannot forgive. Jeanine Nicholson, the former San Francisco fire chief who had been close with Jones and his wife for about 30 years, said she believes wholeheartedly that the denials sped up his death. She called the situation cruel.
What makes the story sting even more is that California firefighters carry a legal presumption that their cancer is job related, a protection earned through decades of exposure to smoke, burning chemicals, and carcinogens in the line of duty. Sam Gebler, president of IAFF Local 798, said Jones held up his end of the bargain. He served the city, he served his members, and he paid into the system. The system, when he needed it most, did not serve him.
His family refused to go quietly. In January, Jones and his relatives sat before San Francisco’s Health Service Board surrounded by a platoon of his former colleagues, asking the board to override the denial. His wife, Helen Horvath, told the room that every delay mattered. His daughter Rachel put it plainly, saying Blue Shield had decided her father’s life was not worth paying for. The public pressure moved the needle, at least partway. After the case drew coverage, a Blue Shield physician reached out to Jones’ doctor and the two worked out a different plan the insurer would cover, though Horvath said it remained incomplete.
Jones was not the only one. About 5,000 city employees and retirees are insured through Blue Shield, one of three carriers San Francisco contracts with at a cost of more than a billion dollars. Other firefighters denied cancer treatment have since come forward. The Board of Supervisors summoned top Blue Shield leaders to answer for the company’s claims process, Mayor Daniel Lurie vowed to stand behind first responders, and the case has opened an investigation into other denials. National attention has followed too, with civil rights attorney Ben Crump sharing Jones’ story and tying it to the larger crisis of firefighters and occupational cancer.
Blue Shield said it was deeply saddened by Jones’ passing and cited federal and state privacy laws in declining to comment further on his case. The company indicated it would meet with union leaders and advocates about potential reforms, while maintaining that its denials were rooted in medical guidelines.
Ken Jones answered every call the city ever made on him for 17 years. The call his family made to his insurer went unanswered until there was no time left to answer it.
