Candace
Talmadge
Read Candace's bio and previous columns
March 10, 2008
Horror Tales from the
Health Insurance Trenches
Think that mandating health insurance purchases will keep a lid on the
cost of getting ill? Or improve access to quality health care?
Think again. And read the stories below, keeping in mind that all of
these people were covered by health insurance.
Cheryl
Scott is a registered nurse in Sacramento, California. During her first
year of marriage three-and-a-half years ago, her husband, Bob, then 57,
was diagnosed with a brain tumor. Cheryl Scott had insurance through her
employer, a local hospital, and her husband was covered under his
employer’s plan and hers.
Both
insurance carriers denied Bob Scott chemotherapy and radiation
treatment. He died within six months after being denied medical
treatment, even though the denied treatment was the common,
standard-of-care practice for their local medical community and
throughout Northern California.
Gina Dooley, in Albuquerque, New Mexico, was 36 weeks pregnant when she
learned her unborn daughter had a lung tumor. She worked for a
pharmaceutical company and had top-line health insurance – for a $1,200
per-month premium that was supposed to cover everything. Dooley’s
insurance company told her that only one hospital in town was covered by
her plan, so she went there for a month of treatment, including surgery.
Months later, Dooley was told that the neo-natal intensive care unit was
not part of her insurance network, although they were the only doctors
available in the hospital she was forced to use. She wound up paying 90
percent of all her expenses plus 90 percent of the $100,000 bill for her
daughter’s surgery five days after birth.
In Dallas, Texas, Lyle Schiele used to own his own rig, contracted to a
major trucking line. He paid $670 per month for health insurance through
the trucking business. Schiele had to have stents inserted into clogged
arteries and was disqualified from driving for 90 days in early 2006.
Not covered by COBRA, he lost his health insurance. He tried to return
as an owner-operator but was forced to sell his rig and work as a driver
for the trucking line after trying to buy individual health care
coverage but being refused by multiple insurance companies.
Tom Wenning, of Portland, Oregon sustained serious injuries from a
high-impact motorcycle accident. He had complete medical insurance and
all of his health care providers were aware of it. Yet before he was
released from the rehabilitation hospital, his various doctors and
hospitals had placed a total of $280,469 in liens against his home. Even
after Wenning’s HMO paid his bills, more than a dozen liens remained.
In
Cleveland, Carol Black in 2003 was denied an MRI of her spine by her
insurance carrier, saying the symptoms she had suffered since 1998 were
not severe enough to merit an MRI. By the time her problem was diagnosed
correctly, Black had sustained severe nerve injury from spinal
compression and became permanently disabled.
She’s now on Medicare, and her husband’s health insurance provider will
not allow her to use it as secondary coverage without a big increase in
the monthly premium. “My
husband has worked at least two jobs, even three jobs at one time for
the last 10 years because of medical bills,” Black says.
Jack
Mahoney of, Boca Raton, Florida was left with a $25,000 medical bill for
the birth of his son after his employer’s health care insurer claimed
that the hospital he and his wife used was out of the network. Mahoney
had told the insurance provider about his hospital choice some months
before his wife gave birth, and was never informed that his option would
not be covered.
A
retired educator, Eugene Donovan of Rowe, Massachusetts, pays more than
$6,000 per year for annual health insurance premiums and co-pays for
himself and his wife, on an income of just under $36,000 a year. They
don’t
qualify for assistance, and must sacrifice on food and heat in order to
pay their health insurance premiums and other health-care-related bills.
A
former registered nurse, bodybuilder and long-distance runner, Janet
Stephens became disabled more than a decade ago due to an incurable
disease called Interstitial Cystitis. The co-pay for the only oral drug
for her ailment has risen from $25 in 1999 for 200 capsules to $250.31
for 180 capsules. And her insurance premiums just keep rising.
“I’ve used my credit cards, home equity line of credit and sold
household items in an attempt to cover my health care costs,” Stephens
says. “I still have a $3,800 balance at my pharmacy, even though I have
made substantial payments every month. I’ve been forced to ration pills,
split pills, skip doses and beg samples from my doctors.”
The preceding personal stories are courtesy of the California Nurses
Association/National Nurses Organizing Committee.
These tales should be required reading for anyone favoring nationally
mandated individual/family health insurance purchases, and for
Massachusetts politicians who have mandated a health insurance nightmare
for their citizens.
© 2008
North Star Writers Group. May not be republished without permission.
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