Candace

Talmadge

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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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