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Monday, July 21, 2008

Private Health Insurance at Work: Hassling Breast Cancer Patients

Saturday I told you about Deron Arnold's battle with cystic fibrosis and his insurance company. Today, another example of private health insurance not just abandoning the sick but harassing them when they need help and rest the most:

NPR's Joseph Shapiro tells us about Jamie Drzewicki, 58, of Florida. She works two jobs: activities director at a nursing home and, with her husband, musician at clubs and cruise ships. She got regular mammograms and pap smears and stayed healthy... until she got breast cancer. Then she learned that her employer-provided health policy had an annual benefits limit of $100,000. Her treatment racked up more bills than that, and she now owes the hospital $62,000.

While one office in the hospital is trying to help her apply for financial assistance, another office in the hospital has called the collection agency. While Drzewicki tries to recuperate, she gets two or three calls a night from the collection agency, saying they're going to sic the lawyers on her if she doesn't pay up. Just what you need to hear when you're trying to recover from cancer, surgery, etc.

To add insult to injury, Drzewicki had to switch jobs. When she came back from her surgery, her old boss gave her a hard time about missing work. Thanks for caring.

We still have millions of people who can't afford a health insurance policy in the first place. But even working folks who can collect the scratch to cover an insurance policy are being left high and dry by their take-the-money-and-run insurers. Shapiro cites a poll by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health that finds one in five Floridians and one in four Ohioans reporting they are being contacted by collection agencies. The number one reason for those calls: unpaid medical bills.

The problem with health care is not illegal immigrants or freeloaders. Middle-income families with two or three incomes, like the Drzewickis, are getting squeezed by the private insurance racket. Workers are playing by the rules, trying to stay healthy, and still ending up broke (and don't forget sick).

Getting sick isn't a crime or a sin. It happens to everyone... and it should bankrupt no one. The sick don't go bankrupt in France, Germany, Canada, or anywhere else in the industrialized world, at least not at the rates they do here in America.

Save money, save lives, and be a good neighbor. Support universal, single-payer, not-for-profit health coverage.

Read more: see Joseph Shapiro, "Health Bills Can Lead to Debt Woes for Insured, Too," NPR, 2008.07.20.

16 comments:

  1. Cory, you have shot an arrow straight into the reason why I favor socialized medicine, even though I've been a Republican all my adult life. Stories like this make me angry.

    A little over a year ago, I switched insurance carriers because I became convinced that the insurer I had would try something like this if I got seriously ill. I had found horror stories on the Web about them. I was (and still am) in fine health, so I decided to buttress my fort while the sun still shines.

    Buttress my fort -- not against the prospect of disease, but against the system that would claim to be devoted to saving my life! It is as if one would go to the beach and fear not the sharks, but the lifeguards.

    I think I can trust the carrier I have now (Dakotacare). I could not find any horror stories on the Web about them. At least, not a year ago, and not to the extent that I tried.

    Preying on the old, the poor, the weak, and the sick is not my idea of democracy. I can't imagine that the nation's founders would feel anything but outrage at a story like the one you tell here.

    Inmy opinion, with well-crafted and well-enforced laws to prevent fraud and freeloading, with good cost controls, and with a reasonable funding scheme, socialized medicine (let's not apologize for calling it what it is) can work, even in America. Carry on the fight!

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  2. Cory, You are attempting to appeal to emotion with a series of heart-breaking stories. People will 'slip through the cracks' in any medical system. I'm sure there's just as many stories in Canada about people who die while waiting months to get the surgery they need.

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  3. If there were notihng but emotion to the story, you'd have me dead to rights, Matt. But these aren't "cracks." Mrs. Drzewicki's story is an example of a sick system functioning exactly the way it is designed: maximize profit, minimize service, and treat people as means, not ends.

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  4. I worked for an insurance company that attempted to become "for profit". After failing we were taken over by a company who sent RNs to hospitals as "hatchet lady's" to gather criteria, limit benefits and be profitable. Why shouldn't we have some aspects of socialized medicine (interdependence), hopefully in the form of tax credits with choice. We have public libraries (information once only for wealthy), public schools (education once only for wealthy), and note our local development corporation just received public tax dollars to loan to business at presumably lower than market rates with some discretion (that's socialized capitalism). You can't have it both ways. John Hess

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  5. I have been involved in health care for 27 years, I have seen many, many changes in government regulation, so to copy a phrase from Corey, I know of what I speak.

    There is much talk of "socializing" medicine. This will not be as simple as many people think. Let me remind you the govermment already has a socialized program, it is called Medicare. Medicare covers only a certain percentage of the population and it is a miserable failure. There is so much to say about the failures of Medicare there simply is not room here.

    There are several reasons why medical care costs so much today. One of the biggest is Trial Lawyers. This country needs tort reform and it is needed now. A physician friend of mine in the state of Washington has told me that he has had to add $75.00 to an office call to everyone he sees just to pay his malpractice premiums.

    Another reason is Medicare reimbursment. This is much too complicated issue to get into here, but to give you an example of the complexity of Medicare, there are 3000 (this is not a typo) yes 3000 pages of law just so a Hospital or Clinic can submit a claim to Medicare. Hospitals are reimbursed about 0.35 cents on the dollar for care given to Medicare patients. So what will happen will 100 % of the population of the US is on socialized medicine? You will see hospitals closing left and right because they will go broke.

    A comment was made on this blog about how illegals immigrants or freeloaders are not the cause of health care problems. You could not be more incorrect. If a health care facility receives and accepts Medicate payment they CAN NOT turn anyone down for health care regaurdless of their ability to pay. In fact when a patient presents for care in the Emergency room we can not ask them anything about financial responsibility until after they have received treatment. There are hospital going broke in Califronia because they are giving fee care to illegals. It is a common practice for illegals (pregnant females) to come across the border and deliver their baby in a US hospital. As I said a hospital that accepts Medicare assignment (and the illegals know this)can not turn a female in labor away. The child is born and the hospital is stuck with the bill, and this bill can be upwards of $20,000.00

    Socialized medicine in my opinion will only make matters worse.

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  6. I summarize Cory's story thus: Woman gets serious illness that would likely have been a death sentence 20 years ago. Women's insurance company lives up to their contract with her by paying $100,000 of her bills in the first year. Women still has $62,000 in medical bills that the insurance company has no responsibility for. Cory thinks the insurance company sucks because somebody sick has to pay for her own treatment and wants a system where everyone else is forced to pay for her treatment instead. Cory doesn't realize how "take-the-money-and-run" he himself sounds.

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  7. To me Firebird makes this point: we don't turn down health care to the needy so tax payers will pay anyway through Medicaid or increased premiums, so why not externalize health care costs and remove employers from the picture? That would vitalize business equally more than any single thing. He was so correct that administration of health care is overly complicated and I would add really takes away from the value. It's a difficult business to learn at almost any level.

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  8. Stan & Cory are right; the rest of your thoughts are dunder. The senators have socialized medicine. The military has socialized medicine. Get over it. It works better than the insurance, hatchet job system we have now - and at less cost.

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  9. But the Military and the Congress (who are treated in military hospitals) don't have the amount of red tape to go through that a nationalized healthcare system undoubtedly will bring.

    More red tape=reduced efficiency=more cost in the long run in dollars and lives.

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  10. To anon 7-21-08 11:58 pm

    You missed the point, government has never nor ever will be able to manage a bureaucracy this large. Medicare is going broke, the VA systems are going broke.

    You are right, congress and the Military have socialized medicine. I challenge you to ask any Veteran if he/she is satisfied with the care that they receive at a VA health care institution. Remember the situation at Walter Reed,one of the largest VA Hospitals? This is a great example of how your socialized medicine will not work. It closed temporatily. Why? Largely because of underfunding.

    I assure there is nothing that the government gets into that costs less than something that is run by private business. If you know of something then I am all ears.

    One other thought about socailzed medicine. If Canada's system is so great why do Candians come to the United States for much of the diagnostic testing and treatment. Why do they have to stand in line for as much as 4 months to see a specialists, then 4 more months for diagnostic testing they may need?

    I could go on and on but I think I made my point.

    One last thing, my thought are dunder? I truely hope you are more informed when you pull the lever in November.

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  11. We have the best medical care worldwide for those able to pay for it out of pocket with huge disparity for those dependent on an overall failing system. True Medicare reimbursements aren't sufficient so many doctors refuse to contract with Medicare and some other insurers. Doctors want to doctor without all the headaches, which is why some like Kaiser Permenente HMO model where they work entirely within that system. I'm personally for mandated coverage, (somewhat like car insurance) through tax credits (Hillary's idea I think). Keep choice and the institutions non-govermental. Firebird does say the system is broken. Some fix is required. In his defense, when has the government done well at administering a large program? JH

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  12. JH: large programs government runs well:
    --national health coverage in several other industrialized democracies (are Americans just not as good at government as the Finns, the Swedes, the Norwegians, the Germans, the French...?)
    --Apollo program
    --U.S. Postal Service (who else will send your letters for 42 cents?)
    --state university system (Go Jacks!)
    --military (Blackwater can never replace)

    Government isn't the solution to every problem. But private insurers make all sorts of billing errors and other mistakes along with their deliberate efforts to deny coverage, and Americans are ending up bankrupt, sick, and dead because of it. Natioanl health coverage won't be perfect (none of the above programs are, either), but it will be better (more cost-efficient, more effective, more just) than the mess we have.

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  13. CAH:
    Nationalized Health- A full 20% of Norway's GDP is from oil exports. So maybe we should just pay for socialized medicine through our oil exports...

    Postal Service: UPS/FedEx/DHL could all do it easily with the economies of scale the USPS partial monopoly has given them.

    State University System: Name a year tuition hasn't increased faster than inflation.

    Military: How good would our military be today without Lockheed-Martin and Boeing? How well would it have succeeded in its present mission without Blackwater filling in as private security forces in Iraq? The military must remain an independent force acting on the behalf of all US citizens. But that is true regardless of how badly it is run. Private industry could run it far better...but then it would not exist for public interests. It would just be a more powerful, less expensive, quicker killing machine

    The Apollo Program: True. Too bad that isn't being applied to energy production today.

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  14. You can get individual cases to support either side of this issue. There was a news item today detailing the problems in Canada's heralded socialized medicine program. Too few doctors, doctors working 18 hr days to try and see all the patients because so many request visits, if drs are full then the pts go to the ER with subsequent long waits, and the long waits for tests themselves.

    Their example: A teenager in Toronto started having seizures, had an Xray that showed a cyst in her brain. She had to drop out of college and lose her credits because she can't attend with the possiblty of seizures at anytime, but yet she has to wait 4-5 weeks for an MRI and/or biopsy, and then will have to wait 4-5 weeks to see a neurlogist for surgery if needed. Wonderful care???

    Gov't care is there and would be here rationed on cost. If you weren't deemed worth the cost, you wouldn't get the treatment you need.

    There are good points and bad points to Canada's system and ours. But truly socialized medicine is not the answer.

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  15. Correction to the timeline in my post above:

    Their example: A teenager in Toronto started having seizures... she has to wait 4-5 weeks for an MRI... and then 4-5 MONTHS (not weeks) to see a neurlogist...

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  16. Truly socialized medicine is an "ideal" answer. Americans aren't raised to think interdependent. Canada shows what we all know: any system will fail at times. But we obviously need a better solution to what we have now. Does capitalism supply the best health care solution? How long do you wait to see a Madison dentist? JGH

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