One major criticism of American society of late has been its health care system. While the specifics of this debate are subtle, there is no denying that some people have been left out on the cold regarding their medical problems. Seemingly daily, a new story surfaces about someone denied treatment or care due to insufficient funds. Other stories involve skyrocketing prescription drug costs or early discharge from hospitals. Regardless of where you stand on the great health care debate of our time, it pays to know the facts of these stories and the sufferers involved. Here are 12 of the most brutal health care horror stories making the rounds!
Denial of Treatment for a $7 Debt
Michael Moore is hardly the epitome of objective journalism, but it’s tough to argue with the story he dug up here. Pictured above is the actual note received by Larry Smith stating that Labcorp would not perform a blood test on him until he made good on his $7 debt. Smith’s wife notes that this was not a pointless or optional blood test, but rather was being sought because Smith had suffered an intense heart attack that made him sweat profusely and changed the color of his skin. Outrageously, weeks passed without Larry Smith ever getting that single blood test done, and Moore’s blog does not state whether the test was ever done. No matter what one’s stance on universal health care, denying someone treatment over a debt smaller than a movie ticket is about as cruel as it gets.
Skyrocketing Co-Pays for Multiple Sclerosis Drugs
An oft-repeated criticism of America’s health insurance system is high co-pays for prescription drugs. A particularly disheartening example is Robin Steinwand, a 53 year old victim of multiple sclerosis. Steinwand had been taking the prescription drug Copaxone, which cost $1,900 per month but which she had received for only a $20 co-pay since being diagnosed in 2000. But one day, her insurance company raised the price, leading to an unexpected (and now ongoing) bill of $325 – or $3,900 per year. An emotional Steinwand told the Times “I charged it, then got into my car and burst into tears“, adding also that this would likely make saving for vacations and retirement more difficult.
Crushing Hospital Debt
Another familiar theme of the health care debate is the huge debt that some are saddled with by uninsured hospital visits. A man identifying himself as “Clinton” submitted one such story to president Barack Obama’s website (established to collect such stories) claiming to have been slapped with a $10,000 hospital bill during the 60 day “probationary” period before benefits kick in. Clinton had suffered a burst blood vessel in his abdomen requiring emergency vascular surgery, but nevertheless reports leaving the hospital “45 minutes after waking up” even though he was “barely able to walk and in intense pain, because [he] couldn’t afford to miss a single day” of work. Clinton also laments the difficulty of buying a home or contemplating career changes because of what this would mean for his health insurance.
Springing Newly Required, Expensive Drugs on Patients
Some of the most painful insurance-related horror stories involve consumers suddenly being told that they need a drug which is astronomically expensive. That’s what happened to Arlington’s Robert W. Banning, a chronic myelogenous leukemia victim who was prescribed Sprycel by his doctor. The twice-daily tablet inhibits the spread of cancer cells without the grueling ordeal of chemotherapy, but a 90 day supply costs a staggering $13,500, of which Banning’s AARP insurance required him personally to pay over $4,000. Banning’s son has courageously vowed to do whatever it takes, stating “you don’t put your parent on a scale“, but there’s no denying the intense hardship a sudden and permanent $12,000 per year drug bill creates.
Breast Cancer Drug Made Unaffordable by “Tier 4″ Classification
Especially harsh criticism has been reserved for “Tier 4″, a new pricing system adopted by health insurers that charges consumers a percentage of drug prices rather than the traditional flat fee of $10, $20, or $30 per prescription. Originally envisioned as a way to contain costs, CommonDreams.org opines that consumers “may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.” A chilling example cited in support of this is Orlando’s Julie Bass, a victim of metastatic breast cancer. She says that her HMO has designated the drug Tykerb under Tier 4, putting Bass on the hook for a third of the cost – which runs to $3,480 for a 21 day supply 150 tablets. The beleaguered woman took solace in the fact that she could go off treatment during stable periods, but wearily cautioned “if we [breast cancer victims] are progressing, we have to be on treatment, or we will die.”
Lupus Leads to Unemployment, Loss of Coverage and Death
Women with lupus have struggled greatly under the U.S. health care system, according to a Wall Street Journal study referenced by MedicalNewsToday.com. A disturbing case in point is Monique White, a Tennessee woman who had to quit her job after being diagnosed with lupus and consequently lost her health insurance coverage. White promptly enrolled in Medicaid, and then promptly “lost her coverage because of budget reductions to the program.” White resisted going to the hospital when her symptoms worsened, citing lack of insurance, but was rushed there anyway when she eventually had a seizure. She died just a few months later however, primarily from not attending to her symptoms until it was too late.
Denied Coverage Despite Good Health
A compelling criticism of private insurers is how they sometimes deny coverage even to people in good health without chronic or pre-existing problems. Juliann Delozier, a 32 year old mother of two described by MSNBC as someone who “in every obvious respect, is in perfect health“, nevertheless reports being repeatedly denied coverage for, of all things, “history of infertility.” Outraged, Delozier tried to plead that this should be irrelevant, as she did not plan to have any more children, but it still took several months of persistent protest to finally be accepted into an insurance plan. UniCare (the company who rejected Delozier) was frustratingly vague about the matter, stating only that such decisions are “made on a case-by-case basis.” Unfortunately, MSNBC claims that such incidents are becoming more and more frequent, as insurance companies feel no apparent compulsion to explain their decisions to consumers.
Insurance Co. Forces Traumatically Early Hospital Discharge
Some health care horror stories involve not high costs or denied care, but early discharges from hospitals. Increasingly, decisions of how long a patient will remain hospitalized are being made with financial rather than medical criteria. Look no further than the story of Virgil Hervey, whose mother survived a car accident that claimed her husband’s life. Doctors recommended extended hospitalization for Hervey’s mother, who psychologists deemed “not ready” to hear the news of her husband’s death. The family’s insurance company mandated that she be discharged the day after awaking from her coma, providing appallingly little time to recover. Nothing could be more outrageous, however, than when the insurer “called to demand she give back the wheelchair before she could walk” following the discharge. Have revenues sunk so low that a mere wheelchair is a make or break expense?
Pre-Existing Condition Headaches
Still another common complaint alleged against American health insurers is their aversion to pre-existing health conditions. Understandable as this may be from a financial standpoint, it creates some truly harrowing scenarios for those affected. Meet Jacqueline Ruess, a Florida woman who received laparoscopic surgery to treat a growth believed by her gynecologist to be ovarian cancer. Though her surgery was successful, Insurers Administrative Corporation (manager of Ruess’ policy) uncovered “evidence of a preexisting gynecological condition” during a routine records review several months later. The result of this fact-finding excursion was the shifting of a $15,000 surgery and hospitalization bill from IAC to Ms. Ruess personally. The true outrage lies in the fact that this pre-existing “condition” was, in fact, “a common issue that at some point affects between 10 percent and 30 percent of women in their reproductive years.“
Inability to Buy Private Health Insurance
Imagine being told that you had to wait 10 years before buying whatever it was you wanted to buy. Then imagine that what you were trying to buy was health insurance to protect yourself or your family against disaster. That’s what happened to Angela Clay, a 33 year old woman who left her job (and its insurance coverage) after being diagnosed with non-Hodgkin’s lymphoma eight years prior. The assumption was that Clay would simply buy health insurance wherever she moved next. Unfortunately, this has proved more difficult than anyone could have imagined. She reports being told that her lymphoma would need to be in remission for 10 years before ever being considered for coverage. And with over two years to go, Clay has been delaying needed care, “including the follow-up she needs to be sure the cancer hasn’t returned.” Asked about the delicate situation, Clay admitted “I know I need checkups for my health. It makes me feel vulnerable.”
Children Ineligible for State Insurance Due to Family’s Income
Virtually everyone agrees that defenseless children should not go untreated for any reason, most especially due to financial hardship. It is this widely agreed-upon notion that makes Kyla Herbert’s plight so difficult to stomach. As Statesman.com reports, Herbert’s children are ineligible for Texas’s CHIPS program because the family makes $260 per month too much to qualify. While state planners may deem that “extra” income sufficient, it barely makes a dent in paying to treat 3-year-old Katie’s seizures, developmental delays and other disabilities. The little girl survives on a mostly liquid diet, and her early 20s parents were repeatedly denied private insurance of their own, making CHIPS their only hope. Unfortunately this is all too common in Texas, said to be the state with the highest percentage of uninsured children according to Statesman.
$22,000 Baby Bill
Few of the current health care crusades focus on child birth costs, but for certain types of insurance, this is one of the costliest medical procedures of all. DoubleX.com tells the story of a woman whose child birth stuck the family with a $22,000 bill, in her words, “precisely because we were insured, on the individual market.” Because she did not belong to a one-size-fits-all program like those offered by employers, she had to shop for her own insurance, which left her susceptible to being swindled into a program that specifically excluded child birth costs. Despite being told she had purchased something called “maternity coverage” (which can reasonably be inferred to cover child birth), it ultimately “didn’t cover [her] labor, delivery, or hospital stay.” Commenting further on the matter, the woman lamented the difficulty individuals have shopping for their own private insurance, such as how they are not protected by federal and state laws that apply to employer-purchased insurance and that “there’s no one looking out for us at all.“