9 Examples Of How Health Care In America Can Be Improved
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1. Carol Ann Reyes Dumped From Hospital Into Skid Row
A homeless woman named Carol Ann Reyes was admitted to Kaiser Permanente Bellflower hospital because of a nasty fall she took. She stayed for three days, at which point Kaiser called her a cab, and instructed the cab driver to dump her in the Los Angeles area known as Skid Row. Reyes was wearing only a thin hospital gown, because, as the hospital later admitted, her clothing had been lost. Carol was confused and suffering from dementia, but Kaiser put her on the streety anyway, and was only caught because of a videocamera running outside of a homeless shelter.
2. Hannah Devane’s Insurance Company Won’t Pay For The One Thing She Can Eat
Hannah Devane has a horrible disease of the esophagus that makes it impossible for her to eat normal foods. Hannah literally needs a special formula called Elecare to survive, if she didn’t drink the Elecare she wouldn’t get enough food to live. Naturally her health insurance company refuses to cover Elecare, calling it a “nutritional supplement.” The thing that she needs to live is a supplement to the insurance company. Her only source of nutrition.
Hannah’s father, a police officer, is now working two jobs so that he can afford the formula for Hannah.
3. 9/11 Workers Denied Health Care
A large portion of the 40,000 people who worked at Ground Zero in the days following 9/11 have come down with life changing respiratory illnesses. The dust in the aftermath of the terrorist attack was filled with asbestos and tiny bits of glass.
This is a terrible fact, but one would assume that these people would have nothing to worry about. Surely the government wouldn’t forget about the people who sacrificed their personal well being on that day. Forty percent of 9/11 responders are without health care, either because they never had it, or because they have lost their jobs since becoming ill. The government pledged a paltry $52 million to cover their health care costs, a figure that was deemed “inadequate” by the federal 9/11 health coordinator. It has gotten so bad for 9/11 workers that they recently have been forced to sued the World Trade Center insurance fund so that their health care needs could be met.
4. Emanuel Wilson Denied Chemotherapy In Wake Of Hurricane Katrina
Emanuel was a school bus driver in Louisiana before losing his job in the aftermath of Hurricane Katrina. The government met some of his needs after he was displaced – he received money and food stamps – but what he really needed was chemotherapy.
Wilson had intestinal cancer, and had been getting monthly chemo before the hurricane hit.
The government helped people with health care after Katrina, but only if they were completely destitute. If you had health care and a job before the Hurricane, you were out of luck after if you lost that job and health care. So essentially Wilson was punished for playing by the rules. He was covered. Until natural disaster.
5. Shirley Loewe Denied Medicaid Coverage For Breast Cancer Because Of Loophole Law
Shirley Loewe was diagnosed with breast cancer in 2003. At the time of diagnosis she was uninsured and her $15,000 a year income as a hairdresser was too high for her to qualify for Medicaid in Texas.
However, there is a federal law that allows women diagnosed with breast cancer to receive Medicaid treatment even if they don’t meet all of the normal criteria.
Loewe was denied again anyway. At the time Texas was one of 20 states that only applied that law if a woman was diagnosed at a clinic that received federal funding. Loewe was not diagnosed at such a clinic. She was diagnosed at a medical center half a mile away from a qualifying clinic. Loewe ended up cutting back her work hours so that she could qualify for charity care.
Loewe died in June of 2007, after four years of stress dealing with money and bureaucracy.
6. Tonya Gullino Has Miscarriage, Blue Cross Deems It “Elective Abortion”
Tonya suffered a miscarriage last August, and understandably had to make an emergency room visit. About three weeks later Blue Cross & Blue Shield sent a statement denying the claim related to the miscarriage. Tonya called to find out why and was told “We do not cover ELECTIVE abortions. If you chose to terminate your pregnancy for non-health threatening reasons, BCBS will not cover it.”
Despite the emergency room visit occuring near midnight (who gets an abortion at that time of night?), Blue Cross still asked Tonya to fax over her records stating that she did not have an elective abortion.
7. Jim Dawson Hit With $1.2 Million Hospital Bill, Despite Having Health Insurance
Jim Dawson found himself in the hospital at the age of 61 fighting an infection. It proved to be a lengthy battle, with Jim spending five months in the hospital, but it had a happy ending. At the end of the five months he was pronounced healthy, and was able to go home to his wife Loretta.
That’s when the phone calls from California Pacific Medical Center started, reminding him that he still owed $1.2 million in medical bills.
This happened despite Jim having health insurance, because his insurance caps lifetime benefits at $1.5 million, a cap Dawson hit two and a half months into his stay. He also has debts totalling into five figures to scores of doctors who were involved with his case.
Tough luck you might be thinking, caps are there to protect health insurance companies from massive payments far beyond what you could reasonably expect right? Sure, maybe, but Jim would have never hit his insurance cap if his hospital wasn’t doing things like charging him $791 for stockings (to improve blood circulation) that can be found online for $12. Or the $2,225 to $6,675 a night for an oxygen mask to help him sleep.
He also wouldn’t have hit his cap if doctors had correctly diagnosed his staph infection early enough to be easily cured. Various doctors made the wrong call however, leaving Dawson with a medical bill he can’t hope to ever pay.
Finally, when a reporter from the Wall Street Journal began investigating the story, California Pacific decided to write off his entire bill. Strange how that works.
8. Aetna Takes Eric Simpson’s Prosthetic Arm
Eric Simpson lost his arm after being brutally attacked by a masked gunman who shot him seven times, all in the arm.
Luckily, he had insurance (for which he paid $530 a month), and Aetna said he was fully covered to obtain a prosthetic arm. Good thing because the prosthetic cost a whopping $37,000.
Eric got the arm, and spent a week learning to use it when he took a call from his insurer telling him they were sending someone to collect his new arm. They told him he should have known he only had $2,000 in coverage for artificial limbs. Despite the earlier pre-approval.
Aetna followed through, and repo’d the arm, before realizing (a week later) they had made a mistake. Eric had full coverage for prosthetics after all, and eventually got his arm back, but not before going through an incredibly stressful experience at an already unbelievably stressful time in his life.
9. Natalee Sarkisyan Dies Because Cigna Drags Their Feet
Natalee Sarkisyan was a 17 year old girl from Glendale, California. She suffered from recurrent leukemia, but was lucky in that her brother was a marrow match. She received a bone marrow transplant from her brother in November of 2007, but the transplant led to multiple organ failure that affected her kidney and liver.
Natalee needed a liver transplant, and was covered through her parents health insurer, Cigna HealthCare. Cigna denied the liver transplent. Her family organized widespread protests and attracted a great deal of media coverage, causing Cigna to reverse their decision. But it was too late, and Natalee died just a few hours after Cigna approved the procedure.