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.“
{ 19 comments… read them below or add one }
$22,000 Baby Bill – where is personal responsibility? She could have purchased an HMO. Maybe looked a little closer at the policy?
I ‘feel’ bad, but is there no personal culpability in this world anymore?
Jon did you read the part where she bought maternity coverage, but it was bullshit coverage. My guess is she would have got the better coverage if she had know that maternity coverage, doesn’t cover a pregnancy.
Again, it’s all in the fine print. Yes, it is a shameful thing to call it maternity coverage and have it cover so little, but most people really don’t dig deep to ensure that they are getting what they think. Personal responsibility is better than just assuming what you are getting. Private insurance that actual covers most of the cost of pre-natal care, delivery, hospital/facility costs, post partum care, etc. etc. is very expensive, most people cannot afford it. Buyer beware of a plan that includes maternity coverage for an unbelievably low premium. We could not find any plans for less than $600 a month, so we got a catastrophic plan and when I got pregnant, I switched to WA Health Program because it will actually cover a large portion of the bill.
BASIC Question… WHY SHOULD ANYONE HAVE TO READ FINE PRINT REGARDING THEIR HEALTH? WHY!? BEING A COUNTRY AS “POWERFUL” AS USA WE CAN NOT TAKE CARE OF OUR OWN? WHY DO YOU HAVE TO BE HEALTHY OR RICH TO HAVE GOOD HEALTH INSURANCE? WHY DO WE ALLOW A BOARD OF TRUSTEES TO MAKE DECISIONS ON PEOPLES LIVES BASED ON MONEY? WHY IS THERE A FAULT IN THE “MATERNITY COVERAGE” TO BEGIN WITH?
It says something about us as a society when we allow profit to dictate the quality of health care to its people.
It’s disgusting that we live in a 1st world country with a 4th world for profit health care system. Republicans say Obama’s healthcare bill is going to setup death panels, I disagree, private industry already has them.
As someone who was unemployed and without health insurance (though thankfully in excellent health) I pray for this bill to pass. It’s about time something is done about the appalling healthcare system our country has.
Please checkout Fatalcare.com, a portal for the book titled “Fatal Care : Survive in the U.S Health System”. This book talks about 10 cases where preventable medical errors proved to be costly to the victims, the kind addressed in this post.
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It is SO simple to get ALL Americans very inexpensive FULL coverage for ANY medical need with no pre-existing condition exclusions. Get rid of the for profit insurance companies that pay their criminal CEO’s hundreds of MILLIONS of dollars in obscene salaries and bonuses. They get this money through post claims underwriting and denial of justifiable services killing over 50,000 adults and 25,000 children EVERY YEAR in their need for greed. This is murder for profit and no one is doing anything.
I almost lost my leg and died when Dr. Ed Lowenstein, medical director for Universal Health Care Inc of St Petersburg Florida denied payment of my claim AFTER APPROVING it 8 times in writing! I was in Thailand at the time and was approved for emergency service outside the country for $30K every year. Yet he denied my care which almost cost me my leg and my life!
This is why a single payer plan would work, it would eliminate BILLIONS of dollars in CEO salaries and bonuses which would then go to paying for the medical care we are now being denied. We do NOT need these CEO Criminals, they accomplish NOTHING except misery and pain for their customers when they need help the most by sucking all the money that we need for medical care into their obscene salaries and bonuses. For my personal horror story, Google: domestic terrorism/gary’s blog and Google: “Dr. Edward Lowenstein, St Petersburg” to read about that criminal health insurance company he works for.
There is really only one solution and it has four parts:
1. Lay off all employeees of the FDA and sell the office furniture at auction.
2. Ban the manufacture, sale and use of ALL prescription drugs and allow any drug that actually serves a useful purpose (there are eight or nine) to be manufactured generically by State and Federal prisoners, which would give them something to do all day instead of pumping iron and fornicating with each other.
3. Teach biology, medicine and dentistry in all schools beginning in kindergarten so that by the time our children enter University all of them will already be MD’s or DDS’s and can practice medicine or dentristy if they choose not to go to College.
4. Replace all Health Insurance Companies with a new organization known as “Real Health Insurance” operated by State and Federal prisoners which would give them something to do all day instead of……..
there’s a point you miss. the underlying cause of ALL of our problems.
GREED. all of the negative things we have become in america, have a single root cause, greed.
It’s disgusting that health care is big business. Everyone is making buckets of money off of suffering.
It should be a provided service. Get the profit out and we all get covered and the greedy ticks will have to find another dog.
How IRONIC – to pay so much to be treated at the “best” clinic only to find out the air there is so polluted by the Medical Center Community there because they use a dirty coal fired power plant located right within a few block of the clinic – that now you have greater health problems caused by breathing pollution than the health problem you came there to have treated!
Case Western (OH) Campus Plant Challenged with EPA Hearing
Posted by: Kimberly Teplitzky at 3:18PM PST on June 29, 2010
Cross posted from RealNeo:
Thanks to the timely, effective intervention of the Sierra Club, the Environmental Protection Agency has agreed to hold a public hearing for citizens to discuss their concerns about the renewal of the permit for the Medical Center Company (MCCO) to burn coal in their powerplant in University Circle (above), harming residents and workers in the densely populated and economically distressed surrounding neighborhood.
As I have previously posted on realNEO, “one of the most serious sources of pollution in Cuyahoga County is literally in my back yard… coal and natural gas fired external boilers at University Hospitals, operated by Medical Center Company (MCCo), polluting the surrounding neighborhoods since the 1930s.” This coal plant is not well publicized – my family did not know it existed when we moved to this neighborhood, and my neighbors are generally not aware it exists. Nor is it well publicized that it provides heat to Case Western Reserve University, and that there are plans for MCCO to build another coal plant less than one kilometer from the current plant.
It was certainly not well publicized that the EPA permit for the current MCCO coal burning facility was coming up for renewal with the EPA – apparently they ran an announcement in the PD… did you notice?!?! Now you know.
The association of this coal plant with Case is kept secret as smart young people hate pollution, and there is great negative global attention on campuses that burn coal, including Case.
Read the full post here. And kudos to Sierra Club Organizer and Campuses Beyond Coal Coordinator Nachy Kanfer for rapid organizing on this that succeeded in getting the hearing moved to a move convenient and accessible venue for local citizens!
I pay $5,000 per year for Blue Cross and Blue Shield and when I was admitted to the hospital (half a day in the ICU and 2 more days) for complications due to diabetes and still I had to shell out $5,000 out of pocket because it was one of those ‘catostrophic’ things they don’t pay for. Anyway, even after all the money for insulin, needles and other stuff, we still couldn’t deduct the hospital & drug bills off our taxes because it wasn’t enough money to deduct from our incomes. And dental care with BC/BS is nonexistent. You’re lucky if it even covers cleaning your teeth. And for a nonprofit organization, do you see the millions of dollars their chiefs get when they leave and what board members earn? Holy crap! I need a job like that, to sit on my butt all day.
Universal health care inc, st petersburg, fl is a company that had to pay 300-400 million aqs a fine for medicare/medicaid fraud. And if the tried to screw medicare imagine what they can do to you. Also this medicare advantage plan co is owned by de desai from india & believe all your personal & medical records are sent to india for procesing, ss#,ph#, address, and medical records. I know as I use to work there & i use to scan all claims including high dollar claims & have it scanned to NDS in india, only to have them denied several times. I see no difference in illegals comming to the US and taking our jobs, Universal helth care saint petersburg , fl actually sends us jobs to be done in india. people please check the better business bureau before signing up with this fradulent company. please read Mr. Gary M Ruehle’s blog on this company. we need to boycott this company not only are they screwing americans out of their money mainly our sr citizens, but also our work force. boycott, boycott, boycott
I live in the UK and you guys have no idea how crazy everyone thinks you are for ‘wanting’ this healthcare system, it is completely shocking how the system is run and we would never allow that to hgappen over here.
Do you realise you pay almost 3x the amount we do (per capita) for healthcare and yet infant mortality rates are higher and people die younger?
Obviously the NHS isn’t perfect but you can pay for private healthcare and it would still cost less than what you pay, I understand you don’t want to pay twice but your education system is the same so what’s the massive issue?? Doesn’t everyone have the right to health care? Evidently not in America…
The NHS is far from perfect but it does free the British from the fear of becoming ill and unable to afford treatment for whatever ails them. I have had experience of the U.S. healthcare system (for the onset of a potentially serious chest infection) and while I received good medical care, the bill was horrendous. Fortunately I had insurance which covered most of the cost but I could not believe the costs involved for the treatment. I genuinely pity those Ameerican citizens who have no access to health insurance for whatever reason – they must be in debt for the rest of their lives if they contract a serious medical condition. Either that or they avoid seeking treatment at all, resulting in possible death. Dreadful situation.
I am outraged at the private insurance companies acting like PROFIT_ORIENTED (and that’s all they care about) organizations. They should operate like NON-PROFITS and care about people’s health, not shareholder’s dividents… the system is completely messed up.
I recently accepted a new job and started having major issues with my back. My neurosurgeon suggested (and 2 other doctors agreed) to have a fusion between L5 and S1 disks and it would be somewhat of an easy fix. I have gone through several years of pain and have tried absolutely everything already. Only delaying the surgery because the pain was at a “manageable” level up till recently. Guess what? My new job’s insurance DENIED a pretty stratight-forward surgery that would MOST DEFINITELY fix my disabilitating problem… And the piece of crap United Oxford insurance is declining the pre-approval for this surgery.
I must say – I had full coverage at all points in my life and either had it through my employers and paid for it myself since I was 18. I am 32 now, for 14 years the most I’ve used it for is to get annual visits to OBGYN and for physical therapy since 2 years ago (on my back- same issue). WHAT THE HELL DO I NEED THE INSURANCE FOR if all I have been doing is paying it for years and years, the insurance companies have been profiting, and when I need coverage for a small portion of what I paid in – I AM DENIED. The healthcare system is effed up in this country!!!
Oh America,
I know you are set in your ways, and this is how your forefathers wanted it.. etc etc.. But honestly a PUBLIC HEALTH CARE SYSTEM is the way to go. You can still have Private health should you choose, in Oz it definately makes the wait time shorter, but I tell you there is minimal stories of people DYING because the didnt pay thee last bill!