8/12/2009

Health Care Horror Story #2

In June 2008, Robin Beaton, a retired nurse from Waxahachie, Texas, found out she had breast cancer and needed a double mastectomy. Two days before her surgery, her insurance company, Blue Cross, flagged her chart and told the hospital they wouldn't allow the procedure to go forward until they finished an examination of five years of her medical history -- which could take three months. It turned out that a month before the cancer diagnosis, Beaton had gone to a dermatologist for acne treatment, and Blue Cross incorrectly interpreted a word on her chart to mean that the acne was precancerous.

Not long into the investigation, the insurer canceled her policy. Beaton, they said, had listed her weight incorrectly when she bought it, and had also failed to disclose that she'd once taken medicine for a heart condition -- which she hadn't been taking at the time she filled out the application.

"I didn't know what to do. The hospital wanted a $30,000 deposit. I was by myself. I didn't have that kind of money," Beaton said through tears. "Can you imagine, having to walk around with cancer growing in your body? With no insurance. It's the most terrifying thing in the world to not have anybody to turn to or anywhere to go."

By October, thanks to an intervention from her member of Congress, Blue Cross reinstated Beaton's insurance coverage. But the tumor she had removed had grown 2 centimeters in the meantime, and she had to have her lymph nodes removed as well as her breasts amputated because of the delay.

Beaton was a victim of both the "Death Panel" at Blue Cross and their corporate stop-loss department and an insurance industry ploy known as "rescission" where your insurance is retroactively cancelled because their corps of clerks manages to find something, anything in your medical records to give them reason not just to cancel your current insurance but to cancel the insurance you've had in the past.

If that's hard to follow, it means that anything they have paid up to that point they take back from your doctor or hospital and leave you footing the bill for things you thought had been paid months or even years previously!

In another "rescission" case Wittney Horton, said her coverage was canceled after her carrier said she did not disclose that she had taken a drug prescribed for weight loss and because of her irregular menstrual cycle. Her carrier sent her a letter saying they would not have accepted her had they known she had "polycystic ovaries," a condition she did not know she had.

Here we have nurses or unemployed doctors making a diagnosis without seeing the patient at all. In fact, making a diagnosis that her doctors who had actually bothered to examine her had not made at all. Responsible medicine? Would the definition of a "death panel" not be one that sat in a close and secret room pawing through medical records without ever seeing the patient face to face then deciding their fate based on how much money they will cost the company?

That is exactly the system we have with our private insurers. If you have insurance, pray you never use it for anything more serious than a head cold or you could find your files in front of Cigna's, United Health Group's, or Blue Cross's "Death Panel".

No comments:

Links