8/15/2009

Health Care Horror Story #5

This one comes from hometown of Newberry, SC. What happens when you work hard for a living and something happens to you that requires very expensive medical treatment that could last for years? In today's America, chances are you'll be bankrupt and homeless - if you're lucky. If you're not lucky you'll die from lack of care or substandard care because every person in the health care chain is interested first in their cut of the money and second in your well being.
Around 11 p.m. on July 27, Macedonia "Mase" Gallman was called to pick up two men near Newberry Academy on Smith Road. The men asked Gallman to take them to Belfast Road.

Later, C & C Commute dispatchers called police to report that Gallman could not be reached and was missing.

Deputy Rusty Fulmer had seen a C & C cab while he was helping remove a fallen tree from Mudlick Road, and when he heard the call, the deputy went in search of the cab.

Fulmer found Gallman lying in a ditch near Mudlick Road and Highway 56 and shot twice.
Since the incident Gallman has remained hospitalized and in serious condition. He is on a ventilator and has required several surgeries with more in store.

It would seem reasonable to expect that insurance would be assisting with Gallman's care, especially since he was injured while working. Unfortunately, this is not the case. As anyone who has dealt with both employer based insurance and "Worker's Comp" can tell you that paperwork jungle is nearly impenetrable. Each points to the other as the responsible party while simultaneously barraging the patient with paperwork and phone calls. If the patient is unable to fill out those forms or take those calls because they are on a ventilator or in a coma then the insurance folks are overjoyed because delay can mean they get to deny the claim!

Friends and family in the community have set up the usual "fund" at a local bank to gather donations for Mr. Gallman. Dinners and bake sales are being planned to help pay for his ongoing medical expenses because the hospital wants its money - insurance be damned in order to pay the salaries of its CEOs and other administrative staff.

I am intimately familiar with this process. Before it was determined whether I would be listed as disabled before my transplant, my family began a number of fund raisers to pay for my care since we had no insurance after I lost my job while sick. Friends from around the country sent in donations to a fund and complete strangers also sent in donations to help pay for my ongoing medical care. Even though I eventually was determined to be disabled thanks to liver failure and was able to qualify for Medicaid in South Carolina, I was required to have nearly $3000 in cash on hand before my transplant to cover expenses insurance doesn't cover after transplant including travel expenses to and from Charleston, lodging for myself for up to 3 weeks after transplant as well as a family member, and other incidentals. Thank God for those donations!

It is ironic that the area of the country that seems most opposed to reforming our broken health care and insurance system is the area of the country where on any given week you can open the paper to find a notice for some bake sale, potluck dinner, poker run, car wash, or local band benefit for a kid or community member with some health care calamity.

There are entire websites devoted to helping people raise money to pay for treatment that insurance companies routinely refuse to allow.

So, the family and friends of poor Mr. Gallman instead of being able to focus on his care and assisting the police in finding his attackers, must spend their time trying desperately to raise money that will allow him to get some modicum of care. Even then, the reality is, he will be destroyed financially - probably for life - by the medical bills and heartless medical collections people that will begin to circle like vultures before he can even begin to mend.



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