How the Health Care Crisis Hit Home for My Family

No way the GOP wins a fight over health care with stories like this multiplied by the millions. You don't succeed when you want to cut back and Obama wants to cover more folks.

http://www.political-buzz.com/

Outstanding piece KT. I'm glad it made the cover. You make a lot of good points.
" A paradox of medical costs is that people who can least afford them — the uninsured — end up being charged the most." It is expensive being poor.
Those without an advocate as skilled as you are in dire straights.
I wish your brother well.

The first irony is that our current situation is not new. While certain elements in our country like to make light of those less fortunate than themselves and pretend they deserve what they get, the truth is significantly more complex and as KT notes significantly more tragic than its been portrayed for going on 15 years now.

The other thing worth noting right off, is that the insurance her brother was buying bears a remarkable similarity to the mortgages many people have bought.
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People profiting mightily on consumer needs couple with misplaced trust.

KT-Thanks for sharing something personal to you with us. I know this is not easy for a traditional reporter like yourself, who loaths to be the story. But your brother's story is important to me too. No one should be without access to needed health care. Period.
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I can't fix our health care mess, but if your family needs assistance to help defray costs I will be more than glad to donate and you can count on me.

What a heartbreaking story. Thanks to your brother for his willingness to lay bare his life in a national magazine. Thanks to you for naming names.
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We can hope that the fear that we all have of losing jobs and health coverage will provide the political impetus to get this changed.
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(Stengel is talking about the story on MSNBC right now, along with Nancy snyderman)
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One thing I haven't seen addressed is the increase in productivity that would surely follow if this burden of fear were lifted from all Americans.
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Please read your story online and let the High Sheriffs know that some of the links into your story (and others, but here we are on yours) are wildly inappropriate to the point of being infuriating:
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That's when Pat, who is now 54, learned that his kidneys were failing. (See the most common hospital mishaps.)
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I said I'd take care of it, bringing to bear my 15 years of experience covering health policy, sitting through endless congressional hearings on the subject and even moderating a presidential candidates' forum on the issue. (See pictures of Barack Obama behind the scenes on Inauguration Day.)

KT, I'm so sorry about your brother. I hope you all find some way to get him help, and that he gets better.
I had major spinal surgery last year. My company's insurance is apparently as good as anybody's, but even with coverage it was astonishingly difficult to get them to pay. Both my hospital and the artifiical disk manufacturer employ several people who spend all day prevailing upon insurance companies to meet their contractual obligations. I think the hospital finally gave up on collecting the last few thousand dollars.
I don't know how people without the resources (and persistence) that I have available could ever get things paid for even if they do have coverage.

Thank you, Karen, for the fine article. You've performed an important public service if it helps to wake people up.
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Your article could be used as a summary for the movie 'Sicko'. The same issues are dealt with in the movie, and the conclusion is the same. I highly recommend watching it to anyone who hasn't. I know Michael Moore is a lightning rod for many on the right, and some of the scenes in the movie (particularly in Cuba) could have been more effective if they hadn't been so contentious. I hope people can get beyond the messenger and concentrate on the message. It's important.
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Your brother has our best wishes.

This article should shine a bright spotlight on any political argument that relies on blaming the victim for their troubles. Such arguments are, of course as common as termites and just as harmful. I hope that your article inspires scrutiny on ALL such debates, bnot just those involving medical care.
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Thanks for the article. You've provided an invaluable service.

KT, thank you. Ditto the comments above. And isn't it interesting that your family's story would have fit right in Michael Moore's "Sicko," which focused on how health insurance in America seeks to not pay for treatment. And wqhich key figures in teh msm sought to discredit (see: Gupta, Sanjay)
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Best wishes to your brother and your family in its entirety.
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I hope you don't mind, but I reposted your blog at my site in the hope of driving more traffic to your story. It is important.

But given "the extraordinary circumstances involved," the company agreed to pay his claims from last year, when the policy was still in force. (Pat canceled it on Aug. 22, 2008.) Those extraordinary circumstances, I assume, included the fact that the state insurance department was sniffing around.
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one suspects, given how bad Texas's health care/insurance system is, that it was your position as a national journalist digging into Assurant that played an even bigger role. I have a hard time believing that you were the first person to complain to the insurance commission about these kinds of policies... and I'd be willing to bet that the insurance commission has let Assurant sweep this under the rug for a while.
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" A paradox of medical costs is that people who can least afford them — the uninsured — end up being charged the most."
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and one strongly suspects that when Assurant did finally decide to pay, that the care providers didn't charge Assurant what Pat Tumulty was being charged.

Karen, I'm praying for Pat's peace, comfort, and return to health. I'm also praying for justice. I worked briefly for QualMed/Foundation Health in the '90s, and know whereof I speak.

It's not a seamless system. Pat gets confused navigating between Smolens, who prescribes tests and medications, and CareLink, which must approve them. "The fact is, for guys like Pat, it requires a lot more work to do the same sorts of things" that would be a snap if he had insurance, says Smolens, sighing.
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this struck me, because CareLink seems to be operating like your average HMO; in other words, even if Pat had "insurance", he'd still be having to deal with a difficult to navigate insurance system instead of just getting the care he needs. (I was referred to a specialist by my "primary care physician" a while back; and when the specialist recommended further tests, I had to go back to my primary care physician to get his approval for more tests....)

KT: Thanks for sharing a personal issue and best wishes to your brother. It amazes me that as a nation we have failed so miserably to provide basic care for everyone. I know there are vested interests and conniving politicians who have made medical care a business for profit. My brother in Canada had major throat surgery and extensive care, free prescriptions for a year, home visits - you name it - oh yes free parking when going in for treatment - and he is okay now. When Pres Obama was in Ottawa the Canadian Prime Minister repled to a question on health saying they factored in that cost so health care in not aan added issue for say auto manufacturers.

You editor was on MSNBC talking about this.

By the way: nothing is more reprehensible than listening to lobbyists and pols sneering at the Europeans about their "socialised" health care system. We truly have idiots in high places.

These short term & emergency health care plans are such a scam. When I worked at DSS companies would come thru all the time & try to sell "cancer plans." It was sad to see people actually sign up for these plans.

Many people don't realize that Medicaid will only pay for a limited number of prescriptions per month. (Used to be 3.). If you have serious medical conditions you are likely to be on more than 3 a month. Tried to help a woman once who had severe mental health problems which required meds, as well as high blood pressure & a siezure disorder. She was poor & illiterate. Each month she would decide between treating her mental health or her seizures. I finally found program to help pay for some of her pills, but she could have never done it on her own.

For many Americans, if you recover from a serious illness, you find yourself physically weakened and flat effing broke. It's a disgrace. When right-wingers pull the "we could end up like Europe!" scare tactic, they don't understand that that's just what we want.

KT, I echo the thanks for the personal and important story and also the good wishes for Pat.
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I'm working contract labor right now trying to get a loan to finish school. No insurance and a painful dental issue I have no choice but to stick it out for a year until graduation and then hope I get a job with insurance quickly.
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That's the choice I have to make in America, live with the freakin' pain for a year or more, just to finish my education.

THIS is the post that should have almost 400 comments, and I hope it gets there.
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I work in a small business, where there are only two of us who are actually insured (through our husbands' work). The rest don't have any sort of preventative care, and very little care even in acute situations. One woman, Wendy, was reaching for boxes and fell. Her knee swelled to twice its normal size. What did she do? Did she go to the doctor? Nope. She hobbled around the bakery on that knee until the swelling eventually subsided--two weeks later. She couldn't afford either time off or a doctor visit.
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For these women, no health insurance means that 1) they get sick more easily because of lack of preventative care, 2) they stay sick longer because of lack of care during illness/injury and because they can't take time off of work, 3) they jeoparidize their future health by not taking care of problems before they become chronic, untreatable, or only expensively treatable, and 4) when they eventually, rarely go to the emergency room, they get charged through the nose and end up in incredible debt, which they can never pay off...because they earn less than $10 an hour.
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On a visceral level, I just don't understand how this system has lasted for so long. Intellectually, of course, I know about lobby groups and conservative fears, but really--look at the human cost here. And we consider ourselves a world leader?
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Thanks, KT. This is, in my eyes, the most important story you could write.

Thanks for the story, KT and best thoughts for your brother, Pat.

But people have to realize that delay and/or denial of care is standard operating procedure and really part of the business model for health insurance companies. They know that if they deny the claim, that a lot of people will give up and they won't have to pay for the procedure. Simply put health insurance companies don't make a profit when they pay out claims. They only make profits when you pay your premiums and don't use healthcare. They use the premiums to invest in the stock market. They are in a world of hurt right now with the stock market going down. Look for the next industry bailout with the new "healthcare reform" bill pending in Congress....