Friday, May 05, 2006

Human Beings: In the Background of the Health-care Debate -- Real People

The last two posts have been about the new health plan in Massachusetts and its prospects. Along with all the pros and cons and the tossing out of numbers, did I forget to mention that real people are involved?

I'm afraid I did. Sorry about the oversight, but you know how it is. It's always about the people with a platform and a political or financial interest: The Romneys, the Kennedy's, the Big Boys of the health insurance and drug companies, anybody big and moneyed.

The 46 million without health insurance? People going without healthy care because they can't afford sky-high health insurance premiums? People having their lives torn apart first by cancer and then ground into the dirt when they learn that their health insurance policy covers only a portion of gigantic medical bills?

Well, we don't hear from them and rarely see them, and then only at a safe emotional distance. First of all, these are for the most part not important people. They don't have platforms. They're just people, like you and me. Also, and be honest now, don't you really think that a lot of them are just plain losers who made bad lifestyle decisions and then expect responsible types to bail them out?

Well, this is Cover the Uninsured Week, so that's as good an excuse as any to bring a few of these creatures out of the shadows. One is Catherine Edwards, 54, of Carthage, Illinois. According to her profile on covertheuninsuredweek.org, she is a divorced mother of two children, Renee, 21, and Douglas, 15. The website has a photo of her and, surprise, she looks like a normal person with one head not two and arms and legs. But she does not look the picture of bliss.

Until April of last year Ms. Edwards worked as a machine operator for an automobile parts manufacturer. In April, she was laid off from this position. While she had the option of continuing to receive health coverage under COBRA, she was unable to afford the monthly payments since her only source of income was her unemployment check.

Although this past October Ms. Edwards was officially terminated by the company, she has recently returned to its assembly line as a temporary employee. In this position, she is ineligible for benefits. Cathy's two children are fortunate to have coverage under their father's policy.

Ms. Edwards suffers from a rare disease called Myasthenia Gravis Pseudoparalytica, which severely weakens her muscles and causes extreme fatigue. In some cases, this disease can be life threatening. In all cases, it prevents people from living a normal life. It makes working long hours very difficult.

While she receives some care at a local health care clinic, she is not receiving the level of treatment required for the medical management of this disease. Ms. Edwards is not the only member of her family who has been affected by the devastating effects of being uninsured.

Her brother, Gale Jones, 59, died last month after suffering from Crohn's disease and colon cancer. He was uninsured and was unable to pay for the treatments he needed to survive. His choice was pay or die. He died.

There are others, however, who make it their business to have health insurance -- and still lose big in the macabre lottery that is health care today. Dana and Doug Christensen bought health insurance from a company called Mega Life & Insurance Company. Covertheuninsured.org has a photo of the couple in happier times.

The Christensens thought they had a good policy and were happy with it -- until Mr. Christensen was diagnosed with bone cancer. Only then did they discover that the policy did not cover chemotherapy. Mega Life refused to pay for treatments, citing legalistic language in the policy's fine print. Eighteen months after being diagnosed and without the treatments he needed to have a chance to live, Mr. Christensen died.

Sherry and Dan Orestuk, also profiled on covertheuninsured.org, bought a health insurance policy from Mega Life as well. They thought they had good coverage. They found out they didn't when Ms. Orestuk was diagnosed with breast cancer.

In fact, when the bills started rolling in, they found themselves with bills in the tens of thousands that they had no hope of paying off. They received endless telephone calls from bill collectors treating them like deadbeats and sneering at them because they could only afford to send $25 a month.

Ms. Orestuk is still struggling with breast cancer. To get the treatment she needs, the couple has moved to New York because the state is one of several states that exercise strict oversight over the coverage that health insurers must offer. What is theoretical to many in the health debate is lived daily by the Orestuks, the Christensens, Catherine Edwards, and millions like them.

Please watch out for the Mega Life's of this world.

Also watch out for the powers-that-be in Washington, D.C. Under the guise of helping small businesses gain access to health insurance, the U.S. Senate is getting ready to vote on a bill that would undermine health insurance for 85 million insured Americans. If passed, S. 1955 would preempt existing state laws regulating coverage, standards, and rates. The measure would substitute watered-down federal standards.

The bill would guarantee countless additional horror stories like the three told above. It would eliminate state protections that prevent insurers from selling only to healthy people and redlining the ill. The bill is so bad that 41 state attorneys general and state insurance commissioners have joined forces to oppose it.

Why is doing right for the health of the many always an uphill struggle?

So long and keep moving.