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Cancer Widow Challenges Insurer Over $450K Medical Bill

The Huffington Post     First Posted: 10/21/10 11:09 AM ET   Updated: 05/25/11 07:05 PM ET

The following is excerpted from The Progressive's Guide to Raising Hell by Jamie Court, published by Chelsea Green in September 2010.

Never underestimate the power of one person's story to change the world; indeed such stories may be the only thing that ever has. The sincere experiences of individuals who have suffered injustice are the best weapons against injustice. Winning campaigns are about the triumph of fundamental human truth, so real people with genuine stories are the best messengers of populist campaigns.

The language of the status quo is often statistical, actuarial, and data-based. This is not to say proponents of change don't have science and statistics on their side. It's just that opponents of change often base their objections on the hard, cold numbers that only accountants can muster and manipulate to show how they will bust budgets, bankrupt businesses, and break up families. My favorite example is tobacco companies' argument against the Czech government's smoking cessation plan. The industry's actuarial study found that the country's health care costs would skyrocket since people would live longer.

While it's tempting to mix it up with scientists when you know you're right, change-making campaigns typically mobilize the public and affect politics by sticking to the human case.

I saw the "people-first" principle work when one woman with a compelling story was able to fell a whole industry. It's the case of "Dana vs. Goliath."

With health insurance costs skyrocketing in 2006, insurers hatched a plan to remove themselves from the patients'-rights laws that were passed in forty-four states in the late 1990s and early 2000s. The industry explained that the insurance companies wanted to "reduce their costs of compliance" so insurance would be cheaper. It sounded simple enough to President Bush and Congress, who were about to enact the plan. Attorneys general, governors, and state insurance commissioners complained, but it looked like the industry had the votes.

Then Dana Christensen came to Capitol Hill with my colleagues Carmen Balber and Jerry Flanagan.

Christensen had been working with my consumer group to warn against the very type of "junk health insurance" policy that we feared would become the norm if state regulation were bypassed. She and her husband, Doug, had been technically insured, yet Dana was left with $450,000 in unpaid medical bills when her husband died of bone cancer.

The fine print in her insurance policy had no limit on "out-of-pocket cost." So she had to pay most of the costs of his chemotherapy and cancer care. On his deathbed, Doug asked Dana to divorce him so she would not have to be liable for the medical bills. She refused. In the end, only because of a lawsuit under state law, which prevented fraudulent representations, was Dana able to recoup the cost of those bills from the insurer.

Dana flew into Washington on Monday, on the heels of a PBS NOW news story about her case that aired the previous Friday. She held a press conference with Senators Edward Kennedy and Richard Durbin, then lobbied other senators. The power of her story stopped the legislation dead in its tracks.

"What's the point of paying for health insurance and then, when you need it, discovering the benefits you thought were promised and paid for just aren't there?" Dana asked. "That's what happened to my husband Doug and me."

Human truth is very hard for a human being, even the most hardened Washington politician, to turn away from.


Jamie Court's new book, The Progressive's Guide to Raising Hell: How to Win Grassroots Campaigns, Pass Ballot Box Laws, and Get the Change We Voted For, was just released by Chelsea Green Publishing Company. Court, an acclaimed consumer advocate and HuffPost blogger, is president of Consumer Watchdog.

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The following is excerpted from The Progressive's Guide to Raising Hell by Jamie Court, published by Chelsea Green in September 2010. Never underestimate the power of one person's story to change the...
The following is excerpted from The Progressive's Guide to Raising Hell by Jamie Court, published by Chelsea Green in September 2010. Never underestimate the power of one person's story to change the...
 
 
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HUFFPOST SUPER USER
sjcarl
01:17 AM on 11/07/2010
let the people who are wailing about health care reform have this kind of policy.
This user has chosen to opt out of the Badges program
12:03 PM on 10/31/2010
Medical care is being globalized; e.g.:

http://money.cnn.com/2010/08/11/news/companies/health_care_medical_travel/index.htm
One way to cut health care costs? Outsource surgeries - Aug. 11, 2010

"NEW YORK (CNNMoney.com) -- Tina Follett and her husband Patrick are in Panama on a two-week all-expenses paid trip. But Tina isn't on vacation. She's there to get surgery..."

This is from a Price Waterhouse Cooper report from 2006:

http://www.eucomed.org/upload/pdf/tl/2005/extranet/communications/resources/healthcast2020.pdf
HealthCast 2020: Creating a Sustainable Future

"England builds a patient safety reporting system on same concept as aviation safety system in U.S.

The Philippines export nurses around the globe.

The U.S. turns to Indian and Australian companies for outsourcing radiology readings

Companies in South Africa contract with the NHS in England for a variety of surgical procedures

Australia enhances U.S.’s DRG system, which is subsequently adapted by Singapore, France and Germany.

Pharmaceutical makers move clinical trials from U.S. and Europe to India..."

The U.S. does NOT have the best health care system in the world, just the most expensive:

These graphs compare the health care systems of Japan, Britain, Switzerland, and Germany to the U.S.:

http://www­.pbs.org/w­gbh/pages/­frontline/­sickaround­theworld/e­tc/graphs.­html
FRONTLINE: sick around the world: Graphs: U.S. Health Stats Compared to Other Countries | PBS
03:48 PM on 10/21/2010
i wonder where they are from i truly symphathize with the husband but i have a feeling she is from one of those states that really don't want health care for anyone else "just a feeling"
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HUFFPOST SUPER USER
CaveatLector
08:26 AM on 10/27/2010
I don't understand your comments. Every state has an insurer of default, but that means NOTHING. Health insurance companies are out ot make a PROFIT; even if they are run as a NON-Profit (take a look at the salaries of Blue Cross's executives.)

Out of pocket medical costs are an epidemic right now. Over 2/3 of all bankruptices in the U.S. are triggered by a devastating medical illness, and 1/2 of the time, that illness is CANCER.


What you will see in the next decade is a surge in the popularity of straight indeminity insurance; supplmental programs (like Aflac, American Heritage, etc. Although I think Aflac's is the best.) People cannot rely on health insurance to pay the bill for their care anymore.
03:22 PM on 10/21/2010
I don't know how these people who prey on and cheat people of health care they naively expect and depend on sleep at night. They're inhumanity when dealing with people in their most vulnerable state is unconscionable. To the people who say it's just business and the company has to make profits to stay alive I say Bull Sh*t. Businesses that literally hold peoples lives in their hands should be held to a higher standard and profits with peoples blood on it should not be tolerated.
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Pandoras Folly
This Micro-bio is of legendary quality
02:03 AM on 10/22/2010
the problem that starts almost all problems is when we begin to think of people as things rather than people. Claims holders, mother father, tax payers, citizens, the list of titles that are easier to hold in our heads goes on into infiinity but they are easier to hold onto when making self centered and ego driven decisions than acknowledging them as people. that and the rate of sociopathy and psychopathy is very high in large corporations and the higher in the organization you go the more of them you find.
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thereisonlyoneparty
more amazing than you
02:18 AM on 10/25/2010
So all grocery stores and restaurants should be held to a higher standard because that is how people get sustenance? Or utility companies? Or companies that make hygiene products?

Here is the sad truth of life. Your life does not matter at all. It has not ever mattered and will never matter. No one's does. The optimum goal of an individual to have a limited negative effect on others. That is the best you can do. Our connection to life as being something precious sort of makes sense, but not really.
02:36 PM on 10/21/2010
Welcome to the for profit medical structure, the companies are more then willing to take and take the policy payments over the years but when it comes time that you might need to use that policy well then that's another story.. That's why it's called a policy, if you get sick you use it.. But thanks to the GOP and all the loopholes they allowed the insurance companies, this is what you get!
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HUFFPOST SUPER USER
CaveatLector
08:30 AM on 10/27/2010
Let me be fan number 13. What you say is 100% spot on. I work in the insurance industry; but not for the big health insurerance co's. Someone's quality of life and right to live unfettered by pain and illness should NOT be fodder for corporate profit. Make healthcare a RIGHT not a privilege!!!
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HUFFPOST COMMUNITY MODERATOR
slimcat
02:29 PM on 10/21/2010
I thought I was done paying for my late wife's cancer treatment about five months ago but it seems I was wrong. We had BC/BS but, both veterans, we chose to make our primary health care provider the VA which put us in a special class of vets who make co-payments and use regular health insurance as a supplement. BC/BS treats VA doctors as non-participants and I'm sure the reason is because the VA is single-payer health insurance. You'd be amazed at what BC/BS wouldn't cover for a woman dying of cancer even though the VA is in the vanguard of treatment and research.

Since the first parts of the new health care bill went into effect in September, I have received recalculated bills from BC/BS going back to 2008 showing a reduction of payment for themselves without explanation (just the recalculated bills and nothing else). I haven't read the fine print of the new health care bill but I sure would like to know what has changed as far as these past payments are concerned.
HUFFPOST SUPER USER
Kathryn Maver
05:34 PM on 10/21/2010
First of all, I am sorry for your loss. Second, I just shake my head in wonder that BCBS treats our nation's veterans this way. Third, veteran or civilian, these companies are enriching themselves at our deathbeds. They are taking every cent they can, while they can still get away with it. It is just wrong. Single payer care isn't perfect, but at least it isn't tainted by the profit motive.
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HUFFPOST COMMUNITY MODERATOR
slimcat
06:39 PM on 10/21/2010
Well said, Kathryn, and, thank you. ff
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HUFFPOST SUPER USER
CaveatLector
08:32 AM on 10/27/2010
Blue Cross is an EVIL company.
06:55 PM on 10/22/2010
My ciondolences on the loss of your wife. I do sympathize with you on your situation with your medical bills but you have VA. That is the best in the nation! Imagine what the rest of us are going through? That is how F*cked up these greedy weasels at the insurance companies have mangled our health care system.
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HUFFPOST COMMUNITY MODERATOR
slimcat
02:38 PM on 10/23/2010
Thank you, Rob.

Now that I'm a senior, I can no longer afford VA care and must be satisfied with Medicare, which actually costs me less. Not surprisingly, the care I've gotten under Medicare isn't even close to the great care I got with the VA. I wish us senior vets had an option to stay with the VA.

I agree 100% on your evaluation of insurance companies. If one/some of us old, well trained vets went coco and decided to take some of them out, it would be very bad for them. ff
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HUFFPOST SUPER USER
DnDCfromChi-town
02:19 PM on 10/21/2010
"The market will correct itself!"

Rand Paul
HUFFPOST SUPER USER
Kathryn Maver
04:56 PM on 10/21/2010
"But my cancer won't cure itself!"

John Q. Public
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HUFFPOST SUPER USER
CaveatLector
08:32 AM on 10/27/2010
"The market will correct itself, after millions have died."
02:12 PM on 10/21/2010
Liberal Americans are fighting a nearly impossible uphill battle to dispose of medical insurance companies. I think this difficulty can be summed up in rally sign i saw a tea partier holding during the heath care debates, it read something like this "GET YOUR GREASY GOV'T HANDS OFF MY MEDICARE". When you are debating people who dont even understand that medicare is government you run into a real problem.
02:24 PM on 10/21/2010
That is the problem as these people have no idea that Medicare is a government run program, but if they are that dumb then give them what they ask for.. Stop any and all government medical programs, then let's see how much they cry "Unfair"...
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HUFFPOST SUPER USER
CaveatLector
08:33 AM on 10/27/2010
I saw that sign. Tea Partiers are the stupidest people I have ever met.
01:55 PM on 10/21/2010
I know this case very well. WHY didn't they say the NAME of the Insurance Company???

The company was the NASE and MegaLife Insurance.
If anyone of you HAVE a plan from them RUN for your life.

DO NOT BUY
NASE... National Association for the Self Employed
MEGA-LIFE
Health Markets
Mid-West

These are very BAD people selling VERY BAD PLANS.

STAY AWAY from them. Health Insurance can be risky enough but the people at this company should be in JAIL.

If anyone needs any advice contact me. Believe me, I made it a mission to help people get off these TERRIBLE plans.
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HUFFPOST COMMUNITY MODERATOR
mendocoaster
03:20 PM on 10/21/2010
I have Mid-West which was the only available to me. I pay around $1200.00/mo. for my coverage which has me paying 50% copay on just about everything and allows me 2 Dr. visits a quarter, which under normal circumstances would be fine. I have recently been diagnosed with a very rare (1-2/million) condition which has me seeing multiple specialists, all of whom require testing, etc. I have found that trying to deal w/ the ins. co. is impossible. I can't get any info which would help me in my decision making. I am very fortunate in that at Stanford, I have a fierce patient advocate who is acting as a go between. That being said, I am scared spitless that I will be dropped or my rates will go even higher. It is ridiculous to be paying $1200.00/ mo. for insurance and then be afraid to use it.
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HUFFPOST SUPER USER
CaveatLector
08:34 AM on 10/27/2010
Mega is awful. I agree; stay AWAY.
HUFFPOST SUPER USER
Daschenk
01:53 PM on 10/21/2010
We need a public option. Health care reform was a good start but a waste in the grander scheme in things.
04:56 PM on 10/21/2010
a public option is the only way to deal with evil HMOs
make them illegal and let EVERYONE have the same health care - then and only then will you start seeing real reform and a decline in health costs
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thereisonlyoneparty
more amazing than you
02:21 AM on 10/25/2010
Health care does not work like a normal good.

Your simple economics plan will not do what you think it will.
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HUFFPOST SUPER USER
ReadMyLipstick1
It can't be that hard.
01:34 PM on 10/21/2010
Health insurance for the most part can’t be relied upon, as these poor unfortunate people found out. Health insurance companies are in business to make money for themselves and their shareholders, not cover people’s bills generated from illnesses. These companies goals are how NOT to pay physicians and patients for services. Companies often delay payments to hospitals and physicians; they intentionally frequently eliminate at random, services which were presented for payment hoping that the provider’s staff just doesn’t notice what was ignored or eliminated; similarly they confuse billing coding numbers at random, paying lesser amounts toward a service, or paying nothing hoping that the provider’s staff doesn’t notice. Insurance companies will routinely schedule meetings wherein claims arriving to be paid are shredded. And on it goes. Next to banks and lawyers, the health insurance business is right up there with a “lets rip them off” mentality. And the premium issue for health insurance is another story. A vast majority of premiums have risen 47% and higher within the past few months. This results in immediate additional cost to not only employers, but to employees who share in premium costs. At an 80-20 premium share, an employee’s 20% share exceeded an additional outlay of $150./month. The health insurance matter is serious, and I do not know (not having read the bill either), whether or not it will begin to work for the benefit of anyone, let alone the patient.
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thereisonlyoneparty
more amazing than you
02:28 AM on 10/25/2010
Insurance companies are the only part of the equation that has any desire to keep costs down.

Those evil insurance companies were actually able to set prices on services for a while until the medical community moved to forming larger practice groups to have more power when it comes to negotiating.

Doctors and drug producers have no desire to keep costs low. Especially when doctors get a fee for services instead of being paid a salary. The doctor gets paid based on what he or she does. Do you think that they will really care about the cost in that situation?

Patients are the same. Studies have shown that people think that there is a lot of redundant or unnecessary medical care being performed, but studies also show that they feel they are not the ones receiving it. When it comes to "me", "I" want everything you got. What does it matter when I am not seeing the price?

Drug makers work to go around pricing schedules by creating new formulations of existing products to charge higher fees for them. And then they provide coupons to reduce the amount paid by the user so people buy them. Too bad the insurance company is not getting a discount at the register.

The only entity that cares about price is the insurance company. That is their business. Doctors do not care. Pharmaceutical companies do not care. Patients do not care. Any "reform" would need to worry about cost to be effective.
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HUFFPOST SUPER USER
ReadMyLipstick1
It can't be that hard.
09:31 AM on 10/25/2010
I’m unable to concede that (health) insurance companies aren’t a major “evil doer” in this fracas. Yes, doctors formed large groups to gain power in getting insurance companies to pay their fees. Hospitals joined in and bought up medical practices. Negotiating power in numbers is often successful in getting insurance companies to see another side of the coin. Like their brethren whole life companies, insurance co. shareholders make out very well.

Doctors are actually paid very little for their services. Most doctors base their fees on particular entities’ allowable charges. Most drs. use the Medicare as their base, some use their state’s w.c.fee schedule, then add a percent to that base. (Most insurance companies pay 80% of THEIR allowed charges.) Assistance programs pay virtually nothing. While the majority of doctors make a good living, they are not being paid equitably. Cost of trained staff, equipment and medical supplies have skyrocketed.

I concur with regard to pharmaceutical companies. The cost to generate a drug and what it sells for is obscene. Pharm. companies blame the high cost of research. Researchers are not rich, shareholders are.

Lasly,attorneys will encourage a patient to sue his/her physician for ridiculous claims. The cost of physician’s malpractice insurance (another insurance company) is so high in so many states that drs. had to stop practicing medicine.

It is a vicious circle, encouragingly, the majority of drs. still practicing are excellent doctors and make every attempt to treat the patient with good care and concern.
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HUFFPOST SUPER USER
CaveatLector
08:35 AM on 10/27/2010
What you wrote is so full of mistakes and misconceptions, I don't know where to begin.
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HUFFPOST SUPER USER
raviandsonia
01:31 PM on 10/21/2010
GOP Response - Sorry, It's just business.
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HUFFPOST SUPER USER
idcsys
01:46 PM on 10/21/2010
Unfortunately, they wouldn't say "sorry".
HUFFPOST SUPER USER
NCScientist
St. Ronnie raised taxes eleven times...
01:30 PM on 10/21/2010
Is this a great country, or what? The only answer is Single Payer.
HUFFPOST SUPER USER
deminmo
just looking for answers
01:07 PM on 10/21/2010
The problem is, the new health care program doesn't kick in completely
for another 3 years. And since it was passed the cost of health insurance
for my folks, the part they are responsible for, has risen 25%. In the time
the insurance companies have they will make health insurance so expensive
and cover so little, that it will make no sense to have it. And not having health
insurance can be costly too. Maybe that is the whole idea, kill off a million
or so uninsured or under-insured people!
01:15 PM on 10/21/2010
For good or for bad, some provisions have already kicked in.
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01:33 PM on 10/21/2010
Rate increases are approved at the State level by your State Insurance Commissioner. That is one of your most important votes. Always.

Insurance companies have sued some States because the Commissioner would not approve their obscene rate hikes. Maine comes to mind.
HUFFPOST SUPER USER
deminmo
just looking for answers
01:42 PM on 10/21/2010
My state wants to keep "Obama Care" out completely.
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01:01 PM on 10/21/2010
Most insurance company CEO's should be executed for pre meditated. These bastards ( know that by denying healthcoverage to sick people, these people will DIE.

I belong to a yacht club and these same sick Republicans (who don't want to help anyone else), are the first to call the GOVERNMENT PAID FOR Coast Guard when their boats run out of fuel. I suggest that the Coast Guard NEVER help a Republican.
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01:53 PM on 10/24/2010
If you or I withheld lifesaving treatment and someone died, we'd probably be held criminally responsible. If a corporation kills someone? Nothing.
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HUFFPOST SUPER USER
CaveatLector
08:41 AM on 10/27/2010
Progressive Thinker: A GREAT Post! I'll go even farther; let's let all Republicans NOT pay taxes, but the next time they need the police, fire fighters, Medicare, Legal protection, Consumer protection, they are DENIED. They will need to simply take their chances; after all, the invisible hand of the free market just fixes EVERYTHING, right?

Let them use medication that hasn't been tested by the FDA, food that hasn't been inspected by ANYONE except the farmer who is growing it (he can be trusted, right?) Let their household products, soaps, any chemicals they use, be simply produced by one party, and then consumed by another. No governement regulation, rules, inspections, testing, safety standards, nothing.

They hate the government so much, then fine, let them live completely on their own. Let's see how long they last.
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thereisonlyoneparty
more amazing than you
01:10 PM on 10/27/2010
Criminal responsibility would still exist.

too bad you are completely ignorant of the ideology you bash.

I would not expect anything more though. Americans are fools.