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Hillary St. Pierre

Hillary St. Pierre

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I Considered A "Medicaid Divorce" When Cancer Began Bankrupting Me

Posted: 01/31/11 07:29 PM ET

It's a common mistake almost everybody makes, the assumption that everything is going perfectly when your friend keeps a smile on their face. Often with me people assume I'm healthy because I've managed to care for my son by bringing him to and from school, playing with him in the afternoon, attending basketball games. But these moments reflect the best of my life. I have stage 4 Hodgkin's lymphoma. I've had 2 bone marrow transplants and I've lost two-thirds of my lung capacity because of treatment. I'm doing people a disservice if I'm leading you to believe that what I do, all the medications, surgeries, and therapies, and yes, the bills, is easy and I'm not crumbling inside.

I've never written about some of my most desperate places, until now. Soon after diagnosis 4 years ago, even though I was "fully insured" with health and disability insurance, we quickly realized how little the companies would actually cover. When I began to see how it could destroy both our financial lives, I tried to legally divorce my husband. In the U.S., the sick can't afford to remain married.

Being unmarried, I would be destitute and have the option of Medicaid. My husband would keep the assets. Our life wouldn't change. We'd remove a legal label. No hospital or insurance company could ever take our home. We could survive off my husband's credit with assistance from my parents.

It's an option few people will admit to entertaining, divorcing for health care, anymore than they'll admit they became married for health insurance. But the guilt of bringing sickness into the family, the knowledge that, if not for your disease, life may have gone as planned and you may have had the happily-ever-after you dreamed of begins to weigh heavily on the individual and the couple. Resentment felt towards the sick spouse resonates between the two until the fear of destroying the financial future of someone you love bears down on you as much as the disease itself. Then you begin to wonder where you'll draw the line in care or how much treatment you should receive without hurting your families' bottom line.

It's an easy jump to consider divorce from here, "why bankrupt two when only one needs to be affected?" Divorce starts looking good now. It offers a glimpse of hope for a stress-free financial life while fighting a merciless disease. Of course, you know the cries of fraud you'll hear from people outside your situation, but few health care providers will be "tsk-tsking" your decision. They've probably encountered this situation before, especially when they see senior citizens forced to drain a lifetime's worth of savings until Medicare or Medicaid kicks in. They know better than most that the system as it stands is a black hole for the middle class when catastrophe happens, like it was with me.

But that choice of divorce wasn't for me. We stayed married. For whatever reason, maybe my husband didn't like the lie, maybe he really wanted to stay together, or maybe he was scared once the divorce went through I'd go "ha-ha, I'm out of this now" and run away. So what happened?

In the first year alone, I blew past a $2500 deductible with a single biopsy and then racked up $3600 in co-pays. At some point, my insurance company tried to stop covering PET scans and we had to put the PET scans on credit cards. With each relapse, each new treatment has forced us to spend tens of thousands of dollars to go to Boston or New York or Cleveland. And just when you think you've hit your very lowest, you get a hook to the jaw from your blind side. In my case it came from my long-term disability company, threatening that anything I've received for my dependent will need to be repaid. Thousands of dollars I already spent just trying to stay alive.

So yes, we stayed married. We did the right thing so they say. But our nation's health care system didn't do right by us.

This post was adapted from a recent piece in Baldie's Blog.

 
 
 
 
 
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09:11 PM on 02/06/2011
God bless you. I have thought of the same thing if i ever got cancer.. Thanks for writing about this.
08:50 PM on 02/06/2011
Your story was very moving. I wish the best for you and your family. I have handled Medicaid divorces before and they are very painful for the parties involved. Sometimes however, it is the right solution to preserve assets for the surviving spouse or children. You are fortunate to have the support of your family.
07:54 PM on 02/05/2011
Thanks very much for this piece. Health insurance should protect assets from financial calamity, just as auto and homeowner's insurance do.
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Icecube
NFC East. Pick your poison.
05:10 PM on 02/05/2011
Did you ever vote GOP? Just sayin....
07:55 PM on 02/05/2011
The kind of health insurance Hillary St Pierre needs to protect her family from financial ruin is exactly the kind that many (not all, but many) Republicans advocate.
09:12 PM on 02/06/2011
Right. Being that republicans are looking out for the little people.
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RoughCollie
Destination: A new way of seeing things.
12:25 AM on 02/05/2011
I sense your hurt and frustration, your quiet joys layered between exhaustion and pain and those moments of respite surrounded by hours of despair. I hear the relief in your "voice" that your husband chose to prove his devotion and stay married by your side. I feel your guilt and remorse for the financial woes that seem your responsibility but are our country's failure.You wrote so beautifully and expressively, you touched my heart..I send you thoughts of strength, kindness, peacefulness and love.
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Indie Mom
independent does not mean lonely
12:52 AM on 02/04/2011
So, so sorry. I am a Hodgkins survivor .. on 6 years now. I had Stage 1, Type A. Even with little body burden, the standard Hodgkins treatment is expensive and brutal on the body. The chemo cocktail for this type of cancer is the harshest one out there .. nicknamed 'the bomb'. I ended up with about $5,000 in co-pays from start to finish, yet changing my diet and adding supplements, etc. has been extremely expensive. No insurance pays for that. I stopped agreeing to PETs and CTs about 3 years ago because I felt they were unnecessary .. too much radiation.

The thing that bothered me so much, and what I learned through my own experience and research, is that the cancer industry takes you through a series of tests. Each one proceeds the other, yet the last few are the ones that really tell the tale. The others, along with several dozen unnecessary doctor appointments, just rack up the co-pays.

Pending divorce, I will be on my own insurance and I have recently spent hours understanding the different plans and speaking to representatives about what plan would be best if my cancer ever came back. It was a nightmare trying to juggle the pros and cons. I now have disability insurance .. doesn't kick in with cancer, though. When I am 'clean' for 7 years, I can get cancer insurance.
09:08 PM on 02/06/2011
They have cancer insurance? Never heard of that.
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contradiction
Share the luv, money and healthcare.
07:38 PM on 02/03/2011
Heart breaking.
You and your family are in my prayers.

xox
03:19 PM on 02/01/2011
I'm a lawyer who spends his days working with folks blind-sided by catastrophic illness. The worst part of my practice is seeing the financial torment families have suffered - genuine pain but completely unnecessary. The best part is working with folks to achieve workable solutions: real, honest, above-board, legitimate, no-problem-if-you-do-it-correctly solutions that do not require divorce or impoverishment of your spouse or family to get the top quality care you need. Hillary, it's bad enough that you've contracted this disease, but what really grinds my gears are the well-meaning, mis/uninformed friends and "experts" who punched you in the gut by advocating divorce. Anyone suggesting divorce to you as a way to deal with health care costs simply does not know what they're talking about. Medicaid can be a strong safety net, if you take advantage of all it has to offer - tragically, navigating the Medicaid system can be so confusing and frustrating that most folks don't get all the benefits to which they're entitled and many many folks just give up altogether. Yes, it IS a goofy, cobbled-together, Rube Goldberg kind of "system" (why should you have to hire a lawyer when you need a doctor?!?) but it CAN deliver life-saving/family-saving results. David Carrier
10:01 AM on 02/01/2011
Thank you for writing this Hillary!
01:42 AM on 02/01/2011
Thank you for sharing your story with us. My aunt, who recently recovered from colon cancer, had suffered similar circumstances - there are so many who have gone through this. I just finished reading a very good book about this called, Uproot U.S. Healthcare: To Reform Healthcare by Deane Waldman, MD MBA. The author offers great advice on how we can change the system. I learned where all the money is going and how much waste we can recover so it can be used for patient care. I found it very empowering, and it gave me hope that through knowledge we can make change happen. If you would like to visit the author's website you can do so here:
http://www.uproothealthcare.com/
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Shaun Hensley
The American Experiment has failed
09:15 PM on 01/31/2011
Our system is so fubar. It is despicable that you and your husband had to even consider this.