Personal Stories / Experiences
Seeking Stories of Health Care Experiences
We are collecting stories of your personal experiences (patients or practitioners)
with the current health care system (HMO, bankruptcy, denial or restriction
of care, cuts in benefits, long waits, high-costs, etc.). If you would
like to submit your story, please send it to joel@uhcan-mn.org. We
would like to compile these stories for others to read on this website
(stories can be anonymous upon request).
Medicare Part D Disaster:
Background: (this so-called Rx drug benefit for seniors enacted by the Bush Administration turned out to be a disaster. When implemented in Jan 1, 2007, it was so complicated and confusing because instead of the Fed govt purchasing drugs directly as a single-payer, on behalf of all 43 million enrollees, the legislation allowed 2,700 HMO middlemen payers to drive wedge between practitioners and patients. Shortly after the program was implemented Governor Pawlenty had to declare a public health emergency because thousands of seniors could not get their meds.)
My name is Dan Mikel. I am a well-informed Medicare recipient. I reside on
the MN State retiree council, Metro Board of the MN Senior federation,and the
white House conference on aging. Like 66% of AFL-CIO retirees across the nation,
i find the Part D system too confusing for most to make an informed choice.
My own experience:
1. 1 1/2 hours on a computer on a recent Saturday. Total frustration.
2. 40 minutes on a call to the Senior Linkage Line. Very helpful, but i was not
done.
3. 15 minutes contacting a possible insurer to clarify some language.
4. Another 35 minutes on the phone with Senior Linkage Line to enroll.
5. two follow-up phone calls received from the insurance company i chose.
6. One follow-up mailing from the Senior Linkage Line.
7. One mailing from the insurance company with indication that i would be receiving
more material later.
Denial of Coverage Due to Pre-existing Condition - Attending AA Meetings
Example of denial of insurance coveragee (PDF) by a health insurance company
due to a "pre-existing condition" of "alcoholism" based on the fact
that the health insurance applicant several years in the past did the
right thing by seeking help and attended Alcoholics Anonymous meetings.
Seeking help, and in this case, not even medical help, should not
disqualify a person from receiving health insurance.
Clinical Encounter with Uninsured Patient
A 60-ish woman, divorced with a live-at home daughter, saw me because of a complaint of
severe back pain. She had a history of kidney stones, for which she had been treated
in the previous year, but continued to suffer symptoms because the stone was not completely
\broken up. The doctor with whom I work recommended she follow up with me, which she did
about 3 months previously. At that time, we ordered a CT scan to assess the size and
location of the stone. Although she and I knew that she continued to have a stone she
explained to me that she couldn't afford to take time off from work or pay for the
recommended procedure to successfully treat the stone. I saw her again recently because
her pain was too severe to continue her job as a driver for a local transportation company.
When I told her we should repeat the CT scan study, she said she couldn't do it because she
was still paying for the last CT scan done. When I asked if she had health insurance, she
told me it was not a benefit paid by her employer and that she made too much money to
qualify for Minnesota Care. She also told me that because she had to stop work early
because of her pain, she lost her so-called monthly bonus, which was a significant reduction
for her unfilled work hours. She told me that she could not even afford a pain medicine
prescription that I wanted to provide her. I felt maddened and frustrated at my inability
to help this person because she lacked the resources to pay out of pocket or for the
insurance she needed. No doubt there are many more Minnesotans and Americans who are in
the same fix. This why I strongly feel that Single-Payer Universal Health Care for All is
a critically important goal for those of us who agree that basic health care service is a
right not a privilege for all. - Jes Siiteri, PhD, PA-C
Trying to Keep Insurance with Cancer and Uncertain Job Prospects
Those who have not been through tough times have no real clue about being one of the numbers.
Those numbers are easy to put on paper. This is not a story that should be a quick deadline.
The decisions we had to make in my family were life altering. Do we stay with Cobra in the
middle of the year. Is my husband going to get a job with benefits or not. Will the insurance
at a job he might get take me. I had cancer. Will the insurance be any good. Do we try to get
on individual insurance - oop can't do that I had cancer. Do we go with MN comp. The questions
we were faced with came at a time when there was a sense of hopelessness anyway because of the
job market. When you are one of those numbers you feel it. You feel like you are fading from the
landscape from America because it has abandoned your family. In a society that stands for values
you wonder where you fit when the values do not extend to the health of your children. The numbers
become the story when a reader understands that everyone of those numbers is a human being. - Jeanne Smith
$35,000 5-day Hospital Stay Uninsured
Dear Friends and Family,
My beloved partner, Paul is recovering from a near death experience.
He became seriously ill, losing twenty pounds in one week and needed to be rushed to the hospital near
my home in Mpls. He was in the hospital for 5 days and received many tests and two units of blood.
He has been diagnosed with Crohn's Disease. His intestinal tract was so damaged from the flare up
of the disease that he had to continue intravenous feeding following his release from the hospital.
Paul's stay in the hospital and his after care are very expensive, probably in excess of $35,000, and
he unfortunately has no health insurance. He had previously been so healthy, he had hardly ever been to a doctor.
I am writing this letter to ask for your support and prayers in this
difficult time and to thank those of you whose support and prayers we have
already received. I am asking that in the spirit of generosity you gift Paul
with money to help with his bills. Gifts can be sent directly to a special
account in Paul's name to Wells Fargo Bank.
Divorced to Obtain Health Insurance
My wife is schizophrenic, and while she worked her insurance covered most health care.
When she couldn't work anymore, no insurance company touched her. Her yearly out-of-pocket
cost was more than $9,000 per year. Our lawyer said get a divorce and let the state take care
of her. Minnesota laws allow living together. She could get two social security incomes by divorcing
to get needed medications.She takes five different medications every day. It is sad that we were forced
to get a divorce to afford medical care.
Denial of Coverage Due to Pre-existing Condition
Letter received from Medica:
"Thank you for applying for Medica Value Choice
Solution health insurance. Unfortunately, we are unable to approve your application due to the information listed below:
The monthly cost of your medication exceeds the underwriting guidelines.
The decision to deny your application was based on a review of the information submitted or
available to Medica, and is consistent with underwriting policies established at Medica.
Enclosed, please find your original check for premium that was submitted at the time of application."
Sincerely, Medica Underwriting Department