Health Care For America Now

You'll be hearing more about Eric De La Cruz and his sister, Veronica De La Cruz over the next few days. But first, you should read Eric's story:

[...] Mr. De La Cruz was told he had a disorder called severe dilated cardiomyopathy, in which the heart muscle becomes enlarged and weak. The symptoms include breathlessness, exhaustion and fluid buildup in the arms, legs and abdomen.

He was a student who had worked part time as a graphic designer and a disc jockey, but none of his employers offered health insurance. Once his condition was diagnosed, his family says, he was unable to buy private insurance because he had a pre-existing condition.

He twice applied for Social Security disability benefits, which would have entitled him to health coverage under Medicare. The applications were denied. He did eventually qualify for Nevada’s Medicaid program, which bases eligibility on financial need rather than age or disability.

As his condition worsened, it became clear he would need a heart transplant.

…

Ms. De La Cruz also began contacting heart transplant centers to determine whether she could pay for the operation with donated money. Because Nevada has no heart transplant center, she contacted several medical centers in California and was told that without insurance, her brother would need to post a deposit of at least $150,000 to be evaluated and placed on a waiting list. The total cost for the transplant and subsequent hospital care, as well as antirejection drugs, would be nearly $1 million, payable in advance.

To exert public pressure and raise money, Ms. De La Cruz began sending out messages on Twitter, with daily tweets about her brother’s health, his dog, Chance, and the red tape she was trying to cut. She gained a following of more than 6,300 people, whom she began calling Eric’s Twitter Army.

The troops included Trent Reznor of the band Nine Inch Nails, which said it would award donors backstage passes and time with the band; the famed Tony Hawk auctioned autographed skateboards. Supporters bombarded Nevada legislators with calls, faxes and e-mail. The Medicare hearing was rescheduled, and by June, Mr. De La Cruz had won his long-awaited coverage, opening the door to a heart transplant center.

Elated, Ms. De La Cruz contacted U.C.L.A. Medical Center’s heart transplant program, but now the hospital insisted that her brother get a secondary insurance policy — even though Mr. Reznor told me the band raised nearly $1 million in less than two weeks. A hospital spokeswoman declined to comment on the case, citing patient privacy, but said the hospital “had been working with” the family.

Eventually, Ms. De La Cruz arranged for her brother to be seen by doctors at the University of Southern California Medical Center. There, he spent a week on the “high-priority transplant” list.

But his condition had deteriorated so much that he soon became too sick for the procedure. On July 4, Eric De La Cruz died…

It's a heartbreaking story, and one that happens far too often.

That's the sieve-like logic of our current health care system. The cracks are designed for people to fall through, so insurance companies can make more money. Pre-existing conditions. Annual premium caps. Lists of covered procedures. These are terms created and used by insurance companies to deny you care and keep your money in their pockets.

Eric's story is why we need a public health insurance option. Eric fell through one of those cracks - he had a disease that could have been cured with a transplant. But he also had a "pre-existing condition," so nobody would cover him. We need an insurance plan that would have covered him and the millions with "pre-existing conditions." We need an insurance plan that is more worried about covering people than penny pinching.

The public health insurance option could be this plan. It would be a backup, something you could always use and afford if you ever found yourself without health insurance for any reason. And it would be a yardstick, giving private insurance companies a standard they would need to live up to if they wanted to compete.

With it, people like Eric would have had a chance. Without it, people like Eric will keep falling through the private insurance-designed cracks. And without it, health care reform will work more for the insurance industry than it will for you.