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Non-Negotiable: Health Care Equality for Women

Posted on November 4th, 2009 by Jason Rosenbaum in Insurance Nightmares

Our health care system is broken, nobody disputes that, and yet even in our broken system, people like me have it much better. Why? Because I'm a man.

Women are charged more for insurance. They can be denied coverage if they're been a victim of domestic violence, or if they've had a C-Section. Many insurance plans don't cover the full range of care they need. Maternity care, in particular, is hard to find. And women statistically end up spending more of their money out-of-pocket on health care, and thus are more likely than men to be uninsured.

The abuses women suffer at the hands of our health care system can be staggering:

Today a woman testified before the Senate because she was denied health insurance as a result of a c-section — unless she wanted to permanently sterilize herself:

Today, at Sen. Mikulski's HELP Committee hearing "What Women Want: Equal Benefits for Equal Premiums," we met Peggy Robertson. Peggy is a mother of two young boys, living in Colorado with her husband. Over the past few years, Peggy and her family have faced not one but two shocking cases of insurance company abuse. First, in 2007, Peggy was denied coverage by Golden Rule insurance, a subsidiary of UnitedHealth Group (the largest insurance company in the US), because of a previous c-section birth. What happened next is shocking (Sen. Mikulski called it "bone-chilling" and "morally repugnant"): Golden Rule said they would cover Peggy if she agreed to be sterilized. Watch the video of her story on the SEIU Blog.

One of Health Care for America Now's principles for reform is equity in health care, and that means these disparities have to end.

That's why we're joining with our coalition partner, the National Women's Law Center, to speak out today about this issue. They've put together a phenomenal site where you can contact Congress and make sure women are treated equally by our health care system, along with an excellent widget to take action:

The House bill that will be voted on shortly gives women equality in health care. So does the Senate bill. But its imperative your representatives in Washington know this issue is important to you, no matter if you're a man or a woman. It's a simple matter of equality.

Architect of John McCain's health care plan can't find health care

Posted on November 2nd, 2009 by Jason Rosenbaum in Insurance Nightmares

It's never a time for celebration when another American can't find health insurance because of private insurers and their denials. Indeed, the practice of denying insurance to people with pre-existing conditions is so common, the media hardly ever talks about individual cases and instead mention the staggering statistics.

One case, however, is worth mentioning today. Dougals Holtz-Eakin, one of John McCain's top policy gurus and an architect of John McCain's laughable health care plan, is about to run out the clock on his COBRA benefits. In a few weeks, he'll be uninsured and shopping for coverage on the individual market, a situation faced by millions of Americans who have lost their job in the last year. And, like millions of his fellow middle-aged Americans, Holtz-Eakin has a pre-existing condition:

Holtz-Eakin, who is about to start shopping for insurance on the individual market, is 51. And he has one of those pesky "preexisting conditions" that insurance companies often cite in denying coverage.

"A right renal autotransplant," he said, pointing to his abdomen as he described the 1990 transplant surgery he went through after one of his kidneys was damaged in an accident. "They got rid of the artery, moved my kidney and rebuilt me for the 21st century. If you look at my file, any insurance company would go, 'Hmm . . .' "

Good luck.

As President Obama has said, it can happen to any of us, even those of us who champion a health care plan that would have done nothing for people with pre-existing conditions.

Perhaps, in light of his current plight, Holtz-Eakin is reconsidering his stance on health reform? Nope:

Despite his personal trials, however, Holtz-Eakin said his conviction on the hot-button issue of health care is unchanged. He believes that reform is needed, but that President Obama and congressional Democrats are going about it the wrong way. The system is "broken," he said, but the bills now before Congress do not cut costs enough. On the campaign trail, Holtz-Eakin promoted McCain's plan to eliminate the tax exemption for employer-sponsored health insurance and give tax credits to individuals to buy their own coverage.

When health reform passes, Holtz-Eakin will be able to get insurance. And it won't cost $1000 per month, as Holtz-Eakin's COBRA payments do - something only the rich in society, like Holtz-Eakin, can afford. Maybe then he'll be thankful.

From the Department of Immediate Results: Ian Pearl, whose care was denied, gets his coverage back after protest

Posted on October 27th, 2009 by Jason Rosenbaum in Insurance Nightmares

You remember Ian Pearl, right? He's the guy who's insurer called him a dog and then threatened to cancel his policy in the entire state to avoid giving him and people like him the benefits they paid for.

As Ian himself explains:

After decades of medical emergencies, we still weren't prepared for the latest crisis — this one created by the same insurance company that once saved my life. Guardian abruptly withdrew our health plan from all policyholders in New York where my father's business is based. Guardian offered a 'replacement' plan with low benefits and no home nursing benefits. They knew that I would never survive with such a plan, but they didn't care.

Suspecting that this action was related to the high cost of my care, we filed a lawsuit and have asked the U.S. Department of Health and Human Services to enforce existing federal laws and require Guardian to continue my health plan. Without federal intervention, I will lose this insurance, and that would be a death sentence.

Our lawsuit uncovered insurance company documents that confirmed my suspicion that I'm a target of discrimination. The documents revealed Guardian had compiled a "hit list" of its costliest members, including patients with muscular dystrophy, multiple sclerosis, brain injury, and paralysis. Guardian executives referred to us all as "dogs" and "trainwrecks," and they debated how and when to dump us from the rolls. Laws prohibited the cancellation of the individual members with serious chronic health problems, so Guardian opted to cancel the plan for all members of this specific health plan in New York, an action that violates federal law.

Ian's mother Susan came to Washington, DC to confront lobbyists Karen Ignagni and the rest of the insurance industry last week. And after an extremely well-attended press conference and a march involving 600+ people, Ian's insurer, Guardian, relented:

The Guardian Life Insurance Company of America today notified the family of Ian Pearl that the company intends to ensure that Mr. Pearl will continue to have the same benefits that Guardian currently provides including 24/7 in-home nursing care. While details are not yet final, our commitment to continuing uninterrupted care to Ian Pearl is absolute.

Needless to say, the Pearl family is ecstatic.

It's unfortunate, however, that a media frenzy and a huge protest were needed to get Ian the care he paid for, deserved, and needed to live. Ian's case serves as an example of the lengths the insurance industry will go to deny care and make a profit.

The case serves as a testament to why we need health reform with a public health insurance option. Without it, there will be no way to hold the insurance industry accountable for their customers who can't travel to DC to confront the industry and who don't have 600+ people backing them up on the street outside. Everyone in America deserves quality, affordable health care, and everyone deserves a choice of public or private insurance.

Rape is a pre-existing condition

Posted on October 21st, 2009 by Jason Rosenbaum in Insurance Nightmares

If you want to know why the insurance companies are enemy #1 when it comes to health reform, read this:

Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month's worth of anti-AIDS medicine.

Only later did she learn that she had made herself all but uninsurable.

Turner had let the men buy her drinks at a bar in Fort Lauderdale. The next thing she knew, she said, she was lying on a roadside with cuts and bruises that indicated she had been raped. She never developed an HIV infection. But months later, when she lost her health insurance and sought new coverage, she ran into a problem.

Turner, 45, who used to be a health insurance underwriter herself, said the insurance companies examined her health records. Even after she explained the assault, the insurers would not sell her a policy because the HIV medication raised too many health questions. They told her they might reconsider in three or more years if she could prove that she was still AIDS-free.

In the insurance company world of greed and money, rape is a pre-existing condition. Shouldn't that be criminal?

This is why we're marching on the insurance companies tomorrow.

These companies need to be taken down a notch. They need their anti-trust exemption revoked, and they need competition from a public health insurance option, so people like Christina will at least have somewhere to go when a heartless bureaucrat denies them the medicine they needs to keep them healthy after their rape.

I am not a pre-existing condition

Posted on October 15th, 2009 by Levana Layendecker in Insurance Nightmares, Profits Before People, Take Action!

When it comes to health care, women really feel the pain. According the National Womens' Law Center, women are denied fair health care every day:

Being a woman is not a pre-existing condition.

But, as NWLC uncovered in our groundbreaking report, women are regularly denied coverage for "pre-existing conditions" including pregnancy, a previous C-Section or past domestic abuse. Insurance companies charge women as much as 48% more for individual health care coverage than men. And it is expensive, difficult and in some states impossible for women to find coverage for maternity care when purchasing their own health insurance plan.

The depths to which insurance companies will sink to deny women health care are almost unfathomable. Today a woman testified before the Senate because she was denied health insurance as a result of a c-section — unless she wanted to permanently sterilize herself:

Today, at Sen. Mikulski's HELP Committee hearing "What Women Want: Equal Benefits for Equal Premiums," we met Peggy Robertson. Peggy is a mother of two young boys, living in Colorado with her husband. Over the past few years, Peggy and her family have faced not one but two shocking cases of insurance company abuse. First, in 2007, Peggy was denied coverage by Golden Rule insurance, a subsidiary of UnitedHealth Group (the largest insurance company in the US), because of a previous c-section birth. What happened next is shocking (Sen. Mikulski called it "bone-chilling" and "morally repugnant"): Golden Rule said they would cover Peggy if she agreed to be sterilized. Watch the video of her story on the SEIU Blog.

It's time to end these outrageous practices once and for all. I am sick of it. For a clearinghouse of all things health care and women go to "Women and Health Care Reform" and take action today.

22 year old dead from swine flu because of delayed care

Posted on September 25th, 2009 by Jason Rosenbaum in Insurance Nightmares

A sad and preventable story:

Friends say the Miami University graduate who died this week after reportedly suffering from swine flu delayed getting medical treatment because she did not have health insurance.

News of Kimberly Young’s death Wednesday, Sept. 23, came as a shock to those who knew the vibrant 22-year-old who was working at least two jobs in Oxford after graduating with a double major in December 2008.

Young became ill about two weeks ago, but didn’t seek care initially because she didn’t have health insurance and was worried about the cost, according to Brent Mowery, her friend and former roommate.

Mowery said Young eventually went to an urgent care facility in Hamilton where she was given pain medication and then sent home.

On Tuesday, Sept. 22, Young’s condition suddenly worsened and her roommate drove her to McCullough Hyde Memorial Hospital in Oxford, where she was flown in critical condition to University Hospital in Cincinnati.

Health insurance companies have priced people like Young - young, normal, hardworking - out of the market, and because of skyrocketing premiums, fewer and fewer employers offer health care as a benefit. They're forced to turn to "urgent care facilities," storefront operations that are a poor substitute for real, regular care.

We must change the dynamic of the health insurance market so pricing people like Young out is no longer the norm. A public health insurance option is needed to increase competition and keep the insurance industry honest so they can't delay care even if they want to. Along with affordability provisions to make sure people like Young can afford insurance, this tragic situation could have been prevented.

Voicemail Stories - Why we need reform

Posted on September 14th, 2009 by Jason Rosenbaum in Insurance Nightmares

During our national call-in days, we invite people to leave a message with us if their Senators or Representative's phone is busy.

The messages we get are invariably stories of our health care system failing hard working citizens. They are heart-rending tales, but what really gets me is how normal these people are. As the President says, health care horror stories can happen to anyone. That's what infuriates me about our whole system - you can work hard and pay your dues and still get screwed over by the insurance industry.

Take a listen. First up, Carol from Naples, Florida:

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Next, Jeannie from Oregon:

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Next, Raymond from Orlando, Florida:

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These stories could be yours, or your brother's, or your neighbors. These are American stories. It's way past time to fix our system so these stories are a thing of the past.

My brother, Eric

Posted on September 2nd, 2009 by Veronica De La Cruz in Insurance Nightmares

Veronica and EricI want to tell you about my only sibling, my brother Eric De La Cruz.

Diagnosed with Severe Dilated Cardiomyopathy five years ago and in need of a heart transplant, my brother Eric passed away far too early this July 4th. All because the health care insurance system in the United States is broken.

You see, unlike most of us (but like millions of others), Eric couldn't get private insurance. His employer didn't offer it as a benefit. And his heart condition, while treatable, was a pre-existing condition that no private insurers would cover. Sadly, there was no affordable, public option to protect Eric. So he remained excluded from the basic right to life-saving treatment that all people deserve. Although a heart transplant would save him, without coverage, Eric's condition needlessly and slowly deteriorated.

People don't realize how vulnerable they are to the devastating costs - both in dollars and in human life - of an insurance industry concerned with one thing: profit. As a TV journalist and correspondent, I've enjoyed a public platform few have, but when it came to the health and well-being of my family, I'm as susceptible as everyone else. Despite a national online campaign and celebrity fund-raising that amassed nearly $1 million, and emotional and political support from thousands of strangers, Eric couldn't beat this broken system. If it can happen to us, with all of THAT support, it truly can happen to anyone. In fact, sadly, it IS happening to thousands all over the country right now.

Veronica and EricAfter Eric's death, I went to Washington this August. I met in the offices of many Senators and Representatives to ask why there is even a debate about passing a strong health care reform bill that would provide all Americans with affordable, guaranteed health care coverage - a bill that would help control the spiraling health care costs that are bankrupting countless families and forcing people to choose between their money and their lives.

Everyone on Capitol Hill was sympathetic to Eric's story, and most were supportive of legislation including a strong public option, but few seem convinced the American people would lean hard enough on Congress to make sure it happened. We must convince them now.

In fighting for Eric's life, thousands of people joined forces to get him on Medicare, get him into a transplant facility and raise enough money to pay for his treatment. He just ran out of time. But the clock has not stopped for you.

Though Eric has passed away, he has not been silenced. Your voice can make the difference. By simply clicking on the link below, you'll help ensure what happened to Eric doesn't happen to your friend, your brother, your neighbor…or you.

Please don't forget your insurance can disappear when you least expect it, because insurance companies CAN rescind policies. If you get sick and don't have insurance now, insurance companies CAN deny you coverage for a pre-existing condition. If you get sick tomorrow, your life can be turned upside down because of your failing health AND runaway medical bills that can force you into bankruptcy. I know you think this could never happen to you. But it can. It happened to us.

We need to get a simple message to Senators: Join with the majority of Americans to support an affordable public option to lower costs, keep insurance companies honest and include everyone, regardless of pre-existing conditions or income.

At this critical time, can you help support reform that the American people want and need? Click here sign up to attend an event in your area.

Help put a stop to these injustices.

Fight to make a difference, not just for you, but for future generations.

Thank you.

Falling through the cracks: Eric's Story

Posted on September 1st, 2009 by Jason Rosenbaum in Insurance Nightmares

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.

The insurance companies tried to kill Maureen

Posted on July 7th, 2009 by Jason Rosenbaum in Insurance Nightmares

On June 25th, Maureen came to Washington, DC from Pennsylvania to lobby her Members of Congress on health care. The Campaign for America's Future documented the trip, and her story.

The insurance company literally tried to kill her, delaying her routine care because they didn't want to pay. She suffered permanent harm as a result. But she survived, and thrived, and was able to tell a crowd of thousands why health care can't wait anymore.

Watch:

Maureen Kurtek Goes to Washington from AmericasFuture on Vimeo.