Health Careers Journal

9 Examples Of How Health Care In America Can Be Improved

1. Carol Ann Reyes Dumped From Hospital Into Skid Row

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A homeless woman named Carol Ann Reyes was admitted to Kaiser Permanente Bellflower hospital because of a nasty fall she took. She stayed for three days, at which point Kaiser called her a cab, and instructed the cab driver to dump her in the Los Angeles area known as Skid Row. Reyes was wearing only a thin hospital gown, because, as the hospital later admitted, her clothing had been lost. Carol was confused and suffering from dementia, but Kaiser put her on the streety anyway, and was only caught because of a videocamera running outside of a homeless shelter.

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2. Hannah Devane’s Insurance Company Won’t Pay For The One Thing She Can Eat

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Hannah Devane has a horrible disease of the esophagus that makes it impossible for her to eat normal foods. Hannah literally needs a special formula called Elecare to survive, if she didn’t drink the Elecare she wouldn’t get enough food to live. Naturally her health insurance company refuses to cover Elecare, calling it a “nutritional supplement.” The thing that she needs to live is a supplement to the insurance company. Her only source of nutrition.

Hannah’s father, a police officer, is now working two jobs so that he can afford the formula for Hannah.

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3. 9/11 Workers Denied Health Care

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A large portion of the 40,000 people who worked at Ground Zero in the days following 9/11 have come down with life changing respiratory illnesses. The dust in the aftermath of the terrorist attack was filled with asbestos and tiny bits of glass.

This is a terrible fact, but one would assume that these people would have nothing to worry about. Surely the government wouldn’t forget about the people who sacrificed their personal well being on that day. Forty percent of 9/11 responders are without health care, either because they never had it, or because they have lost their jobs since becoming ill. The government pledged a paltry $52 million to cover their health care costs, a figure that was deemed “inadequate” by the federal 9/11 health coordinator. It has gotten so bad for 9/11 workers that they recently have been forced to sued the World Trade Center insurance fund so that their health care needs could be met.

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4. Emanuel Wilson Denied Chemotherapy In Wake Of Hurricane Katrina

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Emanuel was a school bus driver in Louisiana before losing his job in the aftermath of Hurricane Katrina. The government met some of his needs after he was displaced – he received money and food stamps – but what he really needed was chemotherapy.

Wilson had intestinal cancer, and had been getting monthly chemo before the hurricane hit.

The government helped people with health care after Katrina, but only if they were completely destitute. If you had health care and a job before the Hurricane, you were out of luck after if you lost that job and health care. So essentially Wilson was punished for playing by the rules. He was covered. Until natural disaster.

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5. Shirley Loewe Denied Medicaid Coverage For Breast Cancer Because Of Loophole Law

Shirley Loewe was diagnosed with breast cancer in 2003. At the time of diagnosis she was uninsured and her $15,000 a year income as a hairdresser was too high for her to qualify for Medicaid in Texas.

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However, there is a federal law that allows women diagnosed with breast cancer to receive Medicaid treatment even if they don’t meet all of the normal criteria.

Loewe was denied again anyway. At the time Texas was one of 20 states that only applied that law if a woman was diagnosed at a clinic that received federal funding. Loewe was not diagnosed at such a clinic. She was diagnosed at a medical center half a mile away from a qualifying clinic. Loewe ended up cutting back her work hours so that she could qualify for charity care.

Loewe died in June of 2007, after four years of stress dealing with money and bureaucracy.

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6. Tonya Gullino Has Miscarriage, Blue Cross Deems It “Elective Abortion”

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Tonya suffered a miscarriage last August, and understandably had to make an emergency room visit. About three weeks later Blue Cross & Blue Shield sent a statement denying the claim related to the miscarriage. Tonya called to find out why and was told “We do not cover ELECTIVE abortions. If you chose to terminate your pregnancy for non-health threatening reasons, BCBS will not cover it.”

Despite the emergency room visit occuring near midnight (who gets an abortion at that time of night?), Blue Cross still asked Tonya to fax over her records stating that she did not have an elective abortion.

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7. Jim Dawson Hit With $1.2 Million Hospital Bill, Despite Having Health Insurance

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Jim Dawson found himself in the hospital at the age of 61 fighting an infection. It proved to be a lengthy battle, with Jim spending five months in the hospital, but it had a happy ending. At the end of the five months he was pronounced healthy, and was able to go home to his wife Loretta.

That’s when the phone calls from California Pacific Medical Center started, reminding him that he still owed $1.2 million in medical bills.

This happened despite Jim having health insurance, because his insurance caps lifetime benefits at $1.5 million, a cap Dawson hit two and a half months into his stay. He also has debts totalling into five figures to scores of doctors who were involved with his case.

Tough luck you might be thinking, caps are there to protect health insurance companies from massive payments far beyond what you could reasonably expect right? Sure, maybe, but Jim would have never hit his insurance cap if his hospital wasn’t doing things like charging him $791 for stockings (to improve blood circulation) that can be found online for $12. Or the $2,225 to $6,675 a night for an oxygen mask to help him sleep.

He also wouldn’t have hit his cap if doctors had correctly diagnosed his staph infection early enough to be easily cured. Various doctors made the wrong call however, leaving Dawson with a medical bill he can’t hope to ever pay.

Finally, when a reporter from the Wall Street Journal began investigating the story, California Pacific decided to write off his entire bill. Strange how that works.

Source

8. Aetna Takes Eric Simpson’s Prosthetic Arm

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Eric Simpson lost his arm after being brutally attacked by a masked gunman who shot him seven times, all in the arm.

Luckily, he had insurance (for which he paid $530 a month), and Aetna said he was fully covered to obtain a prosthetic arm. Good thing because the prosthetic cost a whopping $37,000.

Eric got the arm, and spent a week learning to use it when he took a call from his insurer telling him they were sending someone to collect his new arm. They told him he should have known he only had $2,000 in coverage for artificial limbs. Despite the earlier pre-approval.

Aetna followed through, and repo’d the arm, before realizing (a week later) they had made a mistake. Eric had full coverage for prosthetics after all, and eventually got his arm back, but not before going through an incredibly stressful experience at an already unbelievably stressful time in his life.

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9. Natalee Sarkisyan Dies Because Cigna Drags Their Feet

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Natalee Sarkisyan was a 17 year old girl from Glendale, California. She suffered from recurrent leukemia, but was lucky in that her brother was a marrow match. She received a bone marrow transplant from her brother in November of 2007, but the transplant led to multiple organ failure that affected her kidney and liver.

Natalee needed a liver transplant, and was covered through her parents health insurer, Cigna HealthCare. Cigna denied the liver transplent. Her family organized widespread protests and attracted a great deal of media coverage, causing Cigna to reverse their decision. But it was too late, and Natalee died just a few hours after Cigna approved the procedure.

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15 comments

1 Choocher { 02.15.08 at 1:46 am }

When there are no white knights to bring justice to the land, the people must take it upon themselves. But shutting down this entrenched racket necessitates first dismantling the increasingly fascist corpocracy. It’s too late for making noise about biracial Kennedy puppets during the commercials. It’s time for militias.

2 geo { 02.15.08 at 4:07 am }

The real problem is the medical costs are too high. sure insurance companies also suck but medical care just has to be delivered for less cost.

The AMA has been to effective at limiting alternatives to their overpriced medical training and doctor system. The same care exactly can be done for less cost with much less training the way Cuba does it and by eliminating costly doctors and getting BETTER care.

Here’s how, in cuba they train one person to do each part of a cornea replacement surgery. that person has no medical school bills and does a hundred of his speciality moves a week in a conveyor line. one guy stablizes the eye, the next makes the initial incision, the next removes the bad cornea, the next inserts the replacement, they next finishes up. All highly trained and more expert than our doctors but only in their niche and all experts in it with more experience than a general doctor. And if one person is doing a bad job they get yanked off the line. no medical malpractice suits mount up. They don’t have to charge much becuase they don’t have years of med school bills to pay off for studying things they don’t need to know about.

Its another way and just as it did with automobile manufacturing and it provides better more specifically expert service with MORE QUALITY CONTROL at less cost.

It’s getting to the point where I want to band together with people, get an mri, rent it out for minimum charge per scan just to cover it’s loan cost and give everyone early warning on all diseases so they can fight them sooner.

Pretty soon we are going to have to all pick a medical niche and learn it and form an unofficial medical network of neighbors.
get the public formulas for generic drugs and start figuring out ways to legally make them so they are affordable etc etc.

http://www.clicktoimpeachbush.org

3 Eric Santiago { 02.15.08 at 3:33 pm }

You may have missed this one, but it puts all these stories to shame because he was a MARINE… our service members deserve the best this country has to offer in healthcare!!!
http://digg.com/world_news/A_Question_Of_Care_Military_Malpractice_Kills_Marine

4 Johnny Lau { 02.15.08 at 5:44 pm }

These are horrific stories. HMO’s are governed by profit & revenue, not the best interest of the patient. Why do doctors even bother taking the hippocratic oath anymore when HMOs don’t allow them to carry out their promise?

5 Carlos { 02.15.08 at 6:45 pm }

Didn’t someone make a movie about this. Americans save your money and fly somewhere where they won’t deny you health care and you are more than just another dollar sign. We live in a country of my money, my car, my house, and my job are more important than people. Of course who could blame those poor share holders loosing money when their company fulfills its promise. Maybe if they are not in the business of taking care of sick people then maybe they shouldn’t do it. Why do we put up with this? Oh yeah because the rich and powerful deemed it so. Isn’t that why we have the second ammendment? Yet everyday you hang your head down and pretend to say it’s ok it will all work out if I do nothing. I have some lame ass HMO who says Im in good hands. Not likely. I saw them kill my great grandmother and Im sure they are going to kill my grandparents to. Anyone else need to be left dead in the street? I hunger for the day when we have health coverage that makes people healthy. Not debt ridden to live out the rest of you day being houded by some medical company that says they care but put a price on your life. I wish some terminal patient who was being denied their basic right to life would go into their insurance office with a gun. Give it to person in charge and say “If you are not going to save my life you can at leaste put my out of my misery quickly”. I am acutally surprised some of these companies haven’t put out suicide kits in hopes those who are filing claims will give into their depression and save them some cash. Because let’s not forget that is the most important thing in our existance. Money. Oh and if you are lucky enough for them to save you. The next day reminds me of a gangster movie. I would quote Ray Liota but if you have seen Wise Guys you know what Im talking about. F U pay me!

6 Alex { 02.15.08 at 11:21 pm }

It just makes me sad to see this king of thing happen.

7 Darren { 02.15.08 at 11:47 pm }

Re: #1 – Is that Kaiser Permanente or Keyser Söze? :P

I currently am being treated for Leukemia. I entered a local ER on a Monday night, was given a preliminary diagnosis on Tuesday, had several tests on Thursday and Friday and started my Chemo on Saturday. I spent the first 30 days of treatment in hospital under constant care. Included in this care was all my chemo, several spinal tap precedures, a bone marrow procedure, 24 hour support, a private room and huge amounts of pain-killers. None of this was covered by my work health insurance. The bill upon release was…. $0.00.

Why?

I am Canadian. I feel so bad reading these stories and I truly hope that your health system improves soon. I count my lucky stars I live north of your border. And yet politicians and lobbyists in your country continue to say Canada’s system is broken and not a good model. While it may not be perfect, it certainly gives me reason to be thankful of my birthplace.

8 rhoads { 02.16.08 at 2:38 am }

Do you think these 9 stories are going to keep me up at night? What keeps me up at night is the fact that by writing off the capitalistic system of healthcare, some faceless bureaucrat halfway across the country is going to try to make a small set of rules that will apply for everyone in every case.
This will be the true tragedy because you will have a limited set of resources (doctor time, beds, MRI time, etc) and people will have no dis-incentive to use them (read: direct cost). The only logical step is rationing. How is it any kind of fair, if I have money, for someone to tell me I can’t spend my money on my own health. Life is unfair. People get hit by trucks. Some of my relatives have died, not so nicely. I am not going to gnash my teeth and demand that government take away the spectre of hardship at any cost.
Some of these unaffordable life saving procedures didn’t even exist 20 years ago. Just because a treatment option exists, doesn’t automatically make it available for everyone in every case. At what point will even the government based healthcare system say, “You know what, you’re 80, we’ve spent $2 mill on you, you still smoke, we’re not going to give you a lung. We don’t care if you’d pay for it yourself, tough noogies…”

9 Sally Pie { 02.16.08 at 4:49 am }

These are the EXACT SAME REASONS why I don’t both getting health insurance. What’s the point? When an emergency happens, these people NEVER PAY!! Everyone is better off SELF-INSURING. As soon as you turn 18 years old, OPEN A FUND and instead of paying for health insurance, TAKE THAT MONEY and INVEST!! For the same $150/mo. that makes people millionaires by retirement, this could be used to pay for medical costs as you get older. It costs us $600/mo. for premiums. For $600/mo., I could have MULTIPLE MILLIONS by the time I retire in compounding interest. If you don’t get sick, the money is all yours. If you get hurt or sick, then take the money from that fund to pay the bills.

10 Mr. Canada { 02.16.08 at 6:57 am }

***The bill upon release was…. $0.00.

Why?

I am Canadian.***

Umm….just remember your braggartism when you look at that 24.5% VAT that you, and all other Canucks pay for those services. You and your countrymen paid for it in every way possible. So please, get off your high horse.

11 Scott { 02.16.08 at 8:46 am }

I think this is a useful article to point people here in the UK at when they complain about the NHS… They really dont know quite how lucky they really are to live in a country that has free healthcare.

12 Jonathan { 02.16.08 at 8:12 pm }

To Mr. Canada (too ashamed to use your real name…?)

What are you talking about? Yes we pay higher taxes, what’s your point? In my entire life I will never pay 1.5M in taxes like some of the hospital bills listed in this article. Not even close, no way, no how. Maybe if I was rich yes, but that’s like 2-3% of the population just like in the US.

The point of Darren’s post is that people who do not make insane amounts of money are still treated for their health problems and don’t end up with a bill that most could never pay for even if they tried.

Who’s really on a high horse? All he – and I – are saying is that in Canada, and a lot of other countries in the world, an unexpected visit to the hospital doesn’t ruin your life. And for some reason you take that as a bad thing?

13 Off My High Horse { 02.17.08 at 8:56 pm }

OK, for all the Americans on their high horse about how ‘horrible’ socialized health care systems are, let’s ask one simple question:

As a patriotic American, shouldn’t we have the *BEST* for our country? Should every thing we do be the *BEST*. That’s what these conservitives have been touting since 9/11 when they wave the flag of patriotism.

So, is our health care system the best? NOT IN A MILLION YEARS. And it never will be until we eliminate insurance companies and start looking at price gouging in hosptials. Is the Canadian/British/French/German/??? systems better? Maybe, maybe not, but are they better compared to our? Hell yes.

Quit trying to convince people who are suffering, have suffered or are close to suffering people that our Health care system is great and their health care system is bad.

14 Med Relief Foundation { 02.21.08 at 5:57 pm }

This is sad, sick, and should be criminal. It’s also what Michael Moore’s movie Sicko is all about. Regardless of your opinion of Mr. Moore, I strongly recommend looking at this video as it will likely open your eyes to more of this.

15 Kevin { 02.23.08 at 12:30 am }

We all have to take part in fixing the system, the first step any person can take is by creating a digital health record , this does two important things first it reduces medical errors and second reduces costs so that duplication of services are less likely. It also puts the patient/ consumer in more control of his information which is a powerful tool. We potentially could save millions of dollars if the public would just take responsibility for there own health, and it starts with the medical record.

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