Promoted by Steven D with minor edit.
Mon Apr 24, 2006 at 05:26:30 AM PDT
Jersey Joe alerted me to this extraordinary story.
Catherine Seipp is a writer for The National Review.
Recently I wrote a diary: Cancer MD: “Insurance co’s. are evil, they want my patients to die” which you can read here:
Yesterday in the Los Angeles Times, Ms. Seipp wrote an opinion piece about her horrendous struggle with cancer and one of our favorite insurance companies, Blue Cross of California. She confirms every terrible word I wrote.
More than anything, let’s all wish Ms. Seipp good health.
But let’s also be mindful of the fact that her shameful struggle with Blue Cross of California is the result of a set of deadly policies of this government.
As far as I can ascertain Ms. Seipp has not dared to write about this in NRO. Why should she? The NRO crowd think all is well in the world. They are not concerned that 47 million of our fellow citizens have no health insurance. They believe access to health care is a privilege not a basic human right.
So Ms. Seipp has written her story in the L.A. Times.
In her own blog, her entry about her health insurance nightmare is entitled: Blue Cross to me: drop dead.
Ms. Seipp was diagnosed with advanced, inoperable lung cancer in 2002
http://cathyseipp.journalspace.com/
Here’s what she writes in the L.A. Times about her struggle to stay alive and receive insurance benefits from her insurer Blue Cross of California.
It’s all about profits. It’s all about the bottom line. There is an inherent conflict between insurance companies and their enrollees.
Without me, Blue Cross’ parent company, WellPoint, which reported a $2.5-billion profit last year, could have seen a profit of $2.5 billion plus about $50,000. I was diagnosed with advanced, inoperable lung cancer in 2002 and so now typically reach my $2,500 individual deductible by January and my out-of-pocket cap by February.
Ms. Seipp makes the argument for single-payer and explains why our system of for profit insurance companies playing heartless games with our lives is immoral and should not be the staus quo in America in 2006.
By law, insurance companies aren’t allowed to adjust your monthly premiums just because you get sick. But they can raise the out-of-pocket cap for all of their members anytime they like, which amounts to the same thing because it affects only the unvalued sick members. (And, of course, getting sick means that even while one’s medical costs go up, the ability to pay goes down — earnings potential is curbed when life becomes a series of treatment appointments.)
Lucky you, if you don’t know what your out-of-pocket cap is. And if you’re like every single healthy person I’ve queried, you probably don’t. But you should know, because the out-of-pocket cap is the most important part of your policy, meant to stave off financial disaster in case of catastrophic medical expenses.
She describes the financial disaster faced by millions of Americans.
My out-of-pocket cap is $7,500, which means that after I reach $7,500 in co-payments, Blue Cross pays 100% of my medical expenses for the rest of that year — except for the $30-per-brand-name prescription I have to pay the pharmacy after I reach my $500 annual deductible for drug coverage. According to the policy, it’s supposed to be a $30 co-payment for a month’s supply, but a new anti-nausea drug I was taking for weekly chemo costs $285 for just three pills, so Blue Cross made me go to the drugstore and fork over $30 every seven days.
And the fact that insurance companies count on sick people to just give up. Sick people really fuck up the bottom line of these for profit monsters.
Another thing working in insurance companies’ favor is that cancer patients rarely have the energy to argue about such nickel-and-diming. I recently managed to spend a morning forcing my way through multiple disconnects and transfers on the Blue Cross 800 number, but I was eventually told that the company would probably reimburse me for the extra $90 a month I was paying for that weekly anti-nausea drug if I filled out the right forms. My far bigger worry is that out-of-pocket cap, which is essentially what insurance is for. To drastically raise it seems the definition of bad faith.
Then she heard from that retroactive review department I wrote about here: Blue Cross of California terminates enrollees who file claims:
Or so I thought — until I began getting letters from Blue Cross in February announcing that it was retroactively disallowing the anti-cancer drug Avastin treatments it had been paying for since October, at $5,000 a pop every other week. It seems Blue Cross decided this new and expensive targeted therapy is experimental. (It looks as if Blue Cross is not asking to be repaid for my relatively unexperimental chemo, which had been costing about $2,500 every single week, but who knows?)
She calls the actions of the retroactive review department “bad faith”. The California attorney general is investigating these thugs. It’s lot’s more than garden variety bad faith. Stay tuned.
To decide after a therapy has proved beneficial that it’s merely “investigational” and therefore should not be covered — that, actually, seems the definition of bad faith.
We owe Ms. Seipp a huge debt of gratitude for describing what’s really going on. And she pulls no punches.
But that oncologist’s report clarifies what is the crux of my current problem with Blue Cross — and the problem any health insurance company has with cancer patients who just don’t hurry up and die already. These new therapies may be great for humanity but not for WellPoint executives who don’t like the thought of a $2.5-billion annual profit reduced to, say, $2.499 billion.
You can read the rest of her truly sad story here:
This is so tragic. This is so wrong. Why do the American people tolerate such an atrocious and immoral system?
The message is, even with insurance, don’t get sick.
As my friend the oncologist said, “they [insurance companies] want my patients to die.”
Cross posted on Daily Kos
