Thursday, September 25, 2008

Healthcare Is Not a Right When It's So Wrong

What happened to this woman is tragic on its face, but the ridiculous insurance subplot is just infuriating and highlights the sheer stupidity that is our healthcare policy in this country.

As Jessica Cantrell fights to recover from traumatic brain injuries she sustained in a motorcycle accident, her family has been fighting [Southern Illinois University] insurance administrators to pay for her care.

Since the Aug. 23 accident, Cantrell has been in a coma and unable to attend class. In accordance with university policy, her insurance coverage stopped the last day she attended classes.

University insurance administrator Jim Hunsaker confirmed the policy to Cantrell's brother, Jonathan, in an e-mail dated Sept. 15.

"Basically, if you can come back, you're covered," Jonathan Cantrell said. "If a student gets hurt and misses classes, even if they paid the university, they withdraw the student and say their insurance ended."


Sievers said interim Chancellor Sam Goldman met with other university administrators Tuesday to discuss reinstating Cantrell, a senior from Galatia studying French and Spanish.

A possible solution could allow Cantrell to use the $250,000 policy if she pays her tuition and fees, Sievers said.

Jonathan Cantrell said his family is willing to pay the semester's tuition and fees if the university will allow her to use her insurance coverage.

"It's worth paying $7,000 for $250,000 of coverage," he said. "After hearing it was possible, I was excited, but her bills are higher than the insurance money."

The medical bills she has already accumulated would probably exhaust the insurance policy of Lawrence Thompson, the driver of the pick-up truck that struck Cantrell on the motorcycle, Jonathan Cantrell said. It could also exhaust the university policy,
he said.

"There may be nothing left for her care in the future," he said.

Although Jessica Cantrell served in the Army, her brother said she was denied veterans' healthcare benefits because she was not treated at a military facility.

Sievers said insurance benefits from the university could affect her ability to qualify for Medicaid or other assistance.

"We've learned that there could be other options that would be more in Jessica's best interest," Sievers said. "It could be that they do reinstate her as a student, but it's not a done deal."


Jessica Cantrell remains in intensive care at St. Louis University Hospital in St. Louis following emergency surgery to remove a portion of her brain and skull, Jonathan Cantrell said.
That’s just crazy. It shouldn’t be that hard to get coverage for your medical bills while you are in a coma. You should be using the services of doctors not lawyers. What a wasteful and unnecessarily expensive “system” we have.

7 comments:

Bookworm said...

IIRC, the General Assembly passed a bill that required private insurance companies to keep college students covered on their parents' insurance for up to 12 months if they were forced to withdraw from classes for medical reasons.
Blago rewrote it to allow all young adults to stay on their parents' policies until age 26, or age 30 if they were veterans, and this version was approved and became law. It may not have taken effect yet, though. Does it not apply to policies offered through the universities themselves?

rickmonday said...

This is a sad story, my prayers go out to her and her family

JeromeProphet said...

One card, everyone covered the same. Call me a Canadian, or European, or well, who cares what you call me, but the fact is we live in the 1800s here in the U.S.

rickmonday said...

JP,

I agree that everyone should be covered, but the fact remains that some doctors are better than others. I will give you a real life recent example.

My father was just diagnosed with prostate cancer. He went to a doctor here in springfield who wanted to operate right away. My brother knows several good docs in Chicago and got my father an appointment with a doc up there, Dr. Woods. Well anyway, Woods asked my father to bring the results of his biopsies and cat scan with him to their first meeting. My father said, "what cat scan", the doc here in Spfld didnt order one.

So my father gets the cat scan up there and guess what, the cancer spread to 2 lymph nodes. So now they are doing radiation instead of just operating on the prostate. The bottom line is that this quack here in Spfld would have operated and a year later he would have said, "Sorry, we didnt get it all" and my father would be dead in a few years.

How are you going to get the good doctors to buy into this system? I am not being a smartass, but am asking a serious policy question. I agree that everyone should be covered but how do we go about paying for it. I guarantee you that that doc in Chicago isnt going to do the work for a few hundred bucks like the quack here would have.

JeromeProphet said...

Rickmonday:

Don't assume that doctors will be state workers. They'll be private sector.

And as you pointed out in the system we have today there are both good, and bad doctors.

The single provider system just eliminates the profit incentive from the insurance provider.

This works well all over the world, and people are living healthier and longer lives than in the U.S.

Anonymous said...

Not to me because I am forced to pay for someone else to get care.

JeromeProphet said...

That's the whole idea anonymous. It's called spreading the burden, and spreading the risk.

Let's say you have a beloved parent. Your parents worked hard and saved a few hundred thousand dollars - in home equity, and perhaps some annuities, and a life insurance policy.

They burn through most of it in their retirement, but plan to leave some behind for their grown children, and grandchildren - including you.

One parent dies earlier, and rather quickly, but your second parent experiences old age, let's say your mother, and her health begins to fade.

Medical bills begin to eat away at her life savings, and eventually she ends up in a nursing home.

Nursing homes are VERY expensive. In just a few years every single penny your parents saved over their entire lives has been spent on your mother's care.

Then there is no more money, and you must go and sign your mother up for public aid. That's right - it's either that or pay the cost of around seventy thousand dollars a year for her nursing home care out of your pocket.

The moral to the story is that illness, aging, and death will turn most of us who live long enough into welfarites.

So no matter how proud your parents were during life - no matter how fiercely independent and conservative and Republican they were - unless they were very wealthy they end up on the public dole taking money from hard working American's pockets to pay for their care.

So cut the nonsense because it's the same thing with illness. I've known a man who was very much a Reaganite Republican, and I'm sure if I spoke to him today he'd profess his support for right wing Republicanism, and yet if you knew where to look you'd find he's been sued for unpaid medical bills - that in some way had to be paid for - either by the hospital increasing the cost for services on we insured folk, or by getting money from the government.

In the end the crisis is something we simply can't ignore because the system is on the verge of collapse. We must eliminate administrative cost by moving to a one payer system. Notice I did not say one provider system. We use the government to leverage its power to contain cost, and use preventive universal care to reduce incidence of avoidable cost.

That way everyone is insured. Will the system be perfect? No. But as long as we live in a democracy we can improve the system.

It's a system used around the world, and it works.