December 23, 2008 - Lisa's Story

Today, I follow a link in an e-mail from the Leukemia and Lymphoma Society to “Call to Action: Health Reform 2009,” a white paper issued by U.S. Senator Max Baucus, chair of the Senate Finance Committee. I only have time to glance at it briefly in this busy holiday season, but one real-life story catches my eye – not only because it’s the story of a blood cancer patient, but also because it’s an all-too common story in America’s dysfunctional health-care funding system:

“In 2006, Lisa Kelly was diagnosed with acute leukemia. She had insurance – an AARP Medical Advantage plan, underwritten by UnitedHealth Group Inc. with a monthly premium of $185. Unfortunately, the policy had a $37,000 annual limit. And due to the flimsy coverage provided by her policy, the hospital, M.D. Anderson Cancer Center, requested an up-front cash payment of $105,000 before it would start providing chemotherapy treatment.

Ms. Kelly enrolled in a high-risk insurance plan administered by Blue Cross Blue Shield of Texas in February 2007, with a monthly premium of $633. Since her cancer was a pre-existing condition, she had to wait one year for the new plan to cover her treatment. Although Blue Cross started paying her new hospital bills earlier this year, Ms. Kelly is still personally responsible for more than $145,000 in bills incurred before February 2008, and she is paying $2,000 each month for those bills. In June, she learned that after being in remission for more than a year, her leukemia has returned.” ( “Call to Action: Health Reform 2009,” p. 11)

This kind of story really makes me angry. Here’s a person who didn’t just blow off the need for medical insurance. She went out and bought insurance she could afford. She undoubtedly thought she was covered for pretty much anything that could happen to her. A $37,000 annual limit does sound like a lot of money to a healthy person.

It's not. Anyone who’s been around Cancer World knows that cap is woefully inadequate: but most people don’t realize how rapidly and how high medical expenses can pile up, when certain illnesses come crashing down on you from out of the blue. After diagnosis, it’s even worse. You get branded as having a pre-existing condition, and then you’re up a creek without a paddle. For life.

A free-market conservative might counter, “Lisa got what she paid for: an inadequate policy. She should have shopped around more. Caveat emptor.”

All that caveat emptor (“Let the buyer beware”) talk doesn’t sit well with me. As far as I’m concerned, it’s giving unscrupulous medical-insurance companies a license to steal. If we’re learning anything as a result of the current mortgage meltdown, is that the legal sharks can devour a whole lot of victims by hiding in the fine print. What’s true for predatory mortgage loans is just as true for medical-insurance policies.

Lisa’s story is not an isolated situation. From the white paper’s executive summary:

“The U.S. is the only developed country without health coverage for all of its citizens. An estimated 45.7 million Americans, or 15.3 percent of the population, lacked health insurance in 2007 – up from 38.4 million in 2000. Those without health coverage generally experience poorer health and worse health outcomes than those who are insured. Twenty-three percent forgo necessary care every year due to cost. And a number of studies show that the uninsured are less likely to receive preventive care or even care for traumatic injuries, heart attacks, and chronic diseases. The Urban Institute reports that 22,000 uninsured adults die prematurely each year as a direct result of lacking access to care.” (p. 10)

This past Sunday, we held a Health Care Community Discussion at our church, responding to the Presidential Transition Team’s invitation to do so. The discussion went fine – a lively airing of perspectives among people of differing views. Participants completed a brief poll, the results of which we sent on to the Transition Team afterwards, via the internet.

Two church members had approached me separately, prior to the discussion, objecting that this sort of event doesn’t belong in a church. It’s “too political,” they said.

I countered that the election is over, so this couldn’t possibly be about partisan politics. Responding to an invitation from the President-Elect is different from answering the call of someone who’s still standing for election, I explained. But I doubt if either one heard me. Neither one came to the discussion, unfortunately.

I am 100% convinced that this sort of discussion does belong in the church. It probably belongs in the church more than in any other organization – with the possible exception of a hospital or other health-care provider – because we Christians follow a Lord who made healing a big part of his ministry. The American Cancer society has declared lack of medical insurance to be a risk factor for cancer (see my August 31, 2007 blog entry). If we can foster discussion that will lead, ultimately, to less people being at that kind of risk, then we – indirectly, at least – are about the work of healing.