The statistics demonstrating the scope of our nation’s healthcare crisis are appalling enough. Two of three Americans report skipping needed care each year due to cost, including not filling prescriptions or putting off doctor visits. Millions are forced to borrow money to pay medical bills, leading to crushing debt. Others can’t get the care they need even by borrowing, and suffer fatal consequences: physician researchers estimate tens of thousands of Americans die each year due to inability to afford care.
Yet, as disturbing as these numbers are, they are abstractions. They mask the reality that every data point is someone’s mother or spouse or beloved child, enduring unrelenting, grinding pain and days and nights tortured by illness. So, on the eve of the first-ever Congressional hearing on Medicare for All legislation, this week’s issue of Faith in Healthcare is devoted to pulling together a few of the many reported stories of real people—all of whom have faces and names and loved ones. And all have been victimized by a healthcare system that excels at generating corporate profits, but fails at the basic task of caring for those in need.
Sarah Broughton’s Fatal Sinus Infection. Twenty-year-old Sara Broughton wanted to work with special needs children. But she was among the 28 million Americans who did not have health insurance. Broughton made several attempts to apply for coverage under California’s Medicaid program, but her applications were caught up or lost in the notorious red tape that are a staple of many state’s Medicaid systems. Broughton developed a sinus infection. She could not afford to go to a primary care doctor, so she ignored the pain. The pain worsened, but she ignored it some more. Finally, she went to the emergency room, the far-too-common healthcare provider of last resort for the uninsured and underinsured. For Broughton, it was too late. Her untreated infection had spread to her brain, causing irreversible, fatal damage.
Hedda Martin Sent Begging for her Heart Transplant. Hedda Martin’s chemotherapy for breast cancer led to cardiac damage, and her physicians concluded that she needed a heart transplant. But a Michigan hospital committee rejected her, sending her to hit up family, friends and strangers for some cash: “The decision made by the committee is that you are not a candidate at this time for a heart transplant due to needing a more secure financial plan . . The Committee is recommending a fundraising effort of $10,000.” Martin was forced to turn to the GoFundMe website, like a quarter-million other Americans each year who go online begging for help with medical needs. Even that site’s CEO says, “The system is terrible . . . Politicians are failing us. Health care companies are failing us “
Alec Smith, Antavia Worsham, Meaghan Carter, Shane Boyle, et al. These names are likely just a sampling of a shamefully long list of Americans who have died in recent years due to their inability to afford the sky-high cost of insulin. Three corporations have managed to corner the global market on a medicine discovered in 1922 by inventors who sold the patent for a dollar each. Those corporations hiked the price for a single vial of the identical formula of insulin from less than $30 in the 1990’s to nearly $300 today. For persons with type 1 diabetes like Smith, Worsham, Carter, and Boyle, a month’s supply can cost over $1,000. For various reasons that reflect typical life events—aging off of his mother’s health insurance for Smith, income exceeding Medicaid limits for Worsham, a lost job for Carter, a switch to family caregiving duties for Boyle—they came up short. They, like an estimated one in four Americans with type 1 diabetes, rationed their insulin. The risk for everyone who rations is diabetic ketoacidosis. For these four, and untold others, inability to afford their full dosage was fatal.
Rebecca Hall Dumped from the Hospital. A bystander’s devastating video of a disoriented Hall wandering in the cold outside of a Baltimore hospital, wearing nothing but a skimpy hospital gown and socks, went viral. Hall’s mother later confirmed her 22 year-old daughter suffers from mental illness. The administrators of the University of Maryland Medical Center quickly apologized for ejecting Hall in that condition, and the Centers for Medicare and Medicaid Services cited the hospital for multiple violations stemming from the incident. But, according to several reports, the illegal practice of patient dumping is a regular occurrence when patients are uninsured and can’t pay for care.
Stephanie Sena’s Doctors Order Her Foot Amputated; Her Insurance Won’t Cover It. The part-time professor at Villanova University was among the millions of U.S. workers whose employer does not offer them health insurance. So she purchased a health insurance plan from a broker. Yet, after paying over $1,700 in premiums, she learned that the urgent amputation of half of her foot would not be covered. The company refused to pay a penny of her $22,500 bill. Sena is not alone: for-profit insurance companies have strong incentives to deny claims, and regularly do. Those denials are often illegitimate: several reports have found that as many of half of all claim denials that were appealed were reversed. For many others, their insurance simply does not cover the care they need. Over 40% of American workers with private insurance have high-deductible insurance plans, meaning they are forced to pay thousands of dollars out of pocket before ever receiving any benefit from the premiums they faithfully paid.
Melissa Welch-Latronica Goes to Jail for an Unpaid Ambulance Bill. When a Valparaiso, Indiana police officer pulled Welch-Latronica over for failing to have an updated sticker on her license plate, she never expected that the officer would end up locking her up behind bars. But a five-year-old court order called for Welch-Latronica’s arrest for failing to appear in court—to answer for a $3,000 bill for an ambulance called years earlier when she suffered a mild heart attack while eight months pregnant. Welch-Latronica does not remember receiving any court notices about the bill, but she certainly remembers the three days she spent in jail because of it, sleeping on a mat on a concrete floor and having her meals shoved through a slot in the bars. “My crime was having a heart attack,” she told the Northwest Indiana Post-Tribune.
Jessica Pell’s $5,751 Ice Pack. When Vox healthcare reporter Sarah Kliff spent 15 months reviewing over a thousand emergency room bills, she discovered a world of byzantine hospital cost structures and slippery insurance practices. The result was often outrageous bills for unsuspecting patients. One example: Scott Kohan was personally billed $7,924 for surgery for his broken jaw. Although he had gone to a hospital that was in-network for his insurance company, the surgeon who operated on him there wasn’t. And yes, Jessica Pell was charged $5,751 for a New Jersey emergency room visit where her treatment for a cut ear consisted of a single ice pack.
These tragedies and absurdities did not have to happen. In every other nation with anywhere near the resources possessed by the U.S., all of which provide universal healthcare, they would be unthinkable. If we can finally see our way through to adopting a system that guarantees care for all, we can make such stories unthinkable, too.
Faith and Healthcare Notes
- The Necessity of a Mental Health Ministry. Our friends at Sojourners call for faith leaders and congregations to get intentional about addressing mental health needs, and offer multiple resources for that process: “ Real and sustained progress requires a change in cultures that demand people hide a part of who they are."
- Hospitals Will Do Fine Under Medicare for All. The New York Times reported last week that hospitals may lose billions under a Medicare for All system. But the People’s Policy Project provides a welcome reminder that hospitals would regain most of the lost revenue through the administrative efficiencies enjoyed by systems like the Canadian single-payer system, and the rest could easily be absorbed with reducing—but still not eliminating—hospital profits.
- The Winners from Privatized Medicaid: Health Insurance Companies. Axios reports that 52% of all Medicaid spending now goes to health insurance companies--$307 billion in 2018. That is a steep increase from about 20% of Medicaid dollars as recently as 2007. But with for-profit incentives come predictably poor track records of skimping on care and wrongly denying coverage.