Everyone Has A Health Care Story
by Christine Stuart | October 3, 2008 10:01 AM
Posted to Health Care
And the Health First Authority formed 15 months ago to seek solutions to the health care crisis in the state—heard many of those health care stories Thursday night at the Legislative Office Building in Hartford.
Ted Hughes of Windsor told the authority that 10 months ago he walked into a clinic and was immediately taken to the hospital where he spent the next seven days going in and out of a diabetic coma. When he walked out he had a $15,000 bill. His medicine costs $475 a month and he’s paying for all of it out of his pocket. “It got to the point where I couldn’t pay it anymore,” Hughes said.
Hughes is not alone.
Jody Trestman, who lives in Bristol, said one month after downgrading her family’s health insurance coverage because she couldn’t afford the 9 percent increase, she was diagnosed with severe Crohn’s disease. She said by downgrading her insurance from a PPO to an HMO she should have saved $2,000 a year, however her medical debt is now $6,000 and climbing due to the reduction in benefits and higher deductibles.
Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, said she’s had Crohn’s disease for 33 years. She said she was treated by doctors at Hartford Hospital for many years until her disease got so out of control her kidney’s started shutting down.
“That was when my doctor quit on me,” she said. “Just stopped responding to me, got nasty when he did, told me I had to keep emotion out of my relationships with medical professionals.”
“I was dying and he didn’t want me to be emotional,” Jaffe said. She said she now sees a network of doctors in New York.
Julie Ann Byron told the authority that her husband, 44, has juvenile diabetes. She said he requires extensive medical care just to stay alive. She said the family has health insurance through her husband’s company and this summer he was laid-off for two days, then rehired.
During that two-day period the family worried about what would happen if they lost their health insurance. She said the family spoke with their accountant who was able to figure out that with the cost of the husband’s medical supplies and other monthly costs like the mortgage, the family would lose everything they had worked for their entire life in just two years.
Luckily, her husband was rehired, “we feel very blessed,” she said. However, the family was forced to make some hard decisions. She said she had to give up her small business and go back to the corporate world so the family would have a health care choice in the future, should their employment picture change.
Byron is not unlike many families in the state. “It is imperative the state step in and provide a real safety net for us,” she told the authority.
Shana Moynihan, a 21-year-old student at Central Connecticut State University, said while she considers herself lucky to have insurance, she is underinsured.
Diagnosed with ADHD and anxiety disorder she was prescribed Adderall for the ADHD and Risperdal for the anxiety. In July when she went to fill her prescription the bill was in excess of $400 because she had reached her insurance plan’s $2,000 pharmacy benefit limit. She said filling both prescriptions would max out her insurance coverage in just six months.
She said she was forced to make a choice between paying over $400 a month for medication or paying for her college education. “Obviously I chose my education, however without the old combination of medication that I was on my performance in school has suffered,” Moynihan told the authority.
Tom Swan, co-chairman of the Health First Authority, said that Thursday was the eighth public hearing the group has held. At each one of the hearings, he said “there’s consistently been a demand for reform.”
The authority will hold two more public hearings. The next one will be held 6:30 p.m. tonight at Manchester Community College and another will be held 6:30 p.m. at Danbury Town Hall Monday, Oct. 6.
Comments (8)
Posted by: Christine | October 3, 2008 2:35 PM
Just saw this and wanted to share:
6 p.m. - 9 p.m. HEALTH CARE ACCESS -- Members of the medical community host "Projections: Faces of Hartford," a health care access forum and soiree, a chance for people to discuss health care access problems in Hartford and opportunities for change.
Location: Real Art Ways, 56 Arbor St., Hartford.
Posted by: Christine | October 3, 2008 2:35 PM
Yes, that's tonight, Friday Oct. 3.
Posted by: Emma | October 3, 2008 3:46 PM
When I read these stories I think about how well these people would do under the new Charter Oak plan. And then I think what a mess its going to be.
Posted by: Fedupwithliberals | October 6, 2008 8:49 AM
Ted
Next time you have to go to a clinic or a hospital, just say this.."no habla englaise". You won't have to pay a dime! Seems to work for some people.
Posted by: Walt![[TypeKey Profile Page]](http://www.ctnewsjunkie.com/nav-commenters.gif)
| October 6, 2008 9:58 AM
Fedup
You are probably right, but on the other hand, the poor slob without any health coverage will be clobbered by the doctors and the health establishment as happened to those above.
For example: my wife needed a leg/vein operation last year and we were told it would cost $7500 if our HMO/ Medicare insurance did not cover it.
Fortunately the HMO (Oxford/Medicare, a good one IMHO) did cover it and paid around $1500, and we tossed in a required $75 co-payment.
I dont get why we, insured, can get the operation, done semi-happily by the doc in his office ( which took less than 5 minutes of his time) for about $1600, and , if uninsured, would have to pay the doctor almost 5 times as much.
Don't call me a liberal, please.
I, like you, consider that term an insult, but I certainly can see greed in the medical system and wild inequity in this picture,
Posted by: Dave | October 7, 2008 11:57 AM
Walt,
You CAN get the same (or close) deal that the HMO got, but did you ask?
I have sold Health/Life Insurance for years and have tried to shift many clients into HSA based coverage which makes far more sense than "upfront" plans which cost more than they're worth 90% of the time. These plans have higher deductibles, lower cost and tax incentives. The idea is, you save your own money, which is tax free, and use that money (IF you get sick) and anything you don't spend stays WITH YOU. Therefore, if you remain relatively healthy for a number of years you have a lot of retained cash on hand earning interest (and not being taxed) that you can utilize in the event of any unpaid/uncovered medical issues (and eventually remove for other use at 65).
Now, regarding that "deal" with the HMO. Did you know that I have successfully coached many of my clients to settle as much as 70% of a hospital balance? Do you realize the hospital CAN and WILL deal with you and settle claims (or agree to lower fees upfront) simply by just asking them to do so? You won't always get an ultra-aggressive deal, as large Insurers bring more patients/money to them, but as I said, I have seen bills be reduced by as much as 70% just by making the effort to discuss with the provider. The hospital takes far lower percentages from Insurers than what is actually "billed" so this puts you in a good place to negotiate, and if you have an HSA plan you'll be in an even better place because you'll have cash on hand to settle in full, which usually results in a lower settlement #. The providers also will work out 0% interest payment plans if you ask them to.
Health Insurers/Providers are easy and common targets by the public but the truth is they provide valuable and costly services. If consumers were to simply spend more time learning a little about the system, spending their money on more consumer-friendly health plans, and working with the providers when care is needed, you'd be amazed at how well this system can/does work.
Posted by: Walt![[TypeKey Profile Page]](http://www.ctnewsjunkie.com/nav-commenters.gif)
| October 7, 2008 3:51 PM
No reason for me to ask those questions as I have a good HMO/Medicare plan which costs me zero in premiums.
To me your note says you sell insurance and also help the insured negotiate with the hospitals and doctors ,
Thje doctors and hospitals try very hard to get the patient to pay highly inflated fees first, and then reluctantly may reduce fees as you say if a service such as yours is hired to intervene. If they did not highly inflate the bills in the fiorst place, there would be no need to hire an intervenor
Can see where the service could help some folks, but, except for the fact that you leave no contact method, your note is very close to SPAM.
Your description of your HSA plan omits that like all insurance it is a gamble, and that while if health is great you may accumulate money and win, if health is bad, exorbitant health charges can make you. wind up with major debt if you are not adequately conered, which your HSA seems not to do,
At least that is how I read your post.
Depemding on health, which may not be possible to predict, either typr of coverage might be the better.
Do I misread?
Posted by: Dave | October 11, 2008 1:52 AM
Yes, you do misread, and let me explain why...
You do not have to "have a service" intervene for you, it can be done by ANY consumer simply by asking almost 100% of the time. They negotiate with Insurers and they WILL negotiate with you (you would do it for a car so why not with Healthcare??). Also, in regards to HSA and the "gamble" you mention. Millions of folks who pay for Healthcare gamble every day, and that's how the system works. You gamble that you're low deductible, co-pay rich medical plan will provide you more in benefit than it does in premium, but if it did for most folks then Managed Care companies/Insurers wouldn't make so much $$. The premium you pay is a constant, meaning you pay NO MATTER WHAT, and it keeps increasing. If you take a higher deductible, and with it lower premiums, in the long run (because you can't simply look at 1-6 month blocks of time as you will likely recover from an accident/illness you have) you will save more, in most cases FAR more. Plus, if you had an HSA set up you'd not only save $$ in premiums, you'd have the $$ on hand to satisfy the deductible AND not be taked on those saved funds.
For years and years I advised clients to take high deductible plans and save the difference, and some did. Many others continued to pay $750-$1200+ per month for a "co-pay" plan because in their minds paying $20 at a docs office was a deal, forgetting to annualize the premium + co-pays. Now with HSA you can not only save premium dollars but tax on top of that. For 90% of the public it's a fantastic deal, and for those saddled with existing conditions who won't benefit, in some cases even they can see long term rewards.
Healthcare should be looked at as "asset protection" and not a maintenance plan or you (the consumer) will generally always spend more than you'll get. If not, Insurance wouldn't make up close to 1/7 of the national economy.