Being a Blue Cross patient sometimes sound like being a character in a horror movie. The latest: a four-year old boy in California is born with a hole in his heart…as soon as Blue Cross finds out they cancel the family’s policy. Cruel. Read the whole story after the flip, along with an update on families forced into near-indentured servitude by medical bills, and good news in the fight for affordable prescription drugs and guaranteed healthcare.
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Four months after her first son, Jack, was born, Jessica Bath received a letter from her health insurance company, Blue Shield of California, saying she and Jack were no longer covered. Jack was born at Sierra Vista Regional Medical Center on April 8, 2003, with a hole in his heart. Bath was counting on Blue Shield to pay for a scheduled surgery to repair it.
Suddenly, both she and Jack were uninsured.
“It was absolutely devastating for us,” Bath said. “How were we going to pay for his heart surgery?”
Blue Shield claimed it was canceling the Morro Bay resident’s policy because she had a medical condition, which she failed to disclose when she applied for the insurance. She and her lawyer contend the condition was insignificant and did not have anything to do with her son’s heart problem.
Just in case you’re inclined to believe Blue Cross’ side of the story:
Bath’s attorney, Ray Mattison of the San Luis Obispo firm Ernst and Mattison, said the case fits a pattern of similar lawsuits filed in Southern California accusing insurance companies of “post-claims” underwriting, meaning they search for reasons to cancel a policy after members file claims.
In March, the state regulators fined Blue Cross $1 million for routinely canceling policies of individuals who filed claims. They found that in all 90 cases investigated, the insurance company broke state law that allows rescission of a policy only if the insurer proves members intentionally withheld information when they applied for insurance.
The worst-case scenario was selling her home to pay for the surgery. But she discovered Jack’s condition qualified him for two public programs, California Children’s Services and Medi-Cal, which paid for the surgery.
It’s fortunate the baby got the surgery—but a crime that the public ends up paying the bill after the Bath family spent years paying premiums to Blue Cross. This is called cherry-picking, and it’s why all the reform plans built on private insurance will never work.
Larger questions: how can the Blue Cross executives sleep at night? And why are we letting them do this to people?
The Baths probably will still have some medical bills to pay. Let me introduce you to another woman to learn the effect medical bills can have on a family
Claudie Harris, 54, of Kansas City, Mo., knows about living on the edge. She owes about$5,000 toward her late husband's medical bills. She's paying it, slowly, from the salary she earns as a housekeeper at a facility for the mentally ill. But that leaves her a little short. So, to get by, she's been taking payday loans, which are loans against her future earnings. "It's easy money," Harris says.
The fees are stiff—Harris usually pays $50 for a $250 loan. In two weeks, the loan falls due. If you can't pay, it costs another fee to renew the debt for another two weeks. Pretty soon, the amount of interest could exceed the original loan, making it difficult to dig out: Harris's receipts show an annual interest rate of 521 percent.
This is like indentured servitude. She can keep working but can never be free. All of the “individual mandate” plans proposed by politicians will continue to expose Americans to terrible financial burdens like this.
But there’s hope. David Sirota writes today that the heartless healthcare corporations might be about to suffer a big defeat in Congress. And a reporter in the “Insurance City,” Hartford, CT jumps on the bandwagon of guaranteed healthcare on the SinglePayer model after his incredibly frustrating run-in with an insurer. Finally, a physician in New Hampshire lays out very clearly the reasons why we can and should enact fundamental healthcare reform to guarantee healthcare for everyone.
I don't care what law Calif has against this "post-claims” underwriting, it is pure and simple attempted murder.
Posted by: Sue Watkins | May 26, 2007 at 06:35 AM