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This is a letter to all of the Newsviners who defend health insurance companies. I hope that each one who reads my story will make an attempt to put themselves in the shoes of others who are in the predicament I am facing.
I’ve been a member of Blue Cross and Blue Shield for 10 years. For the first three years I was in a group policy through my employer. When I left that job to open a publishing company, I took the Cobra policy, paying the full premium of $272 a month. Seven months later, in July 2003, I was diagnosed with large B cell non-Hodgkins lymphoma, and somehow I survived.
Each year, my premium went up by huge amounts. I kept paying, and I kept working 12- and 14-hour days, coping with the cognitive impairment that often comes with chemotherapy. My doctors did an excellent job of saving my life. I only wish I could say that Blue Cross and Blue Shield cared whether I lived or died. Today, I was forced to face the reality that Blue Cross and Blue Shield would have far preferred that I had died, and that if I have the audacity to stay alive, well, by God, they're going to get all that money back.
Through the years following my successful cancer treatment, I went through two years of urology tests and appointments, dealing with the bladder problems that followed in the wake of my chemotherapy. I dealt with two years of dermatologist appointments and failed treatment for Wells Syndrome, a torturous, allergic result of my chemotherapy. I dealt with two years of abnormal lab tests, outpatient surgery and biopsies, hoping that all I had beaten would not revisit me in yet another type of medical condition. While my health insurance allowed me to survive the financial costs of my immediate health crisis, it didn't care one whit if I would survive the financial legacy it would create. Or so I thought.
Throughout those years, I faithfully paid my health insurance premium. Each year it increased by extraordinary amounts. By June 2009, my premium had gone up 267.5 percent in nine years, when it reached $1,000 a month. I called Blue Cross and Blue Shield, as I had done the year before and the year before that, asking if there was a more affordable policy. The answer was always the same. “You will have to qualify with an underwriter…and, no, we have no other policy to sell you with reduced coverage.” They know my cancer history. They know I can't qualify anywhere for any policy and that if I drop the one I have, I'm uninsured—and uninsurable.
I contacted the state insurance commissioner’s office. The gentleman there did an extensive review of my case only to tell me that Blue Cross and Blue Shield did an excellent job of documenting their expenses and that, no, I had no recourse. The man went on to tell me that the only reason he worked for the state health insurance commissioner’s office was to provide health insurance for his wife and himself. He told me that his salary paid for little more than those bills. He fully comprehended my situation, mailed me pages and pages of his research into my case, and he gave me his heartfelt consolation about my predicament. He was helpless to assist in any way.
Each year at this time of the year, I hold my breath waiting to receive the letter from Blue Cross and Blue Shield that tells me what my new monthly premium will be. This year, in a letter dated May 2, I was told my premium was $1,032 a month. I was thrilled. Only a $32 increase! Somehow, I would hang on. Somehow, I would keep paying this insurance premium and my family would have peace of mind.
Today I got a second letter from Blue Cross and Blue Shield. This one told me that my annual premium was increasing to $1,113 a month and, if I wanted to talk with someone about it, call this 800 number. So I did.
After waiting on hold for 15 minutes, a representative came on the line. I explained the two letters, less than a month apart, telling me of the two increases. She had no clue why I got the two letters and sent my call to the membership and billing department. The woman there told me the first letter was probably a mistake and that the “system” was showing a premium of $1,113 for my gender, age and place of residence. “Funny,” I said, “those are the same parameters that the first letter refers to, the one with the $1,032 premium.” So this premium had nothing to do with my illness, I asked? I was transferred to a supervisor and waited on hold some more.
Poor Ms. Kilcrease. After being on hold by now for almost a half-hour and listening to one dodge after another, I laid out the facts for her. I got the same response. The first letter must’ve been a mistake, and the higher premium was the one in the system for someone of my age, gender and place of residence. My premium apparently had nothing whatsoever to do with my medical history. So I asked, “This is your mistake and I’m going to have to pay for it?” Repeat of the first response with no clear answer. At that point, I finally let it rip. I told her I understand that she’s an American who needs a job…but how do you do this to people? Why do you work for a company like this?
Ms. Kilcrease kept telling me that Blue Cross and Blue Shield is trying to work on this "problem." I asked her how. She didn’t know. She told me that I would have to be underwritten to get another policy. She told me that another company would have to look at my entire medical history before they would decide if they were going to offer to sell me a policy. All of my personal information? All of the details of my medical history? Not one shred of it is private? Did they want a hair and blood sample to go with that personal information? Why, yes, as a matter of fact, a blood sample and EKG would be required in addition to all of my medical records.
Then Ms. Kilcrease told me that her premium, too, was very high. I asked Ms. Kilcrease what it cost her each month. She said it was taken directly out of her paycheck and that she didn’t really pay any attention to it. My response was that if she could receive a paycheck and not be shocked by the premium deduction, she surely wasn’t sinking in the boat I’m in…and all the others like me.
When I listen to Americans talk about pro-big business issues and privacy issues and how the government is taking away our rights and how government involvement in health care access will result in rationing, I have no choice but to shake my head at their ignorance…and good fortune. Anyone who’s been in the position I’m in knows the rules of the game, and they’re stacked heavily against the individual. Anyone who’s been lucky enough to be healthy and have employer-sponsored health insurance probably knows nothing of how this industry works or even what is covered by their policies. They probably don’t even understand the terminology contained in them.
The health care access reality faced by many Americans today is a deplorable disgrace. And Ms. Kilcrease, to her credit, seemed to understand it. She took the full brunt of my frustration with the patience of a saint (and I give the credit to her, not Blue Cross and Blue Shield). When I told her that I lost my job six months ago and was wondering how I was going to keep a roof over my head and pay this insurance premium, she promised that she would research my situation and call me tomorrow afternoon if she could find a less-costly policy for me to buy from Blue Cross and Blue Shield. God bless her.
Whether or not this woman will be able to scare anything out of the dark, dank corners that are the health insurance industry remains to be seen. Needless to say, I hope she can, but I’m surely not holding my breath. Or maybe that's exactly what I should do and put an end to this stress. I'm not usually fatalistic, but this situation leaves little room for hope.
My call to Newsviners is not to sympathize with me. It is that I hope those who think that Americans who rail against the health insurance industry, who can’t afford their insurance and can’t qualify for even a cheap, catastrophic policy are lazy losers will find a wake-up call in my story. Because until we unite on this issue, demand sustainable change and actually care about hard-working fellow citizens who contribute to this society we call the United States, this reality will not be corrected. And in the process, tens of thousands of Americans will die needlessly. Maybe you don’t need us, but our families do.
UPDATE: It's been 48 hours since I spoke with Ms. Kilcrease, and she has not returned my call as promised.
