Once again I tell my story to yet another administration.
There are many stories like mine please send them to President Obama.
I think he needs to be reminded about his promise regarding health care.
http://www.whitehouse.gov/CONTACT/August 18,2009
President Obama
Regarding: Health Care Reform
Dear President Obama,
It saddens me to have to write this letter, one of many I have written to three administrations since 1991, regarding the need for health care reform. I was hopeful when I donated and campaigned for you that we would see a single payer system. When that was not even part of the discussion, I thought at least public option would be a starting point. Now it seems we will not even get that, instead it will stay status quo with the Insurance Industry calling the shots. I hear they will give up using pre-exsisting conditions to deny coverages. Big deal. California enacted some tough laws in the early 90’s that addressed that and they still found ways around it. California also enacted the “Fair Claims Practice Act” which was great as long as you had thirty days to wait for medical care.
This is a my story one that I have told many times since 1991, but feel I must tell it one more time.
In May of 1990 rashes started to appear on my son. His HMO doctor treated him for eczema for two months. I thought it was strange that they appeared only on his joints and around his eyes. In August after many attempts to treat with topical creams, I requested a simple blood test for Lupus (we had a family history of this). I was denied patted on the hand and told “to quit playing Sherlock Holmes and be the mom” and let him be the doctor. By now a new symptom had appeared, slight muscle weakness and pain. I was on my third HMO doctor by now and still requesting a simple blood test.
Was denied again and told it was only “growing pains” after all (my son was twelve) he is starting puberty and they continued treating for eczema.
In late December I was now on my fourth HMO doctor and was threatening to sue if he did not do the blood test I requested (it took three weeks to convince him). The test was done and I still remember getting that phone call at work and given the news that it came back positive for systemic lupus. It took another week to get an appointment with a specialist at Childrens Los Angeles (where he was diagnosed with Dermatomyositis).
HMO doctors refer patients to specialist out of network only as a last resort. The reason for this is that the cost of the out of network Physician is theirs not the Insurance Company who contracted with them.
Now is where the real fun begins and I learn the hard way how Insurance and HMOs really work. I spent the next ten years fighting denials and “reviews”. I lost a lot of sleep writing letters in response to the denials, but my son had the most to lose, his life. We didn’t have the luxury of time to wait during the many “reviews” of his case before continuing treatment. So when the bills started piling up and I could no longer put anymore of his medications and therapy bills on credit cards, I sold my home. Soon after that I lost my job and Insurance, than my marriage of ten years. (1993-1994)
It gets even better because his father has major medical through his job, (we didn’t qualify for state aid because of this) and my son was put on his father’s policy. California had just enacted laws regarding pre-exsisting conditions but he had a wait time before they would cover any medical treatment related to Dermatomyositis.
So now I’m borrowing money from family, friends anyone until he qualifies. Then the denials and review process starts all over again with a new insurance provider. It’s harder for me to fight them this time because I’m not the subscriber and my ex was never evolved in our son’s life. Now I have to go to court so that I can deal directly with the Insurance Company instead of going through my ex. More time wasted, time my son did not have.
By 1996, I found a job with benefits and once again I begin the fight with the Insurance Cartel. My son is now 18 and disabled, because of his age my Insurance Company said he didn’t qualify. It took me a few months of fighting to get him enrolled and another six months of wait time for his pre-exsisting condition. Unfortunately my son relapsed and was now back at Children’s Los Angels. I now had new bills to pay during the lapse in coverage, due to the “wait” time.
At twenty-five my son was put on medi-cal as a disabled adult, where he has no interruption of coverage or care and gets the treatment and medications prescribed by his doctors.
If we had single payer or at least a public option my son would have had no interruption of care based on my ability to pay and maybe just maybe he would not have lost so much muscle that contributed to his disabilities.
My story is not unique I met many families over the years who have similar stories.
As long as the Insurance Companies control our health care we will see more stories like mine.
So please keep your promise to me, my son and all the others who have fought the Insurance Companies. Do not sign a bill that does not have a public option. Tell the House and the Senate you will veto any bill that does not have a strong public option.
Keep your word many lives (literally) are dependent on it.
Sincerely,
Patricia A
Marietta, GA
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