In March of this year, PBS' Frontline, which had run the outstanding program "Sick Around the World," ran a sequal to that program entitled "Sick Around America." The health insurance lobbying group "America's Health Insurance Plans" (AHIP) doesn't like to be confronted with the reality that what they do bankrupts millions of Americans and kills 20,000 chronically ill patients every year. So AHIP leaned on their Bush-holdover friends at PBS and forced TR Reid, the reporter behind the documentary, out.
The story became a story about internal dysfunction at PBS. Just as right-wing, pro-industry groups had silenced Bill Moyers' just criticisms of the Bush administration by creating phony scandals at PBS, they silenced the shocking truths of this great program by creating a scandal of Mr. Reid's departure.
There's a reason AHIP didn't want you to watch the show, it shows the absurdities of the American health care system vividly, and in living color.
The program touches on the case of a young woman who suffered from a severe form of Lupus, an auto-immune disease which can attack a person's organs. The woman's name was Nikki White. Ms. White worked and had insurance, but when her illness became severe enough that she could not work, she lost her insurance as well.
According to Frontline, TennCare (Tennessee's Medicaid program) briefly allowed White access to the medical care she needed. Then Tennessee Governor, and the founder of for-profit Coventry Health Care, Phil Bredesen cut state payments to TennCare. Ms. White again lost her access to the medical care she needed to keep her illness under control. The Wall Street Journal, via the Pittsburgh Post-Gazette, described the situation Ms. White faced:
Her rheumatologist prescribed it in June, telling Ms. White to return every four to six weeks and undergo a CT scan so that he could check for signs of infection or organ damage.
But Ms. White didn't go back. In July, she received a notice that she was being thrown off the Tennessee Medicaid program, known as TennCare, which launched an ambitious expansion in 1994 to cover people like her. Now, it was being scaled back because annual costs more than doubled over 10 years.
The CT scan would cost Ms. White at least $2,000 if TennCare wouldn't pay. Each visit to the rheumatologist would cost another $80 and each blood test at least $183. Ms. White had been too sick to work regularly for four years, and she told her primary physician that she couldn't afford to see the specialist again.
According the the Frontline program, Ms. White's health deteriorated. Eventually it became so bad that she went to the emergency room, was admitted and had 26 surgeries at a cost of nearly a million dollars before her TennCare was re-established. She was then flown to North Carolina, where she died in Duke University's Medical Center. AHIP's spokesperson told Frontline that they didn't think situations like this should happen, and that an individual mandate alone would solve the problem.
Patient activists I know have heard and seen Nikki's story a thousand times over. Some of then have even experienced it first hand. They know that our health care system will never be fixed unless they take the insurance industry head-on when it comes to their habit of delay, denial, and rescission. Insurance bureaucrats--too many of whom own stock options--seek to maximize the quarterly and yearly profits of insurance companies.
These insurance employees do this by delaying, denying and rescinding coverage for $300 items on a mass scale. These practices reduce the company's expenditures, thereby increasing profits. Increased profits lead to an increase in the company's stock price, which ultimately (through the exercise of stock options) leads to an increase in pay for health insurance executives who make these decisions.
The problem with this is that patients become noncompliant. Patients stop going to the doctor like Ms. White did. Worse, they stop taking their prescriptions. Diseases like Lupus or Multiple Sclerosis spin out of control. Eventually, patients are hospitalized with life-threatening illnesses. Hundreds of thousands of dollars are spent
This is our last chance to stop this horrible system. We can either pass a plan with a solid public or non-profit option that is available from day one and forces the insurance companies to stop making a quick buck off of denying the chronically ill care the modest care we need to maintain our health. Or we can watch as more and more doctors are forced to write what Ms. White's doctor told Frontline was the cause of Ms. White's death:
"died of complications secondary to a failed health care system."
(H/T Firedoglake)