Health Care Crisis: Human Impact of Insurance Company Abuse : Hearing Before the Committee on Labor and Human Resources, United States Senate, One Hundred Second Congress, Second Session ... June 24, 1992, Volume 4 |
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18 months ALICE MILLER Allyson Schott's birth defect bone marrow transplants breast cancer catastrophic illness CHAIRMAN chemotherapy claims committee complete renal failure consumers copayment covered deny dialysis disease doctors eligible for Medicare employees ERISA expensive experience experimental Families USA Florida GALLAGHER Geiger going to pay health care benefits health care costs health care crisis health care system health insurance hear hospital increase individual insulin insurance company insurance coverage insurance policy John Schott JONES June kidney transplant letter long-term medi Medicaid medical bills medical underwriting Medicare Medicare's MILLER paid patients Paul pay the medical payment percent physician POLLACK pre-existing conditions premiums problems procedure protect Prudential Raymond Raeke received reimbursement rejected the kidney Senator METZENBAUM Senator SIMON Social Security disability stories talked tell Thank tion told treatment UCLA utilization review Virginia Beach Boulevard weeks
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Page 17 - I contracted a rare and debilitating disease which has neuro muscle, autoimmune, and inflammatory effects. Initially, despite my concerns about my illness, I was grateful that I had the broadest and most unlimited medical insurance available. My health care required state-of-the art technology and physicians who were the most sophisticated in their field. Treatment of my disease was anything but routine, and I bought the best health insurance policy available find precisely to help deal with problems...
Page 16 - ... major medical health policy. My care was governed my medicare, which pays fixed prospective reimbursement for in-patient care based upon diagnostic related groups — DRG's — irrespective of whether the patient medically requires care and services beyond the predetermined payment amount. National, Medicare pays an average of 40 percent of an elderly or disabled person's health bill. Hospital admission denials, restrictive care, and premature hospital discharges have become epidemic when Medicare...
Page 13 - ... insurance will not cover Paul at all. I have chosen to continue my old insurance under COBRA in order to maintain Paul's coverage. I must pay the entire $218 premium out of my own pocket, along with the repayments for medicine and doctor visits, plus the cost of syringes and blood testing materials. COBRA coverage only lasts for 18 months. Three of those months are now gone. While Paul was on the waiting list for his kidney, I had two different government workers tell me that the best way I could...
Page 25 - I commend you. But as I read your statement, while in general you have discontinued health insurance for your employees, you are still paying Mid-Atlantic so that Allyson can be covered; is that correct? Mr. RAEKE. Yes, sir. Senator SIMON. And yet they have not paid a single penny yet? Mr. RAEKE. No, they have not. They are still promising, but they have not paid. Senator SIMON. And Ms. Geiger, you mentioned your four children; how old are your children. Ms. GEIGER. My children are 9, 7, 4, and 2....
Page 6 - ... after finding out a person had cancer, they died. Cancer meant death. Period. No way around it. Every day you heard about people dying from cancer. Not surviving, dying. My fathers sister had only lasted a few months, my stepdad 18 months. I knew what cancer meant. It meant death. Oh God, I think, My children. My babies. How can this happen to them? I cant watch them grow up. I can't hold them and nurture them and love them and care for them and ease their little hurts. Instead, I'm going to...
Page 5 - ... appeal was denied. Then, on June 5th, the author of that letter telephoned my husband at his office and told him that Prudential had changed its mind and now considered bone marrow transplants for treatment of breast cancer to be eligible for coverage. We received written confirmation on June 9th. As far as we could tell, this about-face came virtually out of the blue. I was afraid to ask them why they had changed their minds.
Page 10 - We called eight working days before the operation was to take place, just to make sure everything would be taken care of. We were both surprised and angry when the secretary called back and said they did not cover birth defects and congenital diseases and would not pay for any of it. We then informed the secretary of a letter we received from the vice president of the insurance company which stated: "your coverage includes full takeover of all pre-existing conditions. But the secretary said that...
Page 14 - A year later, Ron suffered complete renal failure and was placed on the waiting list for a kidney transplant, but a suitable donor was never found. After enduring a year of hemodialysis and five operations, Ron died in April of 1974. I was a widow at 32, with four young children. After his death, our survivor's benefits put us $40 over the income limit for Medicaid, and we lost our health benefits. We were forced to turn to State aid for Paul's treatment and use a clinic in another city where the...
Page 13 - ... before she can obtain treatment. It shouldn't have to be that way. Thank you. [The prepared statement of Ms. Miller follows:] PREPARED STATEMENT OF Ms. ALICE MILLER Senator Kennedy and other members of the committee, my name is Alice Miller and I live in Orchard Park, NY, just outside of Buffalo. I want to thank you for the opportunity to tell you about how the struggle to obtain adequate medical care for my family over the past 20 years has been a central focus of my life. My first husband Ron...