Medical Insurance companies –There is a Light at the End of the Tunnel
By Dr. Eva Mor – Making The Golden Years Golden
Is Health Insurance Healthy?
This story still breaks my heart every time I think about it. It happened to friends of mine, two hard working people, about twenty five years ago. Both held what we would consider good jobs with good pay and very generous benefits, including excellent medical coverage provided by the employer.
My friends were well on their way to fulfill the American dream, with a little house, two children, and annual vacations. As a young family, they considered themselves very lucky, but then tragedy struck. Their ten- year-old son was diagnosed with ADL, a debilitating and terminal illness that took his life four years later.
Initially, the little boy’s care was fairly simple, consisting of regular visits to the doctor. A year later he required assistance with activities of daily living, as his motor skills began to fail. As the illness progressed, and the child lost the ability to ambulate, became incontinent, and needed home care, the insurance company began to reject the bills. The father, whose insurance coverage was being billed, was called in to his boss’s office, and apologetically informed that they have no choice but to let him go. Otherwise, the company will loose the health policy for the whole company of some 80 workers, and the cost for the policy would go up so much that wouldn’t be able to afford it.
So my friend, not only lost his health coverage, he also lost his job. All this happened as my friends were in a heart-wrenching race to find something that would slow down the illness from robbing their son’s ability to walk, to talk, to see, and eventually to live. For part of the care, the wife’s insurance stepped in and covered the expenses; unfortunately her medical insurance was not as good as her husband’s, and had high co pays.
For the next two years, the care for the little boy advanced to feeding through G-Tube, which required special care and supplies. His home care was extended to 24 hours per day with aides coming and going, and nurses visiting to provide daily care, such as medication to deal with reoccurring infections that he was unable to fight. They fought with him and for him for the next two years, until his untimely passing. In the process this fight depleted their savings, and forced them to slowly sell off whatever they had of value until they sank under the debt.
I was so naïve at the time. I actually thought that the insurance companies were there to help you, that if you or your employer pays for years for medical coverage, they would be there for you when you need them, especially in the cases of serious illness. But some insurance companies are there to take your money, and the need occurs, they will do anything from paying.
My friends still have not recovered from the loss of their child, or from the financial loss, for that matter.
If there is anything that can lighten the tone of this story it is that some protections have been put into place that can serve as a protection to Americans, such as my friends. Because of the new laws that are now in place or are to become law in the next two years, no one can be refused medical care, regardless if he or she has a preexisting medical condition. No cap of cost to medical care can be afflicted on the patient, and children will be covered on their parents’ insurance policy till the age of 26.
This may not alleviate all the worries of the family that deals with a serious illness of a loved one, but at least they will not have to worry that the medical expenses will ruin them financially.
For more info: www.goldenyearsgolden.com
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Eva Mor, PhD, an epidemiologist and specialist in gerontology and health care management, has worked with the elderly for more than 23 years. She holds an M.A. in Gerontology and Health Administration.
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