As a former exec at the health insurance company Cigna, I need to share a horrible story involving my old company and a sick American -- so she can get help, and to highlight why our health care system needs to change. This story is awful, but sadly typical: (1/11)
At Cigna, I handled many high profile cases about patients having trouble getting care they needed even though they were insured. They became “high profile” when a reporter called, after hearing we were refusing to pay for a potentially life-saving treatment or medication. (2/11)
If I were still there, I'd have heard about Jill Eicher, a former social worker in Baltimore for the homeless. In March, Jill thought she might have COVID, so she got tested. She learned instead that the breast cancer she’d survived 9 years ago has returned & metastasized. (3/11)
Jill, 56, is covered under a Cigna policy, but the deductible is so high she and her husband are selling their belongings & asking for financial help on GoFundMe👇. “It’s stage 4 and terminal,” says Jill’s husband, Ron Tanner. “We are devastated.” (4/11) gofundme.com/f/d66qr-jill03…
You read that right: They’re selling their belongings in order to afford emergency care. In America. And they have insurance. So far, they’ve raised $33K, but know they’ll need a lot more to cover Jill’s medical expenses over the coming weeks and months. (5/11)
Because Jill can no longer work, she is now on COBRA, which extends her employer-sponsored coverage for a few months -- so long as she pays the entire cost of the policy, which is $600/month. That is challenging enough, but her policy also has large copays and deductibles. (6/11)
“Over the last 3 weeks, we’ve spent nearly $3k in out-of-pocket medical expenses,” Ron wrote on the GoFundMe. “Once this insurance runs out, we'll have to buy a policy on the open market at about $1000/month, with even larger co-pays and deductibles...We need help.” (7/11)
If Jill doesn’t get the radiation & chemo her doctors say she needs, she'll likely die within a year. With them, she could live years longer. Go on GoFundMe & you'll see plea after plea from Americans with insurance who can’t afford the care that could save their lives. (8/11)
One reason I quit my job was I could no longer mislead people into believing that high-deductible plans were a good option. I knew millions in those plans would not get the care they needed because they couldn’t pay thousands out of pocket before the coverage kicked in. (9/11)
When I quit in 2008, insurers embarked on a campaign to move all of us into high deductible plans. The more people have to pay out of their own pockets, the less insurers have to pay in claims. That’s one big reason for their record-breaking profits year after year. (10/11)
High-deductible plans can steal years from our lives & that’s just fine with my former industry. As a result, Americans (even those with insurance) are begging their friends, neighbors & strangers to help pay for emergency care.
This is America in 2020. We must do better. (/END)
This is America in 2020. We must do better. (/END)
