We made a difference

Health care advocates from across North Carolina filled the gallery this morning when the NC House Health and Human Services Committee met to consider House Bill 115, a bill that would hand over the control of the state’s health insurance exchange to the insurance companies and their allies.

They had a bit of the deer-in-the-headlights look as they saw the gallery filled to overflowing. There wasn’t even any standing room.

As of late last week, the plan was to push H115 through to the House Insurance Committee, which is chaired by Rep. Jerry Dockham, the insurance broker who introduced it.

But we advocates got the word out about the bill, despite the reluctance of most of the state’s media to pay any attention to it, and filled the gallery. Without saying a word, we let them know the word is out and we will fight them on this.

The bill that was supposed to create the health exchange was being drafted by a diverse panel of experts including health care providers, advocates, consumers, physicans and more. The group was put together by the NC Institute of Medicine, and it met several times to turn a suggested federal bill into a framework that would work for the protection and benefit of people of North Carolina.

But the insurance companies wanted control. They wanted to be able to “pre-authorize the expensive diagnostic tests that drive up health care costs.”  Sounds reasonable enough, right?

Wrong. Last year, they forced my husband to wait two days for a nuclear stress test after a bad EKG, very nearly killing him.

They wanted to be able to “offer consumers a wide variety of plans from which to choose.”

Like the catostrophic plan a friend of mine chose with a $10,000 deductible. When she developed breast cancer, she was told her chemotherapy wouldn’t be covered because it was outpatient.

What they want is to be able to confuse people into buying something that covers little more than the insurance company’s butt.

Then they asked for a voting seat on the board of directors, and nearly everyone at the meeting said it would be a clear conflict of interest. A couple weeks later, H115 appeared, before the Institute of Medicine panel could finish its work, giving seven of the 11 seats to insurance companies, brokers and their allies, all of whom opposed reform.

This morning, committee chair, Rep. Bill Current (R-Gastonia), said he didn’t even know “why we’re bothering with this since Obamacare is unconstitutional anyway.”

Insurance Commissioner Wayne Goodwin told him it’s a good idea “just in case,” because if the Affordable Care Act isn’t unconstitutional, and North Carolina doesn’t have an exchange, the federal government would operate the exchange. Then he went on to make some proposals from what the IOM panel has worked on:

  • A seven-member board composed of people with technical expertise and no financial interest in the exchange. The board would be complemented by five advisory committees that would include insurance companies and consumers.
  • Compliance with open records and open meeting laws, something H115 lacks.

The committee decided to meet again to discuss the insurance exchange in two weeks, which gives advocates two more weeks to get the word out that health reform in North Carolina is in danger of being subverted by big business and big greed.

If we don’t stop the takeover here in North Carolina, other states will follow suit. If we do stop it, big insurance will be on notice that we’re watching and we intend to put a stop to their efforts.

Let me introduce myself

Publisher’s note:

AWOP is pleased to introduce our newest contributor, Leslie Boyd. A fierce advocate of health care for all and I am super excited to have her join us!

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I’m Leslie Boyd. As a newspaper reporter for more than a quarter century, I saw and told the stories of real people in real situations who were being held down by systems that worked against them.

In 1983, it was Jeannie Alkema, a woman in Passaic County, NJ, with debilitating multiple sclerosis who was being cared for in her home. Her 12-year-old son suffered nightmares of his mother being put in a nursing home and him being placed in foster care. It was less expensive to care for Jeannie in her home than in a nursing home, but one day she called me in a panic and said the Department of Social Services was going to cut off her home care. Her son’s nightmare was about to become reality.

I called the DSS director and told him I was working on a front-page story about the mess( which I was, if she was going to be sent to a nursing home)  and he knew nothing about it. A few minutes later, though, he called me back and said it had been a computer glitch and Jeannie and her son would continue to get services at home.

My father, also a newspaper reporter, loved when he was able to right a wrong, to help people caught up in systems that were harming them.

I called what I did – writing about social justice issues by telling the stories of real people – advocacy journalism.

In 1992, I started writing about the health care crisis when a woman I knew told me she would be in debt for the rest of her life because she had thyroid cancer and had to pay for her treatments out-of-pocket. President Clinton had just been elected and was promising to help the then-16 million uninsured get access to quality health care.

His efforts were defeated by the health care industry, which didn’t want any controls in place.

Then, at the end of 2005, my son, Mike Danforth, got sick. He had a birth defect that left him very vulnerable to colon cancer. That being a pre-existing condition meant Mike couldn’t get insurance at any price, so he couldn’t get the colonoscopies he needed. The gastroenterologist wouldn’t even let Mike pay over time – he insisted on having the full price up front.

Mike and his wife, Janet, were students. They didn’t have $2,500 or more to pay, so Mike didn’t get his colonoscopies, and in December of 2005, he got sick. He couldn’t keep food down and he had abdominal pain. Still, he couldn’t get a colonoscopy. His doctor wrote in Mike’s medical record that Mike needed a colonoscopy but couldn’t afford it and then suggested Mike should get financial counseling.

Mike went to the emergency room several times and was given laxatives, pain killers and antibiotics, but he continued to get worse.

The doctor finally agreed to do a colonoscopy, but he never told Mike the results: “couldn’t finish procedure; next time use (pediatrics) scope.”

Mike’s colon was blocked. His life was in danger and his doctor just sent him home.

The next time Mike saw the doctor, a couple weeks later, he was vomiting fecal matter and his organs were shutting down. Mike, who was 6 feet tall, weighed just 112 pounds. He was admitted to Memorial Health Center Hospital in Savannah.

It took doctors five days to stabilize Mike so he could have surgery. By then his cancer was stage 3; it had spread to 11 of 13 lymph nodes.

Mike got chemo and radiation through a charity in Savannah, where he lived and was neglected, but the radiation caused a new blockage. This time his doctors let him get down to 104 pounds before they did anything, and the only reason they did was because we were going to take it the media.

The pathology report found “a few viable cells,” and they just gave up. No one from oncology ever even came to talk to him, and his doctor failed to treat a life-threatening infection in his surgical incision.

Fortunately for Mike, his life was extended when I got him a consultation with Dr. Herbert Hurwitz at Duke University Medical Center. He took one look at Mike, and knowing Mike would be dead in a few weeks if he was sent back to Savannah, Dr. Hurwitz “adopted” him.

Mike still needed Medicaid for his chemo, though, and he and Janet had to split so he could get it. He applied for disability but was turned down twice. He was finally approved in March 2008, but he died at age 33 on April 1, 2008, nine days before his first check came.

We used the bulk payment to pay off the debt we incurred supporting Mike for three years while he waited for disability.

In July 2009, I left the newspaper to do real advocacy. I founded Life o’ Mike as a 501(c)(3) nonprofit so I can stand up for what’s right and try to help people get the care they need. I tell Mike’s story and the stories of others who are suffering because Americans don’t think health care should be a basic human right.

Americans desperately need to be told the truth, but Big Insurance – and Big Media – prefer to keep people in the dark; that’s where they operate best – in the dark.

It’s up to progressives – liberals – to stand up and tell the truth and to work for social justice – living wages, safe, affordable homes, health care, education, consumer safety, food safety and more.

We have our work cut out for us.