Horror Story: Lifetime Caps, Bankruptcy & Divorce

I originally met  Theresa Pussi Artist BrownGold  in a healthcare advocacy group online. When she learned about my husband's story, she was interested in painting his portrait for her Healthcare In the United States series.  Maybe one day I'll post his portrait in this blog, but for now, these are the stories that I'm worried people have forgotten or ignored -- classic cases of "Well that happened to them, but it couldn't happen to me."

I encourage every reader to visit Healthcare In the United States.

(oil on linen, 40 ins. x 30 ins.) (Interview 5/2011) 

Former Heavy Equipment Operator and Excavator, Uninsured, Age 53: In 1991, while insured with a large excavating company, subject had twins premature by 3 months . 

The company was self-insured*. The subject did not know that his health insurance policy had a lifetime dollar limit for claims. Medical bills for his twins reached and exceeded that lifetime limit. The medical care over several years for his premature twins totaled over a million dollars. 

Subject’s wife quit her teaching job to care full-time for the twins and two older children. Subject took a second job as a cashier at a beer distributor. The couple sold a rental property to pay some of twins' hospital bills. 

By 1999 subject had a new excavating job with health insurance benefits, but was laid off after the Crash of 2008**. After fits and starts, and hopes and promises of re-employment, company finally folded in 2010. 

With savings spent, and medical bills still looming, couple went bankrupt. Attorneys for the hospital and mortgage company went after their primary residence. "We held on for as long as we could. " Couple paid a portion of the mortgage payment every month. Couple was eventually given 72 hours to vacate the premises. 

On a Monday morning at 7 am, a sheriff oversaw the family's expulsion. The couple found a home to rent for $750/month. The couple eventually separated (no money to get actual divorce) which subject believes is largely attributable to the stress caused by dire financial straits. 

Subject now lives in a trailer he inherited from his deceased mother. A local clinic helped him get back surgery from a local hospital system for which he received bills for $93,000, $7,000 and $5,000. Subject has no idea how he will pay the new hospital bills. Subject was also diagnosed with a heart condition which runs in his family. 

Although the hospital has some money for “charity care,” they said they do not want to see him again until he has insurance. 

"I cannot mentally or physically go through it again." Subject did not qualify for assistance because he has a trailer valued at $58,000 (inherited from his mother), a 1996 Jeep and $400 in the bank. Subject is trying to get disability health benefits. 

"I've been an excavator for 37 years. That's all I know. At 8 years old I was stacking block for my dad. I don't understand the system. I'm trying to get medical assistance." Subject quoted his senator as saying, "There will always be poor people." 

ARTIST’S NOTE (2011) The twins are young adults now. That's how long this subject tried to keep it together. All his children are doing very well today. And they are very close to their dad. This subject was strong, gracious and kind -- disillusioned with the system but not broken. I wonder if we are not squandering the working capital of people. Americans' efforts could be better spent growing this country and economy. Instead, people's best selves are depleted trying to survive a medical system that bankrupts them. 

*Here is what I can say about “self-insurance” in my own words. Very large companies can collect the premiums from their employees and set up their own accounts from which to pay claims. One can imagine just how large these pools of funds need to be. The businesses then hire an insurance company to administer the plan but the money belongs to the company itself. See below 

* SELF-INSURANCE (from Wikipedia): is a risk management method in which a calculated amount of money is set aside to compensate for the potential future loss. If self-insurance is approached as a serious risk management technique, money is set aside using actuarial and insurance information and the law of large numbers so that the amount set aside (similar to an insurance premium) is enough to cover the future uncertain loss. 

**THE CRASH of 2008-2009 (from Wikipedia): On September 16, failures of massive financial institutions in the United States, due primarily to exposure of securities of packaged subprime loans and credit default swaps issued to insure these loans and their issuers, rapidly devolved into a global crisis resulting in a number of bank failures in Europe and sharp reductions in the value of equities (stock) and commodities worldwide.

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