When the health care crisis hits home: Three sisters share stories of insurance illusionsWritten by Bibeka Shrestha
Nothing could have prepared Franklin sisters Suzanne Thomas and Karen Rice for the total financial ruin that followed their injuries.
Thomas, 63, and Rice, 70, are still coping with the impact of astronomical medical costs from nearly a decade ago, while another sister Shirley Ches, 74, is dealing with a health insurance bill that already scoops up about 33 percent of her household income and continues to climb significantly each year.
Thomas had to file for bankruptcy, while Rice had to move into a mobile home, giving up electricity and washing machines in the meantime. What astonished the sisters most about their plight was that they both had what they considered good health insurance when their injuries occurred.
Ches, Rice and Thomas have channeled the anger and frustration of their experience into an active fight for healthcare reform across the country, helping to organize vigils, sending petitions to Washington and sharing their story with crowds of strangers.
“We have all made a career out of writing letters to the editor,” said Ches.
Through their activism, the sisters have realized they are far from alone in their hardships.
“When you go to these things, you find people with phenomenal stories,” said Ches. “We’re shoulder to shoulder with so many people.”
Losing it all
Thomas had been perfectly happy with her health insurance before she suffered a major shoulder injury due to a fall in 2000.
“I had wonderful insurance. I didn’t worry about a thing,” said Thomas, who never hesitated to visit the doctor, the dentist or optometrist.
Two years later, Thomas had not only lost that health insurance, but also her job, her home and her good credit. Thomas had to file for bankruptcy and move from her two-bedroom apartment in rural Michigan to Ches’s home in Franklin about seven years ago.
It was all the result of a ruptured spleen that doctors didn’t even discover until two days after her accident. Thomas had complained about stomach pain, but her doctors wrote it off as a side effect of her pain medication and sent her home to await shoulder surgery.
Thomas began throwing up frequently and continued to suffer excruciating pain. Her friends decided to rush her back to the hospital as she floated in and out of consciousness.
After making the 32-mile ambulance trip to the hospital, Thomas summoned up enough strength to sign off for the splenectomy surgeons said she needed to stop her internal bleeding.
Along with the splenectomy, Thomas had five surgeries on her arm, and physical and occupational therapy over the next year and a half. Her hospital stay alone rang up $35,000.
When the time to pay the medical bills rolled around, the insurance company refused to pay for the splenectomy — Thomas had never gotten pre-approval for it.
Thomas was appalled that the insurance company expected her to give them a ring during the emergency ambulance transport.
“I was half-dead,” said Thomas.
Thomas couldn’t work her full-time job as she recovered, so she ended up losing her health insurance along with her job.
“You can only do Cobra for so long and afford it,” said Thomas.
Though Thomas tried to take on spot jobs, including a stint harvesting grapes with her non-dominant hand during Michigan’s chilly fall, she could not make enough to keep up with her monthly bills.
At one point, Thomas had to run outside as a tow truck began to pull away with her repossessed car to salvage all her belongings from the vehicle.
At a time when just getting dressed proved to be a struggle, Thomas had to deal with a steady stream of hospital bills and an unsuccessful legal battle to appeal the charges. Thomas had no recourse but to file for bankruptcy and move into Ches’s basement apartment.
According to Thomas, most people in the U.S. are not immune from suffering the same ordeal.
“I paid my bills. I had good credit,“ sad Thomas. “Yes, you have a job right now. Yes, you have health insurance right now, but ... maybe you’re going to end up having to pay.”
Thomas currently works as a cashier at Harrah’s Casino in Cherokee, mostly because the job provides health insurance.
“I never thought I would be working at this age,” Thomas said.
Because of her own shoulder injury, Rice now finds herself living in a single-wide mobile home in Franklin.
After several months of physical therapy and doctor’s visits, Rice had to pay between $25,000 and $30,000 in out-of-pocket expenses.
Rice said she checked in with the insurance company each time she went to the doctor’s office to make sure she had enough coverage. It turned out her insurance company had not yet processed her bills, so they were not aware her coverage had already run out.
“I would have said ‘Look, I’m running out of money. I will settle for a certain level of disability, find an alternative source of treatment I can afford, or save up until I can afford to continue,’” said Rice.
Instead, Rice had to sell her 200,000-square-foot home and move to a single-wide trailer in Franklin to be closer to her two sisters and save up for the “next healthcare disaster,” Rice said.
Rice, who said she always paid her bills on time and never carried credit card balances, saw her credit ruined since she couldn’t keep up with medical payments.
But Rice decided to take a proactive approach after that financial catastrophe.
Rice slashed every expense that she could, using candles instead of electricity and washing all her clothes by hand. She stopped traveling to see her children and no longer sent them any gifts. Rice consolidated trips to the grocery store, going only every two or three weeks, to save on gas.
“If it wasn’t something I absolutely needed to survive, I didn’t spend the money,” said Rice, who didn’t meet her youngest grandson until he was three years old and came to the area to attend Rice’s husband’s funeral.
Now that Rice believes she’s saved up enough of a cushion, she has started using electricity again, though she continues to wash her clothes by hand.
Rice hopes the money she has saved will be sufficient to cover her future medical costs without relying on others.
“All seniors are afraid that we’re one disaster away from ruin,” said Rice. “I do not want to be a burden on my neighbors, friends, church and society.”
Rice said she had previously been ashamed about her financial turmoil, wondering what she could have possibly done wrong. But she decided to share her story because many others were experiencing similar predicaments.
“I’m not alone. I’m not unique,” said Rice. “That’s the sad part about it.”
Rice said she does not want health care reform for just her or her sisters.
“We want this for others, our children and grandchildren, for everyone,” said Rice.
A broken system
Ches said she and her husband are being punished unfairly for simply growing one year older. Her insurance costs have gone up by 15 percent this year.
“It has gone up for no reason,” said Ches. “We have not been sick. We haven’t even used the amount of money that we’ve paid into it.”
Ches wonders what will happen if she has a medical emergency like those her sisters experienced.
“We’ll join the mob in the emergency room,” said Ches. “Then, all the people currently have health insurance will be impacted negatively.”
After having such a terrible experience with the American health care system, the three sisters feel very strongly about passing health care reform.
“The people who have insurance don’t realize that they can lose it,” said Rice. “The people who have insurance are very happy with the status quo.”
The sisters say those who are sick should not be spending their time wondering about how they would pay for treatment.
“I think something is really broken here,” said Rice. “I have to be afraid to spend a penny because I’m afraid of a medical emergency.”
Ches said those who receive health insurance through their employer and believe they are safe from similar scenarios are living in a “fool’s paradise.”
“You have employer subsidized insurance until you are out of work,” said Ches.
According to Rice, the U.S. must ultimately come up with its own solution rather than following how other countries run their health care system.
Though all three sisters say they would like to see a single-payer system, Rice said she has had “wonderful conversations” and found common ground with those who oppose exactly what she supports.
“Fox, CNN, MSNBC – I watch all of them. I will listen to all sides, the truth is somewhere in between,” said Rice, who is disappointed that the health care debate has taken such an ugly turn.
“This should not have become a partisan issue, the people need to realize that,” Rice said.