Blog | Friday, October 23, 2009

Denied health insurance


One difficult part about being a doctor is the realization that I am part of a corrupt industry that I cannot influence. Such strong words about American medicine? Well, I have encountered yet another patient who is denied health insurance for underwriting reasons that are just plain unfair.

Maryanne has run out of COBRA, the temporary continuation of health insurance that is guaranteed when a person loses their job. It only lasts 18 months and, in case you didn't know it ... we are in a hell of a recession and there are a lot of people who are unemployed.

Maryanne, age 41, was turned down by Blue Shield of California after submitting all of her health records because she (and I quote) "did not meet the underwriting acceptance criteria:
--migraines treated with Imitrex, Aleve, seen in emergency department once 2009
--thyroid adenoma treated with Synthroid
--deaf"

This is pretty outrageous. One migraine headache that required an over-the-counter pain killer and a recognized pill that works for migraine is hardly a rare health condition. Some 30 million Americans have migraine headaches.

She is deaf since childhood and functions completely normally by lip reading. Of course, being profoundly deaf does affect her ability to get just any old job in this economy, doesn't it?

She does have a thyroid enlargement that will likely need further investigation. These are easy to work up but, without insurance, the cost can be exorbitant and probably more than an unemployed person can comfortably pay.

Another one has joined the 47 million uninsured. There is no safety net for Maryanne or millions of others who are living with the anxiety of being uninsured.

Toni Brayer, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.