I didn't really intend to become a victim of our country's patchwork health insurance system. And, really, I'm not a victim. To understand how my life's savings got cleaned out by a callous insurance company and a quirk in state insurance law, you have to understand how the system has very much worked for me over the years.
This week, some very gracious friends are throwing a benefit for me, one that wouldn't be nearly so helpful were it not for my public visibility. That visibility also prompted a lot of questions as to how, exactly, I got into this financial mess in the first place. It's a long story but one worth telling, because it illustrates how thin the margin is between a health care system that works and one that doesn't.
Fourteen years ago, I was diagnosed with progressive kidney failure, and 10 years ago, I had a double organ transplant that saved my life. The transplant was a miracle, but it also left me with a chronic problem: The drugs needed to prevent organ rejection had to be taken for the rest of my life, they suppressed my immune system, and they were extremely expensive. Medicare covered many of my hospital bills but none of my drug costs. So not only am I prone to getting sick in ways people with healthy immune systems don't, I'm unable to work full time, and my ability to get health insurance has been a constant hassle.
In 1996, I thought I had the problem solved, with a company called Principal Insurance, one that not only offered reasonably priced comprehensive insurance but promised, as part of their contract, not to cancel the policy for any reason. Well, they did—they pulled out of the state, in fact, as did many private insurers in the era of former Insurance Commissioner Deborah Senn. A group of us wound up filing a class- action lawsuit for breach of contract, and Senn's office negotiated a settlement that stipulated, in part, that policyholders would have to find other secondary coverage but that Principal would continue, for five years, to pick up the difference—which, for drug costs, was substantial.
Fast forward to 2001. By this point, I had managed to negotiate the health care system for a dozen years despite an expensive, debilitating disease, not much income, and constant changes in insurance status. The system, somehow, had worked. Senn was gone as insurance commissioner, and the Legislature had established a high-risk pool for the most chronically ill 8 percent of the state's population, taking us out of the private insurance market altogether. That pool was the insurance I planned to switch to at the end of 2001, when the legal settlement's five years of coverage elapsed.
But I had the date wrong. It seems that the original settlement agreement stipulated that my coverage from Principal would terminate on July 1, 2001. I didn't discover the termination until the benefits stopped getting paid. The result was that I was without insurance for six months. By the time I could enroll in the state's high-risk pool, I'd spent well more than $20,000 on drugs. My appeal to be covered retroactively was denied.
Normally, I don't inflict personal woes on readers. I'm doing so here for two reasons. First, there's the music benefit Saturday, July 24 (details at www.geovmedicalfund.org), an immensely humbling experience for which I'm extremely grateful. It is, however, leading folks to quite reasonably ask what the story is.
Then there's the story itself. The past couple of years, I've been hearing others like it—the common theme being that a lot of people have "unique" situations, and a lot of people are ill-equipped to understand, let alone master, the byzantine world of our health insurance system. The new Medicare drug discount cards are introducing far more of the same. When coverage depends on the fine print, you can bet it's the people who do this for a living who will come out ahead. The house always wins.
The new Medicare drug benefit system is, by all accounts, a complicated fiasco. But then, it has to be. Hardwired into it—as into all of our health coverage—is the imperative that private insurers make money. Forget ideology; look at the results. For a lot of people, the system works reasonably well. But for the country's nearly 50 million uninsured, it doesn't. And then there's the rest of us—who are insured, pay our bills, but somehow fall between the cracks.
A benefit for the Geov Parrish Medical Fund will be held Sat., July 24, at Trinity United Methodist Church, 6512 23rd Ave. N.W. (Ballard), starting at 7 p.m., with performances by Rebel Voices, Jim Page, the Pinkos, United Sheep, and others. Suggested donations: $10–$100. 206-525-9998.