Sick Around America is an investigation into the health care system in America. The program presents a series of stories of ordinary Americans who all have had health problems which wouldn’t take care of by health system.
The episode stars with Will Lyman talking about the case of Melinda Williams who fell down and was in a pool of blood in February 2008. Melinda gave birth to a premature child. Melinda and the baby’s health care cost was nearly half a million dollars. Luckily as Lyman points out Microsoft paid for the cost since she was an employee.
However, as Lyman continues companies like Microsoft are laying off thousands of workers making their health care coverage meaningless.
We move on to an interview with Drew Altman of Kaiser Family Foundation talking about PPOS and HMOS. He says premiums were high with PPOS and says no info was giving as to why.
The show shifts to the case of Paul Stevens who used to work for a telecommunications company. At nearly fifty-eight years old, Stevens was laid off. Stevens decided he didn’t want to pay high premiums and tried to find insurance in private sector.
As Lyman points out finding insurance without employer paid benefits is even harder as insurance companies don’t have to cover one. In fact, as episode shows many medical insurance companies participate in what’s known as medical underwriting. Medical underwriting as Georgetown professor Karen Pollitz explains is the process where people are denied the chance to have health insurance for the most trivial of health problems such as acne or hay fever.
The higher health risks that a potential holder has the less likely that he or she will get insurance coverage.
We go back to the case of Paul Stevens. Stevens has diabetes and thus was a high risk, so Stevens never had a decent chance of getting insurance. Stevens had a heart attack and had to face getting open heart surgery. Bills for the surgery cost him about two hundred thousand dollars. As Lyman explains Stevens was “too rich for Medicaid and too young for Medicare” eventually had to declare bankruptcy.
As Lyman points out according to a Harvard study, nearly seven hundred thousand Americas have declared bankruptcy due to high medical costs.
Ceo of Kaiser admits if he tried to get coverage himself without the benefits he has in private insurance companies he wouldn’t get it.
We are told the story of Scott Johnson who now works at Menards just for health benefits. From there we are told the story of Camel who used to work in TV industry.
Lyman talks about consumer directed health programs. He discusses the pros and cons how they have high deductibles, require co-insurance, and co-payments, and can put cap limits on their coverage.
Karen Pollitz is interviewed again, and she describes coverage available as junk.
We move to the story of Jennifer Thompson. Thompson’s case is different from others in that brings into discussion the medical industries use of rescinding coverage to its holders sometimes under false pretenses.
Thompson was a woman fighting cancer. Blue Cross initially gave her coverage even though she had cancer.
Thompson required surgery after her cancer came on again. During this Blue Cross decided to rescind her coverage. They did after they had already declared that they were going to provide coverage. They cited as their reason not the fact that her cancer had come back but because she was starting to bleed internally.
Wellpoint who owns Blue Cross declined to address the Thompson case. Samuel Nussbaum, the Executive Vice President and Chief Medical Officer, is interviewed but again doesn’t provide any answers.
LA Times Reporter Lisa Girion talks about rescission. She says that the official stance on rescission by medical companies is that it’s used to stop fraud but it’s another case of medical underwriting. Girion talks about the case of Health.net which paid its employees bonuses for rescission.
As Lyman tells us a lot of these companies for charges of improper rescission. Wellpoint for example paid over ten million dollars. He tells us that although the companies made a huge settlement officially they denied all wrongdoing.
Lyman talks about medical care under what’s called guaranteed issue before moving on to the last case of the episode.
The case was that of Nikki White who had Lupus. Nikki didn’t have employer supported health care. Nikki applied for health care and was denied by many private companies. After she died, it’s revealed that one of the companies that denied White health care actually made a mistake. It turns out that she did qualify.
The remaining parts of the episode discuss whether health care will ever be available to everyone.
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