"It's Called Insurance Insecurity, and It's Traumatic"

The following testimony was delivered to the Joint Committee on Health Care Financing on Tuesday, June 11, 2019 in support of H.1194/S.683 

In December 2015, I was diagnosed with stage 2 breast cancer that had spread to my lymph nodes. Before I even had a treatment plan, and was in still shock at hearing my diagnosis, I met with the Financial Office to find out what my coinsurance and cap was for my out-of-pocket payments. This insurance-centric reality followed every step of my treatment plan.  

Cancer taught me to live every day and be grateful but it taught me other things as well.  Catastrophically ill patients and those with chronic illnesses often lose their life savings to the current medical system. The wicked good Cadillac health insurance I had from my ex-husband did not cover the whole thing. I was expected to pay 10% as coinsurance. Some plans call for the patient to pay 30% of the costs of their treatment.  For 2019 the capped amount is $7,900 for an individual and $15,800 for a family. This amount is before copays, medications, and many other needed procedures that patients carry the bill for in their treatment. I found out very quickly that people go bankrupt because they get sick. Many lose their house after 4 or 5 years as they can never make up for lost income and what they had to pay into the system.

One of the most baffling parts of the system was extreme administrative redundancies. Each procedure had to be checked and rechecked to make sure it was covered. Mass General, Emerson Hospital, My Primary Care office, testing labs and my pharmacist each contacted my insurance company to make sure I was covered. And while this happening, I kept being told that breast cancer patients statistically have a better outcome if they have a positive attitude. There were times I told them what to do with their positive attitude.  

You see, my positive attitude was hampered by the stress of not knowing what's going to be paid what isn't going to be paid. This is because our multi-payer for-profit system puts money and profit over patient outcome. Many patients are told they need an additional medicine, tests, or procedures. Each time that happens, you have to go back into the complicated system and get your approvals all over again. I was denied treatment. I was denied medications. I was denied tests. Each time my team appealed. I barely had the strength to get up in the morning between my rounds of treatment. I was forced to spend those hours hyper-vigilant about what was getting paid for and what wasn't. It’s what I call Insurance Insecurity, and it is extremely traumatic. 

I believe we can fix this! We can start right here in Massachusetts.

(1) We need a system that focuses on the patient first. The medical professionals and hospitals are stuck on this multi-payer treadmill with their patients. As our current system is for-profit, we do it backwards putting Insurance companies first, and patients last often footing the bill with their employers.  

(2) All insurance claims must have the same forms and approvals so that a doctor's office is not forced to have multiple administrators dealing with a myriad of health care companies.  One form, one approval, one insurance.

(3) Prescription costs must be lowered and drugs that our Doctors prescribed need to be approved without retroactive refusals. Medicare for all would take care of that. Prescription costs will go down due to our ability to negotiate with drug companies en masse. 

One of the first things I did when my immune system recovered was to volunteer at Open Table food pantry on Main Street in Maynard. Since then, I have become a manager and speak to many of our guests. I quickly realized that medical costs were one of the main factors in why people have food insecurity in Massachusetts.  

Costs keep going up, the system keeps getting more complicated, and patients are left breathless with less beneficial results than in other countries. I’m determined to speak for those in treatment right now. I know there are people lost and lonely who feel they have been left behind by our healthcare system. I often say Cancer changed my life for the better. I am extremely grateful that my diagnosis turned me from a Survivor to fighter, standing up for the next patient.  

Increments won't do it! We need a bold Leap Forward. Let’s start the health care revolution right here in Massachusetts, the home of the American Revolution.  

Thank you for hearing me on this important issue.

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