Do you know anyone who needs a medical procedure but can't afford it (or the co-pay)?

In My Humble Opinion
1

I am looking for anecdotal stories that you know are true where a person needs a particular medical procedure and can’t afford to get it because they are uninsured, or are insured but can’t afford the co-pay or deductible.

I am guessing there are people suffering under conditions like this who need things like cataract surgery, root canals, knee surery…you know, things that really degrade the quality of life.

Or perhaps you know of people who are not able to afford the medicines they need and need to decide which they will forgo.

It may sound like I am looking for political ammunition or something, but I am not. I am looking at the possibilty of developing a fund to help people in situations like this. We are in the basic fact finding stage now, so your input is appreciated!

2

Other that some homeless dudes that I dont really “know”, the answer is no, I don’t.

3

I just posted a bit about this in the MMP, but I’ll post it here again.

I just got a call today letting me know that my mentor is now in a nursing home. For several years she has needed both knees replaced and now needs at least one hip replaced. She’s 62 years old and is basically waiting until she can get on medicare because she’s never been able to afford health insurance.

She lives in a 2 story house, which she’s been trying unsuccessfully to sell and fell twice recently. The last time she fell was on Christmas day. After the second fall, she had to call the paramedics as she could not get up on her own. She’s currently confined to a wheelchair and can’t get up out of it without the assistance of others. Honestly, I don’t know what’s going to happen to her now. She had to give up a job that she loved because she couldn’t handle the walking involved anymore. Now she has two other part-time jobs and I don’t know if she’ll be able to keep them.

I typed more but erased it. All I guess I will say is that I feel very helpless and angry about this situation.

4

I had some health issues the last few years. For one of them, my doctor recommended surgery, but there was no way I could afford it, afford to miss the time from work, any of that. So, to this day (about two years after the diagnosis), I still haven’t had the surgery and struggle every day. I just can’t afford it. I can’t do it. I’m hoping I can find a job with better insurance so that I can get better finally.

5

I was in this position when I lived in the US as I had no access to health insurance. I moved overseas and was able to immediately purchase private health insurance and get full access to treatment.

A recent surgery cost me $450 (no insurance involved as it was below my deductible). The same surgery in the US would have been $12,000 or more.

6

A friend of mine needs some sort of treatment (Not exactly sure what.) and pain control. Her recent pregnancy threw her spine all out of whack and she’s in near-constant pain. If her husband put her and their daughter on his insurance, they wouldn’t be able to buy groceries or pay their rent. So she goes without, and hopes she can make it through school.

7

I am self-employed, and uninsurable due to pre-existing conditions. I have cataracts and extremely painful knee problems. Knee replacements cost over 100K, and the cataracts are a huge problem, because I am an artist.

The good news is that 9 months from today I turn 65, and will be eligible for Medicare. It’s going to be a long, frustrating 9 months, but I can make it.

And aside from these problems, I spend thousands of dollars every year on doctors and prescriptions . . . for diabetes, high blood pressure and cholesterol.

8

My friend has not worked in over a year and has had no end of trouble getting on disability, primarily because the condition that makes her eligible for disability makes her unable to properly navigate the bureaucracy, and all her attempts have been stymied by unhelpful social workers. She’s currently suffering from at least two internal problems, one of the gallbladder and one of the bile duct. Her only recourse right now is to wait until they become life-threatening and get rushed to the ER for emergency surgery.

9

My friend is in his early thirties and employed full time with benefits. He did something to his shoulder that makes it extremely painful to rotate in a particular direction. Even with the insurance, there is no way they can afford the surgery to repair it. Since his shoulder is dodgy, he can’t get work anywhere else (he’s in a small town where nearly all the jobs are blue collar). So he’s stuck in a job he hates.

This one is older, but has a certain amount of wow-factor that I can’t pass up:

About 40 years back, a friend of mine was working as a scout for a logging operation. His job was to hike out and find the trees that were the right type and maturity to be harvested. He’d mark their location, and then a cutting crew would come the next day, chop down that particular tree and helicopter it out.

He’s out hiking in the woods, walking along a large dead tree trunk. Just then, the tree rolls underneath him and a broken branch rotates up, spearing him through the groin. The branch is just longer than his legs. So there he is, by himself, in the middle of nowhere, suspended on tippy-toe by his scrotum on the point of a thick branch. He manages to push down on the end of the branch sticking through his scrotum just enough to pick himself off the branch and fall to the ground. Having nothing else, he wadded up the paper he’d brought along for toilet breaks into the hole in his sac and limps home. With no insurance, no money for the hospital, and no particular desire to admit what happened to anyone else, the wife patches him up as well as she can. Fortunately, nothing major was damaged. He’s gone on to father two children.

10

I’m not in this boat YET, but I inevitably will be. I’m thirty pounds into what I hope will ultimately be a weight loss of 150+ pounds, at the end of which I will pretty much inescapably have acres of loose skin that will have to be surgically removed. My C-minus health insurance, needless to say, will not be paying for such a procedure, which means I’m going to have to pay for it myself, and I can’t afford to.

To add to the pressure, my wife is also looking at a similar weight loss goal and will need the same procedure… what if we manage to scrape up enough to have one of us done but not the other? (If I actually wore the pants in this family, that would be an easy question to answer – she would go first – but the only time I get to put my foot down around here is when she tells me to come kill a bug for her.)

11

That would be me.

I need a CT scan every year; although it used to be twice a year up until a year ago.

CT scans cost in the neighborhood of $7000, last I checked. My insurance deductible has been around $3K… started out at $2700 I think, and went up by a couple hundred bucks every year since, so 2009 was a flat $3000. It jumps up by a huge chunk this year though – for 2010 it’s $3500.

Anyway. I get the CT scan, insurance pays for about half. The other half I basically can’t pay for, so multiple things happen, depending on who’s billing me.

For the hospital bills, they pretty much eat it. They have a charity care program, which I apply to every year, and they write off at least some, and give me a payment plan for the rest. The payment plan they gave me last year was still more than I had (at this point I’m in the hole every month just paying for food and shelter), so after some annoyed letters back and forth they simply stopped asking for it. They haven’t actually told me what any of that’s about, so I’m kind of twisting in the wind for the time being. I still can’t afford to give them any money, so I’m not exactly anxious to remind them about me, y’know?

For the radiology bills, they send me an invoice every month, I throw them $20 every couple months or so to keep it from going into collections. This will not, by any stretch of the imagination, pay off the bill anytime soon (or ever, probably), especially since I’ll be incurring new ones in March.

For the doctor’s bill, it’s usually low enough/last billed so partially covered by insurance at that point, that I can squeeze the $150 or so out of my bank account to pay it off when the invoice arrives. At least I could last year; this year, maybe not.

This, by the way, doesn’t even address the things that the insurance company has decided are unworthy of full coverage. The cap for mental health coverage is ridiculously low; something like $20 a visit with a limit of 12 visits a year. For this, unfortunately, I have an arrangement with my therapist – she bills me $20 a visit (about 20% of her normal fee) and we don’t even bother with the insurance company.

Unicare is pulling out of the Illinois market, however – for 2010 my policy was “transferred” by some formal agreement over to Blue Cross. The coverage is supposed to be better (although, as mentioned, the deductible a helluva lot worse), so we’ll see what happens this year. The paperwork that they actually send me is pretty vague about what exactly is covered, so who knows.

This is an individual policy, btw, which I was damn lucky to get (I fully expected them to turn me down when I applied, and in fact was only applying because the State of IL’s high-risk pool requires you to have been denied within the last 9 months). If I ever dropped or lost this policy, I’d be screwed – no one would ever insure me again, not with my medical history.

12

Not if you don’t lose it too fast. Seriously. I’m up to here of my mother and her fattest friends using that as an excuse for “not wanting to lose too much weight,” but the people I know who’ve lost a lot can point to something like droopy cheeks tops - and those who have droopy cheeks, guess what, so do several of their ancestors.

Skin shrinks.

13

My mother put off having a knee replacement because she had no health insurance. It got done when I lent her the money, she later re-financed the house and took money out to pay me back. It’s a longer story than that, but the short version will do.
She also put off getting a hernia fixed (for more than two years I think) until she qualified for Medicare.
Now, we’re struggling to keep my grandmother in a group home for Alzheimer’s. Fortunately, grandma inherited about 9,000 from a cousin, so we’ve put off the “what happens when the money runs out” until June, but it’s something we’re going to have to deal with soon.
I can also think of at least four times I’ve known people who needed dental work and been unable to afford it, or had a tooth pulled because that was the least expensive option.

14

It depends on your age. The older you get, the less elastic your skin becomes. Eventually it won’t shrink at all.

15

Me.
Osteoarthritis has destroyed the cartilage in right shouler and is working on the left.
One spinal disc is gone.
I have good insurance, but not that good, and letting a cutter I could afford operate on my spine is a non-starter.
I am now in the market for another PCP - current one doesn’t like dispensing narcotics, and I am tired of arguing with him.

16

I have insurance with a $1000 deductible (which I know isn’t WAY up there but still it sucks). I’m have a procedure scheduled in 2 weeks and I can’t afford the $500.00. It’s not cancer *yet *but could develop into cancer if it is ignored. I’m going to try to reschedule it for the end of February. I *think *I might be able to afford it by then.

I do feel like “What the hell am I paying insurance for?”.

17

I know people financially ruined by medical costs, who had insurance at the time the costs were incurred. I don’t know anyone who has chosen not to get medical care for a serious, life threatening condition because they can’t afford it. People won’t let themselves die because it’s too expensive to live, but “if I don’t, I’ll die” is pretty much the price-cutoff point for many, many people.

I do know some people who avoid non-critical medical costs, including a man who drank himself into a stupor to blunt the pain of a kidney stone because he doesn’t have insurance for a doctor visit to get real pain medication.

I knew a person whose tooth infection rotted all the way to the gum over the course of almost a year, turning the tooth completely solid black, and was spreading through the gum to nearby teeth, before a stranger gave him $150 to go to the dentist and have the tooth pulled. He was intimidated by the thought of going to the dentist because he thought it would be too expensive, even though he didn’t know exactly how much it would cost him.

I know plenty of people who get upper respiratory infections and don’t go to the doctor for antibiotics, which usually turns out fine in the end, but in one case led to an advanced case of pneumonia and an ambulance ride.

That’s all I can think of for now. I’ve always gone to the doctor when I was sick, and if I didn’t, it was because I just didn’t want to, not because I was concerned about the price.

18

Perhaps asking for emails or PMs on this would be more appropriate. I’m sure there are people and details you won’t get as an addition to this thread.

I have medical problems I can’t afford to get fixed and I’ll leave it at that.

19

Insured. Needed a biopsy. Wound up owing $$$ after insurance paid what it paid. Paid the hospital $20/mo. until…

Like someone said, “what am I paying insurance for?”

Now I’m on COBRA. Don’t know what will happen when that ends. I’m counting the years until Medicare but that doesn’t cover everything either. When did seeing a doctor get to be a major rather than an incidental expense?

20

My insurance deductible is going to be $10,000 this year.
I should go and get a mammogram, and since I’m turning 50, a colonoscopy. But I can’t afford either, so I’m not going. Not life threatening, but things They say you should have done.

One of my kids is uninsurable, due to a certain diagnosis. This kid should be seeing a therapist and possibly a psychiatrist, and possibly taking anti-anxiety meds. There is no way we can afford that out-of-pocket. This one bothers me, because I know that treatment for a person in their 20’s can often ward off future problems when it comes to mental health.

I have finally resigned myself to the fact that nothing about our current situation is going to change. There will be no meaningful health care reform. I will never be able to afford “good” insurance. I’ll always be one accident away from a ruinous hospital stay. That’s just the way it is.