We all know somebody like Joyce.
[img]617|left|||no_popup[/img]
Her story has a familiar patois. .
At the age of 52, Joyce, the divorced mother of two children, decided to change jobs. For most of her professional career, she had worked in various aspects of the insurance industry.
After being contacted by a recruiter, Joyce made the move from mid-level management. She accepted a position with a domestic division of Lloyds, the storied British company that once insured ships like the one that carried tea to a party in Boston Harbor.
With the new job came new opportunities and a new healthcare plan.
Something Very Wrong
About eight weeks into the new position at a stylish office tower along the San Francisco waterfront, Joyce began experiencing abdominal pain. Initially, she attributed her gastric discomfort to the stresses associated with her heightened responsibilities.
At the urging of her fiancé, she made an appointment to see her doctor.
Following a series of tests, her physician delivered the bad news. Joyce was diagnosed with pancreatic cancer.
It was as if a ton of bricks had fallen on her.
Joyce always had been healthy. She was a competitive power lifter, and she rarely had taken a sick day.
Being a stoic and pragmatic, Joyce began exploring her treatment options. With an aggressive disease like pancreatic cancer, her options were few, and prohibitively expensive.
A Time to be Aggressive
Joyce did what any of us would do; she sought intervention from the best medical professionals she could find. There was one catch. After receiving the confirmed diagnosis, her new healthcare insurer had to approve the claim.
To her shock, coverage for her illness was denied.
In a form letter written by an otherwise anonymous clerk, her new insurer pronounced that they would not provide her with coverage because her cancer was a pre-existing condition.
[img]618|left|||no_popup[/img] Joyce appealed the denial. But, that too was rejected.
Without insurance, her treatment options were few.
Although Joyce was a homeowner, had put her daughter through college and had a son in the midst of his first year at university, she did not have enough savings or equity in her home to pay for the care she needed.
Joyce turned to Medicaid.
Because she owned a home and made a reasonable living as an insurance professional, she didn’t qualify for government assistance.
With the aid of her children, her fiancé, a dedicated network of friends, and even her ex-husband, Joyce scrambled to secure available treatment.
She managed to get herself into an experimental study. But the costs of the drugs and additional care were more than she could carry.
Then came the final blow. She was fired from her new job.
First the Worst, Then the End
Regrettably, because Joyce had missed so much work resulting from her illness, Lloyds had decided to replace her.
Even though Joyce may have had a valid claim for wrongful termination against Lloyds, she had more important things to do, and time was running out.
After losing her job and only source of income, Joyce turned once again to the government for assistance. She was told by a social worker that Medicaid would again review her claim, but coverage would be unlikely because she still had assets.
Death came quickly for Joyce. The malignant scourge had metastasized throughout her body.
In her final days, Joyce decided to have a party for her friends and family to say goodbye. Despite the great food, lively music and laughter, a pall hung over Joyce’s future.
She knew that as the sands of time ran out, she would still require additional care. And she didn’t how she or her family would pay for it. She worried that her children would be left holding the bag. Instead of fond memories of their mother, they would be faced with thousands of dollars in medical bills.
Joyce was right.
Much Better Elsewhere
Last night, I watched the President’s press conference.
Like many Americans, I’m not sure there are any easy solutions to fixing our healthcare system. But there is no question that it is broken.
Other industrialized countries like Germany, Japan or Canada make certain that all their citizens have access to healthcare. According to the World Health Organization (WHO), even the tiny Central American nation of Costa Rica manages to better deliver quality healthcare to a broader swath of its populace than the U.S.
Opponents of universal care charge that it smacks of socialism. But no one has ever accused Germany, Japan or Canada of being anything other than capitalist.
Fixing our healthcare system is also an economic imperative.
The current system is expensive, and fraught with inefficiencies. Every year, Americans spend hundreds of billions of dollars for equivalent care that costs less in other countries.
Millions of Americans miss work for illnesses that could have been resolved through access to preventative care. This undermines our productivity and costs businesses countless billions in lost time.
Doctors and healthcare professionals deserve to be compensated fairly for the critical services they provide. But, this should not stand in the way of our system becoming more efficient or providing greater access to care.
In this down economy, the healthcare sector is also the source for a myriad of new jobs in a nation that desperately needs them. If, as many experts agree, we truly are in the midst of a jobless economic recovery, then why not also look to healthcare as a potential source for new training and long-term employment.
Our medical science is second to none. With few exceptions, American hospitals, doctors and healthcare professionals are among the best on the planet.
But what’s the value of all that skill and knowledge if folks like Joyce can’t use it?
John Cohn is a senior partner in the Globe West Financial Group, based in West Los Angeles. He may be contacted at www.globewestfinancial.com
