CNN
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Instead of being able to calmly focus on her chemotherapy treatment, Arete Tsoukalas had to spend hours on the phone arguing with her insurer while receiving infusions at the hospital.
Diagnosed with leukemia three years ago, Tsoukalas, 26, was stunned to learn that her insurer’s coverage for the medication she needed came with a monthly co-pay of $13,000, which the recent college graduate couldn’t afford. She was forced to go without medication for three months, before finally being able to obtain it through the drug manufacturer’s assistance program.
“No one should have to fight cancer and insure at the same time,” Tsoukalas, a resident of West Lafayette, Indiana, who is now studying law, told CNN. “It’s such a cruel system. We live in a country where people are truly laid off when they are at their weakest and most vulnerable, both physically and emotionally.
Tsoukalas, now in remission, is far from alone. Americans’ pent-up fury toward the nation’s health insurance industry burst into the spotlight last week after the fatal shooting of UnitedHealthcare CEO Brian Thompson. in downtown Manhattan. They social networks flooded with articles and videos about medical treatment denials and complaints, and other frustrations with the complicated system.
Police arrested Monday Luigi Mangionethe suspect in the assassination of the leader. Mangione has undergone surgery to treat back pain in recent years, according to a friend and online posts. The backdrop for his book review site.
The majority of insured American adults had at least one health insurance problem – including refusal of claims – within one year, according to a survey released in June 2023 by KFF, a nonprofit health policy research group. Yet 81% of respondents rated their health insurance as “excellent” or “good,” according to the same survey.
More than 200 readers have written to CNN since the shooting to share their experiences with their insurers. While some had positive stories, many recounted problems related to being denied treatment and care, receiving unexpected medical bills, and struggling to resolve issues – all while paying high premiums and out-of-pocket expenses. . Several medical providers also wrote about the hours they and their staff spend trying to get their patients’ care approved.
Isaac Rosenbloom, 43, doesn’t know if he has cancer because his insurer won’t approve an MRI for nodules on his lungs, which were discovered on an X-ray when the Pueblo, Colo., resident underwent a appendectomy. He plans to appeal, but he doesn’t hope the decision will be overturned.
“Should I wait until I start coughing up blood?” » Rosenbloom, paramedic and father of four. “Wait until it’s stage 3 before the insurance company takes it seriously – and then will it be too late?”
Some Americans feel they have no choice but to get the care recommended by their doctors, even if their insurers deny it. This can result in massive bills. About 41% of adults had debt caused by medical or dental bills, according to one study. KFF 2022 Healthcare Debt Survey. A separate KFF analysis 2021 census data suggests people owe at least $220 billion in medical debt.
After Mélanie Duquette, 70, underwent major back surgery earlier this year, her doctor sent her to a rehabilitation center to recover because it was not safe for her to be alone at the House. But after six weeks, her insurer said it would not pay for any additional time, even though her medical team argued she should stay. Duquette, who has worked as a nurse for nearly 50 years, told CNN she was afraid to leave because she still needed help getting out of bed and going to the bathroom and didn’t feel stable on her feet – so she stayed for several more weeks.
Today, Duquette finds herself saddled with a $14,000 bill that she says she can never afford to pay and may have to declare bankruptcy. Which adds to her anger: she paid several hundred dollars per month for the best insurance plan offered by her employer in order to benefit from more comprehensive coverage.
“They refuse to treat people while they make millions of dollars,” said Duquette, who lives in Worcester, Massachusetts.