Don't Worry, Get Angry: Hillary's Health Care Travesty

"Don't Worry, Be Happy" is the song that often pops up on the playlist at Baldie"s Blog, and it's a pretty jarring accompaniment to the heartbreaking and infuriating tale that is unfolding there.

Hillary St. Pierre is the reigning bad-ass baldie in question. She is a relentlessly spunky 27-year-old mother whose life has been ransacked by two different attackers: cancer, and a health care system that doesn't even protect those who have insurance, let alone ones who don't.

I met Hillary when I served as sort of a web research czar for a dear friend who was diagnosed two years ago with lymphoma. My friend is now cancer-free and thriving; Hillary is not. Despite round after round of chemo and two bone marrow transplants that came very close to killing her, the cancer has continued its assault, and appears to have spread to her liver, GI tract and spleen. She is currently on what she calls "Plan Y", which, as you might guess, involves more tortuous treatment. No one wants to be on Plan Y. And no one so gravely ill wants to spend their precious time drowning in bills and fighting with multiple insurance companies. But that's exactly what Hillary is doing, and what President Obama said his late mother was doing in her own fight with cancer.

The New York Times' Nicholas Kristof, in his latest scathing column on the health care uproar, mentions a statistic that's worth repeating here: that 78 percent of the people who had to file for medical-related bankruptcy actually had health insurance. Hillary is a case in point.

When she was diagnosed three years ago, Hillary had health insurance, short and long-term care insurance, and life insurance. Let's first look at her health insurance. In the first year, she says she had a $2500 deductible (she blew past that with a single biopsy), and then began racking up $3600 in co-pays. At some point, she says the insurance company tried to stop covering PET scans, the PET scan being the gold standard for cancer staging. Rather than accumulate unpaid bills, they put the PET scans on credit cards. At another point, her husband, who has Crohn's disease, needed to have 20 inches of his small bowel removed. He should have temporarily stopped working, but that might have meant getting COBRA insurance, with premiums of $1600 each month with a $6000 deductible. His employer let him continue working from a hospital bed, recovering from a bowel resection that required an 8-inch incision. If you can believe it, they were lucky: had they needed COBRA and been unable to pay for it, they risked a lapse in insurance. That would mean potentially falling into the pre-existing condition trap which could have left them both permanently uninsurable.

Next there's her disability insurance. Hillary was a registered nurse when she was diagnosed, and nearly half of her income came from overtime. But disability insurance would only pay according to her base pay. Then, at a perilous moment during Hillary's first bone marrow transplant, the same week her husband was told to plan her funeral, the disability insurer informed them that Hillary had been overpayed and they wanted the money back. Cost: $7452, which also went on credit cards. Recently the insurer once again argued overpayment. Rather than try to fight the company and risk owing them $18,000, she is giving up that $566 a month.

Then there's life insurance. What life insurance? Hillary was dropped 6 months after diagnosis. And none of this accounting includes those ancillary costs of getting really sick, like the cost of travel to and from treatment centers, and the huge expense of child care.

Managing her bills and fighting the insurance companies for what she needs could be a full-time job: she has an Excel spread sheet that's color-coded and runs about twenty-five pages. But she already has a full-time job, you know, trying to stay alive, and it seems as if every other day she has to fight a battle that can affect her health in ways that can't be predicted. One of the latest issues: her insurer requires a prescription mail-order plan to control costs, which, in theory, sounds sensible. But Hillary takes a few dozen different drugs a day, which require constant recalibration. Last week she woke up with bleeding gums that have receded down to the roots, and knew instantly that she might be dangerously anemic. Too bad for Hillary that her folate needs to come through the mail, and not same-day delivery either.

Could you afford catastrophe? Do you think you're insured? Start reading the teeny, tiny print and follow every asterisk on every policy you hold and you might be surprised by the answer. I know I was. There's a reason that every other cancer patient linked to Hillary's page seems to have a 'donate' feature on their page, and it's not because they are grifters. They all had "insurance" too when disaster struck.

Hillary's 6-year-old, Xander, began asking Santa months ago to make his Mommy healthy; that's all he wants for Christmas. It's not clear if Santa will be able to pull that off. Hillary, for her part, has found her cause, and has become a health care reform advocate in her home state of New Hampshire. She implores politicians privately and attends germ-happy town hall meetings, even with chemo and pain that only the strongest narcotics can control. It's her twist on that song that's always playing on her website: don't worry, get angry.