A recovery room RN for some 30 years, mainly in the South and in Southern California, Campbell moved to the San Francisco Bay Area in August 2005 with her husband Allen, a semi-retired former commercial and private airplane pilot. She worked first as a traveler, then became per diem at University of California San Francisco Medical Center while she waited for a full-time, permanent position to open up. They settled into a cozy apartment in the city’s Sunset district, close to her work.
Allen, 68, gets health insurance through military disability and Medicare, and they bought Campbell a short-term policy through Blue Cross of California to tie her over until she went on staff at UCSF. The job opening, however, proved elusive. Before they knew it, it was June 2006 and her insurance was going to soon expire.
Campbell called up Blue Cross and asked about extending her policy.
To her surprise, the agent told her that if she had used the policy even once, they would not extend. Yes, she had used the insurance, in a manner of speaking. She had gone to an urgent care clinic that May
about a urinary tract infection, once to get diagnosed and again to correct her prescription for antibiotic medication. But that was it.
Her whole life, Campbell says she had never had any major medical problems. Because the deductible on the policy was so high, she had paid for the visits out of her own pocket. Still, she had shown her card. So now, no insurance.
“They weren’t even out a penny and they wouldn’t let me extend the policy,” said Campbell. Dressed in khakis, a comfortable cardigan, and a magenta scarf tied sideways around her nearly bald head, the
normally calm Campbell actually raises her voice. “It’s like going into a restaurant, and paying for a meal, but if you ever dare expect them to serve it, you’re never going to be allowed back in again.”
With the help of her husband, Campbell found an insurance broker who set her up with yet another short-term policy, this time through Blue Shield. Still anticipating that Campbell would soon go on staff at UCSF, they prepaid only one year’s worth of premiums.
On Friday July 21, 2006, Campbell felt out of sorts as she finished her shift. Over that weekend, she thought she had bad indigestion. But then her abdomen started swelling and distending. It ballooned larger and larger until Allen took her to the emergency room on Monday.
There, they learned some shocking news: Campbell had a cancerous, stage IV tumor in her belly called rhabdomysarcoma. It was one of the biggest ones the doctor had ever seen. Later, doctors would
discover that she also had adenosarcoma. The survival rate for this diagnosis is lower than 20 percent.
“Learning you have cancer is such an overwhelming piece of information to process,” said Campbell. “You can’t think.”
Within a week, Campbell had surgery to remove the tumor and then started a series of grueling chemotherapy treatments. She made it to number seven before the doctors called off the chemo because
they weren’t sure if she’d live through it.
“They said I had fatal fatigue,” said Campbell. “I was so tired. I felt like a million cells were saying, ‘I’m dying, I’m dying.’ Sometimes when I exhaled, I thought I would just osmose into the air.”
If the diagnosis and treatment weren’t devastating enough, the couple received more disturbing news: the hospital wasn’t getting paid because the insurance company claimed Campbell wasn’t insured. Reams of bills and statements started arriving in their mailbox. “I quit looking when they hit $800,000,” said Allen.
Allen wasn’t about to burden his wife with this paperwork nightmare, so he tried to sort it out himself. The nine-month struggle to get Blue Shield to pay UCSF, and for the various parties to cooperate with each other, sorely tested the limits of Allen’s patience and sanity.
He learned that the hospital typically sent documentation and bills to Blue Shield’s big claims processing offices in Chino, Calif. But for some reason, Campbell’s paperwork needed to be processed through Beattyville, Ky. Chino would reject the hospital’s claims, saying Campbell had no policy. But no matter how many times Allen called, the hospital would keep billing Chino. To make matters worse, claims originated from five different divisions of the hospital and, according to Allen, they didn’t share information or talk to one another.
Meanwhile, Blue Shield’s Chino and Beattyville offices seemed incapable of coordinating claims processing on their end. Acting as a liaison between the hospital and Blue Shield, Allen felt almost like an employee of both. “It took 38 calls to the hospital just to get them to start sending things to Beattyville,” said Allen.
“Then I’d talk to Beattyville and they’d say, ‘The hospital needs to send us A, B, C, D, E, and F. And the doctor has not sent these two forms.’ Then the hospital would argue they did send it, but I’d have to convince them to send it again. I was struggling so hard just to help the hospital get paid. And all this started days after Cynthia was in the hospital.”
Allen says that only in mid April has Blue Shield started to pay some of the claims. Since July 2006,
though, the couple says they have spent from$1000 to $3000 per month out of their own pocket for
Campbell’s medication and drugs that insurance won’t cover. One of her anti-nausea medications costs $116 a pill. They’ve drained their savings, and without Campbell’s salary, have little money coming
in. To this day, Allen says he still receives large packages of paperwork returned from Chino.
And the last indignity? Campbell’s short-term policy is set to expire July 19. Blue Shield has told their insurance agent that they will not cover her past her current policy. Though the cancers seem to be held at bay for the time being, she requires CAT scans every two to three months.
There’s also always the very real possibility that the cancers will come back and that she will need further treatment and hospitalization. Allen is talking to social workers and desperately researching any and
every option: Social Security disability, Medi-Cal, any other insurance.
So far, nothing has panned out.
“We feel like somehow we’re street people,” says Allen. “All of our lives, we’ve paid into the system. This is a huge betrayal. Why are we in this position? Where do we go? Where do we turn? I really do not know what we’re going to do.”
All this stress might have broken a weaker couple. But Campbell and her husband are no ordinary pair. Married 12 years now, their short courtship started when a sleepless Campbell tuned into a late night
TV broadcast about humanitarian air missions to rescue refugees from war-torn Africa. The program
ran just an audio interview with the pilot, Allen, and Campbell was drawn to his voice. She spent months tracking him down and even donated money to his charity, Air Care International. They soon agreed to meet, and instantly recognized each other at the airport.
“A few months after we met, I told him I would marry him,” said Campbell with a big grin on her face. And they did. “I was 40 at the time, and had given up on the thought that I’d ever meet someone I could ever marry. And as soon as you think that, Allen comes into my life.”
They each describe the other as their best friend, and this ordeal has clearly brought them even closer together and united in wanting to share their story in hopes that public policy will change to provide
insurance and real healthcare access to everyone, no matter what. “The tragedy of the situation is that the healthcare mess is totally preventable,” said Campbell. “It’s a product of greed, not a product of
lack of resources. There’s this middleman mentality that you’ve got to get profit to the insurance company. There’s no logic. It’s obscene that in this, the richest country in the world, we can’t take care of our
own people.” _
http://www.calnurses.org/publication...g_may_2007.pdf
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