Wednesday, February 11, 2009

An Open Letter to the President, Senators Dick Durbin & Roland Burris & Anyone Else Who Will Listen

Dear President Obama & Senators Durbin & Burris,

I am writing you this open letter today to discuss the current healthcare situation in our country. Until now, I had employer provided benefits that, while not stellar in my eyes, were very good. Recently, I lost my job and chose to find an independent insurance plan rather than pay the $800 a month for COBRA benefits. I figured an independent insurance plan through my same provider (Aetna) would be less expensive than COBRA and would offer comperable coverage. Little did I know...

After being accepted by Aetna to one of their Managed Choice Open Access plans I thought things were fine. And they were, at least until I received my credit card statement with the first month's premium charged to it. The premium Aetna charged my card was a 90% increase from the amount I was quoted. 90%!!!!! Naturally, I was shocked so I called Aetna and was told by a member of their underwriting staff that because I had had surgery to correct a deviated septum 2 years ago, they consider me has having chronic sinusitis which is a pre-existing condition and basically means they can charge me whatever monthly premium they want. I am in the process of filing an appeal on this outlandish claim because since the surgery I have not had a single case of sinusitis and not a single sinus infection. The surgery worked to fix the problems and as any reasonable person would expect, once the problems were fixed they are no longer problems. I should have known that this did not bode well for the Aetna Managed Choice Open Access plan.

As luck would have it, I ended up needing to go to the doctor this week for an ear infection & cough. After finding a physician in Hyde Park who would take the insurance and who could get me in this week, I was hopeful that things were looking up. Not so. I saw the doctor this afternoon and he prescribed 2 medicines to help me get better, Levaquin - a common antibiotic and one that is highly favored by Otolaryntologists, and Asthmanex - a steroid inhaler to help clear up the cough and congestion in my chest. My husband and I really liked the physician and talked about making him our primary care provider in the area as we walked to the local CVS to fill the prescriptions. That's when things took a definite turn for the worse. When it was finally my turn to pick up my newly filled prescription I was given a rude awakening. The Aetna Managed Choice Open Access plan does not cover brand name prescriptions until a $500 deductible has been met and since both drugs were brand name (and not available as generics) I would have to pay nearly $275 for my much needed medicines. I was completely caught off guard as I did not see ANYTHING in my Aetna application that stated that there was a separate $500 prescription deductible. Had I seen that there is no way I would have applied for the plan. I immediately came home and calleld Aetna and the agent I spoke to confirmed the $500 deductible for all non-generic prescriptions. With me jobless and my husband in graduate school, paying essentially an entire month worth of grocery money for 10 days of drugs was not an acceptable option.

I called the Dr.'s office and asked if there was anything they could do to help. My doctor's nurse was able to change the antibiotic prescription to one that was generic. She had some samples on hand of the inhaler that she gave us for free because it's not available generic. I really have no other way to thank her than with my words, so to Diane in Hyde Park my most heartfelt thanks go out to you. I am so appreciative of your compassion and committment to caring for your patients. I will never forget this thing you have done for me. Thank you.

President Obama, Senators Durbin & Burris, and any and all who are reading this: Insurance and drug companies in America are no more than institutionalized highway robbers. To charge people who need medicines hundreds of dollars for essentially 10 days worth of drugs is absurdity and we need to change this now. Insurance companies should not be able to make up pre-existing conditions just because they feel like it. Insurance companies should not be able to "bait and switch" applicants and charge hugely increased premiums after advertising different amounts. Insurance and drug companies should not be able to hold patients hostage to paying extortianate fees for necessary prescription drugs. We need change in our healthcare system and we need it now.

I cannot believe there are millions of Americans who put up with this kind of treatment from insurance companies and prescription drug-makers every single day. It chills me to the bone to think that there are elderly people and children in our country who are unable to afford their medicines because of these exhorbitant fees levied upon them. The American dream promises all who live here the freedoms of life, liberty, and the pursuit of happiness and I think there are many who find it very difficult to adequately pursue that little thing called "life" when often times medicines and Dr. visits are tossed to the wayside because food and shelter are more pressing concerns. When prescription medicines cost the same as a month's worth of groceries it is time for a change.

President Obama, Senators Durbin & Burris - Please fix our healthcare system. Please make it work and make it affordable for the millions of us who have lost our jobs and our quality insurance. Please make it affordable for students and blue collar working families with children to support and many mouths to feed. Please let it help the elderly in need of care. Please make this a top priority in your administration because if those of us who are forced to pay these mountainous fees cannot afford it for much longer. Please help us.



  1. Thanks. I'm working on a re-draft that is actually going to be sent to the president among others. I really hope they can fix this.