Guest Column: Letter to Rep. Manzullo about health care

By Ken Follett
April 10, 2010
The Honorable Rep. Donald Manzullo
Washington, D.C.

Dear Representative Manzullo:

I wanted to send you this letter to thank you for all your tireless work against health care reform in this country. I am sure you are very proud of the countless hours and dollars you and your Republican colleagues have spent over the past year attempting to block this major legislation at its every turn. Rights—and taxpayer dollars—were at stake. And they still are. So I am sure you will continue with your efforts to make sure this new legislation does not bring our nation even one step closer to “socialized medicine,” the likes of which those poor Canadians and Europeans (and you as a beleaguered U.S. Representative) have to suffer with!

Recently I have had the opportunity to experience the quality of our country’s health care system as it stood before this terrible legislative move. I work for a very small family practice clinic, and am the only employee there in need of health coverage. So my boss (and my doctor) and I found me coverage on the “individual” insurance market. Now I have never smoked, and I rarely have anything alcoholic to drink, but yet I did have the lack of responsibility to be a few pounds overweight and the misfortune to have a family and personal history of high blood pressure (which I manage with the help of medications). Because of this, I was allowed to have a health insurance policy, albeit rated up significantly due to my lack of responsibility and my genetic background, so the insurer could still make a profit on me. Is this not a great capitalistic country we live in?

I did my best to remain as responsible as possible with this coverage, only seeing my doctor for medical reasons if I was so sick I could not continue treating myself over the counter, and getting generic prescriptions whenever possible and absolutely necessary. I also never submitted unnecessary claims by seeing dentists or other frivolous specialists like optometrists and the like. I even worked diligently to lose 40 pounds to resolve some persistent asthmatic symptoms that had been bothering me. I did my best to play by the book (and its multiple pages of fine print) as it was sold to me by the agent.

Then, about three years ago at the age of 49, I started having vague headaches and increasing fatigue. Since my mother died suddenly of a massive brain aneurysm at the age of 62, and my sister was diagnosed with Multiple Sclerosis around the age of 50, coupled with my personal and family history of high blood pressure, my doctor decided I should have an MRI done of my brain to make sure there was nothing developing we should be aware of. Dutifully, I followed my doctor’s orders and scheduled the test. I had insurance, so I anticipated no problems with the process other than a co-payment. Less than a month later, I received an EOB (Explanation of Benefits) from the insurance company stating they had discounted the cost of the test from the billed $5,000 to a total of $2,900. However, the EOB went on to say that the insurance company would NOT be paying ANYTHING of the bill, as the test was “not related to an inpatient hospital stay within 20 days prior.” Silly me, I listened to what the agent promised and did not read the pages of fine print where this rule resided amidst many others. Therefore, since I now owed the hospital nearly $3,000, I could no longer afford to pay the insurance company’s rated-up $250 monthly premium as well. (I know that may not seem like a lot of money, but when you are stretched to the limit with savings and retirement but a mere dream, every penny counts!) I had to drop the coverage so I could continue caring for my disabled partner and his disabled elderly father. No problem, I thought. I could find less expensive catastrophic coverage elsewhere.

Unfortunately, seven other health insurers saw things differently. Because of my pre-existing condition of high blood pressure and now in addition, my major weight loss, none would take me on as a policy holder for at least 2 years (in which my weight needed to be stable off any weight-loss medication), and then at a severely elevated premium. How could I have been so irresponsible to have such a genetic background AND have to lose weight to improve my health condition? So ever since, I have been going without health coverage, doing my best to stay healthy and not need anything more than my boss/doctor can provide for me gratis or at low cost.

This past month, my luck ran out. An infection in my finger became so bad, I was nearly septic before my boss/doctor went to heroic efforts (out of her own pocket) to get me the IV antibiotics I needed to bring me back from the brink. This staved off the inevitable long enough for me to apply for charitable assistance from OSF St. Anthony Medical Center, so she could admit me for the intense therapy I really needed to save my finger (and my life). How am I going to pay even 40 percent of the bill for my 3-day stay–which so far is approaching a total of $25,000 and counting—I do not know at the moment, but at least it is better than 100 percent. I realize the responsible thing would have been to let the infection go and get out of the picture as soon as possible. After all, now the hospital and other patients will have to help shoulder the cost of my care. And I realize that the insurance companies paying for the other responsible patients will now have to cut into their already razor-thin billion-dollar healthcare profit margins to make up the difference. And my boss/doctor is looking into a patient assistance program to get the $200 a dose IV antibiotics I need to be on daily for the next 4 weeks or so for free, which I am sure will cause undue stress to the pharmaceutical company’s billion-dollar bottom line as well. How could I be so selfish!

Fortunately, the insurance and pharmaceutical industries have fighters like you and your fellow Republicans in Congress to protect them from the irresponsible likes of me. You are in there daily fighting for their rights to make huge profits and pay enormous CEO salaries and benefits. If you and your Republican allies were not there doing that for them, who else would? And think of all those poor lobbyists without gainful employment! This terrible piece of legislation that just passed might eliminate many of their jobs! What would they do? I am not sure many of them could find gainful employment with so many irresponsible people already out of work. After all, to stimulate the economy so those deadbeats might find a job would cause the government to spend even MORE money and maybe even regulate the multinational corporations to actually forgo some shareholder returns and CEO compensation just to employ those irresponsible fools! And you and your fellow Republicans have diligently fought against such nonsense! And thankfully, the Supreme Court has given those corporations the right to support you even more financially to continue that fight!

I read recently that you and your fellow Republicans are really FOR reforming the current healthcare system and have been all along. I know those 12 years of almost exclusive Republican rule were a very weighty time for you all. There was a financial industry in dire need of deregulation so it could take our economy to new highs (and lows), making huge profits along the way. There was a military-industrial complex that needed wars to be started so they could maintain their enormous profitability with government help. And the pharmaceutical industry was in desperate need of an unfunded government mandate to provide Medicare recipients with a drug benefit that dumped billions of dollars in their bottom lines, at the expense of taxpaying generations to come. What would all these corporations do without the help of you and your Republican colleagues? So it’s understandable that you all were not able to accomplish anything in the way of reforming our healthcare system during that time. But at least now you have something to work together on to repeal so we can get back to business as usual! At least you all were able to block any kind of effective “public option” that would have been so “socialistically communist! BRAVO!

None of this making health insurers accept anyone who applies no matter of their health conditions. None of this making health insurers actually PAY claims instead of finding any possible way to weasel out of doing so, and maybe even canceling policies based on years-old technicalities. None of this making health insurers compete (at least with each other through exchanges) to keep premiums somewhat affordable for those who pay them. And most definitely NOTHING for us irresponsible uninsured fools in the public like what you as a distinguished member of Congress have to care for you (as with your recent abscess surgery)! You keep up the good fight for your principled talking points.

In the meantime, I will get ready to start my second job so that I can earn some extra money to pay all these medical bills I have amassed in the past month or so. Maybe there will even be a little left over to go towards buying another “individual health policy” through one of those nasty “exchanges” that you and your Republican colleagues were originally for, but decided to oppose because that “tyrant” Nancy Pelosi put it in the bill that eventually passed. Maybe if I work 60 hours a week in addition to my duties caring for my disabled partner, I can start to see a little light way down at the end of the tunnel somewhere.

Due to your diligent efforts, I can look to my friend in Toronto who was recently in the hospital for several weeks and snicker about the fact that he never had to pay a single dime for his care and, despite that, is on the mend anyway! Thanks to you and your colleagues, I see what an inferior system they have up there! He should have been sent home after a few days like he would have by a profitable insurance company here in the good old US of A! Let him suffer through numerous follow-up appointments where co-pays could be collected and more insurance money spent to finally figure out what was wrong with him like our superior system would have done down here. And if the problem was serious enough, I’m sure the insurance company could have found SOMETHING in his original application that would allow him to “rescind” his coverage! What are those Canadians thinking up there?! Again, thank you so much for making my life as miserable as I deserve, being as irresponsible as I have been about my health care in this great country.

Sincerely, your constituent,

Ken Follett, RN, Rockford, IL

PS: If you or your staff plans on sending the usual “canned” talking points response to this letter, please save you, them and the country a little time and money, and don’t bother. I already know what you stand for and will be working diligently to see you replaced this November—FINALLY! (Remember that 2-term promise you made all those years ago?) And by the way, I hope your surgery went well. Thankfully, I will at least not be needing that—I hope!

cc: President Barack Obama, Sen. Dick Durbin, Sen. Roland Burris, Rep. Nancy Pelosi, The Rockford Register Star, The Rock River Times, Buzzflash.com, Rachel Maddow (MSNBC)

Ken Follett is a full-time registered nurse at a family practice clinic in Belvidere.

From the June 2-8, 2010 issue