Wednesday, January 30, 2008
It can happen to you
The Zeiglers hold baby Brooke
By Dr. Sanjay Gupta
Chief Medical Correspondent

The Number 1 cause of personal bankruptcy in the United States is unpaid medical bills. As we found, it is not just the uninsured, but also the underinsured. It is also people who think they have excellent health insurance, but it is simply not enough.

Dawn and William Zeigler were living the American dream with a nice house, cars and plenty of money. When their daughter Brooke was born too early and required multiple surgeries, they never considered the cost because they thought they were covered. And, they were, at least for a while. They were amazed at how quickly the bills piled up, though. Tens of thousands of dollars a day, and soon their policy no longer provided any money. (Watch Video)

Brooke Zeigler died when she was 18 months old. Her father told me that he had to tell the doctors to stop working on her. It was the hardest thing he ever had to do in his life. The bills that arrived for nearly a million dollars may pale in comparison to losing one's child, but the Zeiglers are now at real risk of losing their dreams.

The health care debate is complicated. Again, the Zeiglers were covered, but not enough to cover little Brooke's millions of dollars of expenses. This is the reality of our broken health-care system and continues to be one of the biggest domestic issues on the minds of voters. Any thoughts on how to address this specific issue within of our health-care system?

Programming note: Watch "Broken Government: Health Care - Critical Condition" on Thursday and Sunday at 11 p.m. ET

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My son is 26 living in Portland,OR. He is a cook and struggles to make ends meet and has no insurance. Last year he was attacked and was sent to the hospital. He did not sign any forms, but because he was critical, the hospital admitted and treated him. He had moved around a bit, and never received any bills from this. This month, he finally received a collection notice of over $20,000 of medical bills. They are planning to garnish his wages to pay for this. Should he or could he declare bankrupcty to overcome this dept?
Thank you Dr. Gupta for airing that..

I am in tears... that was so heart wrenching...

I love the Zieglers ~
Brooke had a room next to Matthew over at Sunrise Hospital.. that's how I came to know them.

If this doesn't open some eyes w/ our politicians, I don't know what will.

Thank you for listening to us,
and caring.
That means the world to families like ours.
Dear Dr, Gupta,

I have been watching your series on broken health care on CNN's morning programs. All of this brings up THE question that no one seems to be asking anymore. WHY DON'T WE GET THE INSURANCE COMPANIES OUT OF HEALTHCARE?

I see it this as a public health issue. If my house catches fire, I call the Fire Department. I don't need insurance to do that. If I'm attacked or robbed, I call the Police. I don't need insurance to do that either. So why, if I get sick, do I need to have insurance to call a doctor? It's all the same!

For some reason, one that I do not understand, you have stopped talking about this aspect. Not just you, but ALL of the politicians as well. Why? Every other industrialized country has done away with the insurance system. What is wrong with this country?

Dustin Logan
Pampa, Texas
There is a misconception about insurance in this country. Insurance is a business, not a welfare system. Insurance is about risk management, not guarantees. To suggest that the medical system in this country is broken because everyone has a lifetime limit on their insurance brings to the surface a very important issue, healthcare insurance is about the allocation of a finite resource. There is not an unlimited number of doctors, nurses, and hospitals waiting for us to use them. This country appears to be heading to some type of nationalization of healthcare in the form of health insurance and that is a good thing. But your story exposes the harsh a reality, insurance is not an open ended, unlimited guarantee of that no matter how much you want to spend everyone in the country is going to chip in and pay. Two million dollars was a pretty high limit and most likely does not represent the reality that most of us face. I cannot image the pain this couple feels to have lost such a little child, but there is a limit to everything, including the amount of money that society is prepared to spend on saving an individual, whether that individual is 80 years old or 18 months. When we finally have universal healthcare in this country there will be a limit and someone will have to tell a very sick person that they have reached their limit.
would you put your child to sleep?

What would you do?

People run out of coverage because the costs are too high!

I would say that Stanford being paid $26,000 a day for the bed alone is a little much...

when a NICU gets paid $1600. a day..
that is PAID out...

Is that what the world will come to? Just ending a life b/c it's expensive?
The costs need to come down.

What I think is ironic..
if the Zieglers baby were born to an illegal alien...

all the baby's costs would have been covered by Medicaid..
and if you don't believe me...

go ask a hospital worker or social worker.

How is that right?
To the Anonymous poster, yes insurance is a business but when did providing healthcare become a business? Why have we given insurance the power to decide who lives and who dies? Have we all missed the point out of humanity if there is a possibility of saving a person's life through medical treatment, then by all means treat them? Isn't that why doctors became doctors - to help? How is is right that families must choose whether to treat a member or be thousands if not millions in debt?
I wish to remain anonymous, because I am a health care employee. Americans need to wake up and realize that we are providing the best medical care to illegal undocumented individuals.We have to make our GOVERNMENT ACCOUNTABLE. We are too generous with our resources. Yes, I come from immigrants, who arrived the hard way. They were sponsored, and worked themselves to the bone. They gave more then they received in benefits. We need to place pressure on our politians to clean up this mess. It's heart breaking to read about the Zeiglers heartache and loss. I have to priovide my expertise unbiased because of my position, which I do, but no longer can remain silent. I also treat homeless and indigents, who come to my hospital for "3 HOTS and A COT", under the pretence of their being Suicidal. They're doing cocaine, smoking marajuana, shooting up heroine, and abusing prescription drugs, such as oxycotin, xanax, percocet fentynol patches and other drugs. They collect disability checks from our Government, which arrive on the 1st of the month, and use our hospitals to house them until the next check arrives.They refuse to live in homeless shelters, and refuse to rent a room. As soon as these checks arrive, they have a miraculous recovery and hence the cycle begins again. Who do you think is paying for their benefits???? The Zieglers, you and me!!!!!! I'll discuss this with any government official and individual, but because of the HIPPA Act, I cannot enter into any further details. However, if any investigative reporter wishes to go undercover and research my facts, I highly encourage them to do so. Thank you Dr. Gupta for your reporting the facts, and proving this forum.
I recently lost the use of my left hand due to lack of proper insurance coverage. I'm an interpreter for ASL so my career is over after 20 years.I was refused proper treatment(surgery) because I have State insurance while I finish my degree. They booted me out of the ER under such heavy narcotics that I couldn't even sign my discharge papers.
Why is it that health care isn't about caring anymore. Why can't nurses or someone inform a patient if the place of care isn't willing to give proper treatment? Shouldn't there be a social worker or someone to arrange care? Provide options of some sort?
This almost did happen to me and my family when I gave birth to my twins...I got so sick, I couldn't hardly get out of bed....I hope we can get something better than the healthcare coverage we have now.

Thanks for covering this CNN
I've been self employed for 20yrs and have been paying $350/mo for my health insurance with a deductible of $3700.
After 19yrs of rarely using my insurance, I was ordered to have an MRI. I called my insurance co. to be certain they covered the test. My doctor's office called as well, and the day I went for the test, the MRI facility called the insurance co. to forward and you guessed it, now they say they're not paying. The insurance co. issued a denial saying the MRI was "exploratory"and not necessary.
I appealed their decision and the insurance co. had an orthopedic doctor review my history and he of course agreed with their position.
I've seen three neurologists since then, and they each asked to see my most recent MRI. Apparently they didn't think it unnecessary.
Now I have a $6000. bill that I'm paying little by little, I've been prescribed a parkinsons medication that's $250/mo. and they won't pay for that either, so now I'm trying to decide whether to continue my health insurance and quit taking my medication (which means I can't work, walk, etc) or drop my health insurance so I can afford my medication.
I supposedly have good insurance, but if they decide they're not paying, there's not much you can do.
I also worked in the ED. It broke my heart to have patients come in and out with chronic problems which we couldn't fix. They couldn't get anyone else to help them because they couldn't find a doctor that would see the uninsured. And while they were in our ED, we didn't have beds for people with no-kidding "you're gonna die without care right now" patients (which was what the ED was supposed to be).

It also broke my soul to see the system abusers another person mentioned above. Yes, they're there as well-because we haven't figured out ways to help them cope with their lives, or make them face their lives. So they use the ED to cope.

And I don't blame doctors, either-what is the point of mastering multiple insurance companies' ridiculous forms and regulations? What is the point of doing effective primary care when insurance pays squat for that, but big bucks for specialist proceedures?

The problem with Republican hand-waving to fix our system is that there is no such thing as "free and open competition" in health care, nor will there ever be as long as "insurance" equals "access" (which is unlike every other use of insurance in the world). Thus, there's no real pressure to bring down costs, and no real ability to encourage efficient effective health care.

The problem with Democratic hand-waving to fix our system is that universal unrestricted health care for everyone guarantees abuse, shortages in critical areas (see Canada or the UK for some of their wait times and problems with access to proceedures), lack of providers (see what happens to Medicare patients today). And,if they try to regulate it, ultimately the government gets to tell the citizen how to live (which, again, is what happens now to some extent in Medicare, and is what happens when you see insurance denying people coverage for pre-existing conditions).

I'd like to see basic primary care covered for everyone under a single administrative system, and insurance dramatically throttled back to provide for catastrophic events like the Zeiglers'.

Yeah, and I'd like world peace, too. Unfortunately, the second is as likely as the first
My heart goes out to all Americans who have huge medical bills or can't get medical treatment because they have no insurance. I was wondering if your government has looked into Canada's health care programs and how they are run. I live in Ontario and young, old, rich and poor are covered by Health Care Insurance.
You can pay nothing or a percentage of your wages on your income tax form, once a year, to cover your health care depending on your earnings.
We have a shortage of Dr.'s but our care is next to none.
Each time I see your canidates speak on this I can't believe it is taking so long to help your own.
Dr Gupta,

Thank you for again bringing this story to the forefront. I hope one of our many qualified presidential candidates reads this blog or watches you on CNN!

Also, to "Anonymous" who commented @ 3:58,I just want to say "Thank you!" for your courage and comments. As a health care provider, it must be terribly disheartening to hear stories such as the Zeigler's. My heart is broken also, but most of all I am left boiling mad at our health care system!! Many out there probably find your comments hard to take, but I believe every letter you said. I live in a homeless shelter and am employed without health benefits. Every freaking week the shelter gets women who abuse the health care system, all becasue some pencil pusher down the line deemed THEM to be more "worthy" of recieving health care than I do. I find myself growing weary of telling the story of the woman who lived at the shelter for 11 months, and who was so regular a visitor to the emergency room (try 22 times a month) that she was eventually provided her own nurse. Why was she a "regular" to the emergency room? Why, because she COULD be. She got fistfuls of Vicodan and Percocet and morphine for being on heart failure (due to her weight--330 pounds, all paid for with food stamps provided by working people's taxes), and COPD (supplanted with cigarettes paid for, again, with taxpayer's money), and drug addiction, and she got DRUGS for complainsts such as back and knee pain, and once, for a bruise the size of a thimble that she put there herself after throwing her 400 pound frame against the wall(I was there, this was no accidental fall.) Oh, and why visit so much? To supplement her income--once word got out to other residents that "C" was at the emergency room, residents started pacing the doors like dogs smelling meat. Yes, she'd sell those drugs she got. For $15 a pop. That'd be 3 hours pay on minimum wage, for me. And I myself emailed the so-called Social Security fraudline, to no avail. People told me to "feel sorry" for her. "Feel sorry"? there's a thin line between assistance and co-dependency, and if I were to diagnose the health care system at this point like a doctor would, I'd call it an unsustainable, mentally ill, and overall unsurvivable relationship steeped in emotional abuse and manipulation.

After I myself recieved a legitemite back injury at work, I too went to the same emergency room as "C". And here's what I got: nothing. As in, nothing. No XRay, not even a Tylenol. They offered me a doctor's note to be off of work for 4 days, but did nothing to make me able TO work (I have scoliosis, degenerative back disese, and tethered spine syndrome). Guess I needed some pencil pusher 800 miles away to be on MY side, but as long as Americans like me want to work, (homeless or not)there will be NO ONE on our side. Do drugs, be an illegal, make society afraid of you, and the help will come.

Dr. Gupta, America cannot survive this way!!
Dr. Gupta:
I've been watching your show tonight and repeatedly I found myself relating to the stories that were being told by the families--thinking I NEVER thought I would be in this position, but here I watch your show with the same worries and options!

I am 31 years old and single. I am educated with a Master's degree in Healthcare Administration (yes, ironic!), and have a six figure job and up until now, a carefree lifestyle. I've been an athlete and active my entire life. Things came to a halt last year when I was diagnosed with a congential heart defect that was both shocking and life-changing. Upon learning of diagnosis, I attempted to have my defect corrected with a minimally invasive stent, however, I had complications with a blood clot that was surgically removed two weeks after the stent placement and later was prescribed Coumadin for 6 months. During this process, I had excellent health insurance--I worked for a major consulting firm in the Healthcare consulting. Luckily, I reach the maximum out of pocket, as my hospital bills totaled over $100K. Even with my salary, I couldn't have paid for this out of pocket, thus facing bankruptcy. I was thankful for insurance.

Unfortunately it's about a year later, and I changed jobs and I began thinking about pre-existing conditions--luckily, I didnt' have problems, but I definitely did my research to ensure I had coverage. I watched tonight and sympathized with the gentleman who said he'd always have to work---due to his condition there is not a way go into private business, or if your spouse doesn't have coverage--you will work for the rest of your life to be covered "just in case." Every job and career decision I make from this point now depends how/if health insurance will cover me. It is both scary and disappointing being so young, and already planning a career that's going to "cover" me with health insurance I need.

Over the past month, I was told that I need heart surgery, potentially sending me to Cleveland Clinic--as the surgery is specialized and complicated. Unfortunately, this time my coverage is NOT what is was before. Because CCF is out-of-network, my healthcare bills will easily reach over $200K, with a large portion of this cost to be covered by me--not to mention the other costs of travel to get there and outpatient follow-up. As with the couple tonight with the twins, my carefree lifestyle will not only be hampered emotionally and physically, but financially devastating as well. I've actually had friends say get married--your coverage will be complete. It's sad to think that this is a viable option or consideration!! Simply put, I felt scared and anxious watching your show. I've done everything "right' --college, grad school, good job, healthy lifestyle--and now, because of my diagnosis, I, too, am going to become one of these stories.

Wish me luck with the heart surgery, and I hope that I can work out the financial aspects, but right now, I sit and wait to see what the insurance company will negotiate, leaving me the remaining balance--potentially putting me into bankruptcy status.

I don't consider myself political, but I've found myself drawn to this election and this topic. I don't have the answers, but something HAS to change-- Thank you for producing this segment--I found it enlightening and educational.
Dr. Gupta,
A great program!I think you are basically in agreement with Michael Moore ("Sicko")

Regarding those statements on cancer care in Britain, I would like to provide the following anecdotal data.

My cousin's wife was diagnosed with breast cancer in England 3 years ago. As soon as it was diagnosed she had a lumpectomy performed within 3 or 4 days and was immediately on chemo and then radiation. No 8 month wait - and this was all under the NHS. Furthermore because she lived about 30 miles outside London and her chemo and radiation had to be done at St. Thomas & Guys in Central London, a car was sent to pick her up for her chemo and radiation treatments and drop her back - all under the NHS. She is doing very well and her follow up has been very thorough. By the way my cousin and his wife are ordinary people with middle class incomes and no political connections - so they didn't get any special fast track treatment as far as I know.

Next about Canada. 30 years ago a friend was visiting Canada when she noticed a rash on her daughter's stomach. It looked a bit serious to her, so she took her daughter to the emergency room in one of the big cities. After a 20 minute wait her daughter was seen and diagnosed with chicken pox at very little or no cost. As recently as six months ago a friend from California was in Toronto. She and her husband developed a respiratory problem. She went to the emergency room & was seen - yes - within 20 minutes. Also she got a prescription for an antibiotic. Paid the hospital a total of $40 for the doctors fees and about $12 for the antibiotic. Just compare that to the US costs for both the physician's fees and the drugs.

I have waited in top notch hospital emergency rooms in the US for 3 hours or more before a doctor has seen my family and several years ago my aunt with a broken wrist had to wait 6 hours before an orthopedist saw her. The Canadian system appears to have worked for the past 30 years and still seems to be working. I wait much longer in doctor's offices in the US than people wait in emergency rooms in Canada.

So these folks who make incorrect statements about 8 month waits for urgent treatment/surgery in the UK and Canada are either uninformed or are people with an agenda or just plain ideological demagogues.

Okay - so 14% have to wait for elective surgery in Canada. I am quite sure this is a much lower percentage than the percentage of people in the US who can't get (or can't afford to get), lifesaving surgery/ treatment let alone elective surgery/treatment (like the gentleman in your program who couldn't even get radiation treatment for his cancer).

Also you mentioned that Canada has more people dying of cancer but you didn't mention US's higher infant mortality rate and the fact that Canadians & the Brits live longer than us. That was a bit unfair wasn't it?

Healthcare costs money, anyway you choose to slice it. So let's spend the money in a way that is morally right and equitable.
I have a dr.that is considered one of the best in my area.since seeing her she,or the cardiologist from her hospital,have pushed the following drugs on me;vioxx and celabrex,vitoren,zetia,plavix and aspirin.All of these have come under fire for being unsafe and even lethal!After they put a stent in me on10/04/2005,because i just mentioned occassional chest pains(angina),I was told to take plavics and aspirin as well as vitoren.When I used these drugs I could no longer even walk 100 yards with out chest pains.In fact my chest pains stayed with me untill about a month ago when I started taking 300mg of zinc gluconate 14 days in a row.My chest pains are gone and at a cost of $8.99.My insurance would not pay for that.rather,they paid about $24,000 for a stent that was worse than worthless.I went to "pub med" on line,and looked up zinc and angina pain.The last paragraph Of the article said that zinc should be the FIRST line of treatment for angina pain.Now I am stuck with a strange piece of wire mesh in me that my body will for ever more try to reject.My health is almost as good now as it was befor the stent.I have a little pressure in my chest and can walk as far as I want.AS FAR AS I WANT!! Also I am drug free.These doctors should be ashamed of themselves.I eat vitamins a,b,c,d,cod liver oil,chondroitin and glucosamine,zinc,natto,and magnesium.I am free.My insurance could pay for these the rest of my life and never come close to the hundreds of thousands of dollars they would have to pay if,as my cardiologist suggested,I have more stents put in me to ease my pain.
I really wish I could help Anonymous 2:15 P.M. She contributed another part of this unfair treatment of people such as herself. I wish to validate her comments. She stated comments which I didn't. It sounds like untrue accusations, but this is another segment of the drug abuse that is going on. There is also doctor hopping and securing these prescriptions for resale to others illegally. They're no better then a DRUG DEALER selling cocaine or heroine in the street. Health Care Workers, such as myself and patients such as Anonymous 2:15P.M. need to expose the fraud that is ongoing in our facilities. These people are collecting MEDICAID, and SOCIAL SECURITY DISABILITY. They're hoping to have a diagnosis that will validate a disability in order to collect benfits. It seems the easiest diagnosis for disability is MENTAL ILLNESS such as DEPRESSION, BIPOLAR, SCHIZOAFFECTIVE, PSYCHOSIS, and MOOD DISORDER. I hope others in health care will come forward. There are too many individuals defrauding the system. People that really need assistance aren't getting it. Again, I'm taking care of ILLEGALS, who need psychiatric care. What happened to the old days of emigration? If you had a mental illness, you couldn't come to this country. Our GOVERNMENT IS LOOKING THE OTHER WAY. We need health care for our citizens. I feel it's the responsibility of all health care workers to start reporting the illegals, who are using our health care system, and put pressure on all our politians.
I am 62 years old and I do not qualify for health insurance because of pre-existing medical conditions. I am not classified as disabled. I was recently layed off and now collect unemployment which does not cover my monthly expenses, but it is too much to qualify for indigent care. I am out of my prescriptions that keep me alive. I know I am not the only one in this situation, so why doesn't any politician come up with a plan for people in this kind of situation. I cannot afford any insurance premium, no matter how cheap. Too bad we live in a country that doesn't honor it's seniors.

B. J. Smith
Sacramento, California
I'm so sorry to hear all of the stress and pain you're all going through. I will say a prayer for you all tonight. May God bless you and comfort you. Put your trust in Him.
Please look into the New Jersey Catastrophic Illness in Relief Fund for Children. It is a unique program that has been around for 20 years. It defines a child's illness as catastrophic based on the financial impact on the family(after insurance if any). This phenomenal program has made the lives of many families whole again. It is funded by a surcharge on employers that pay into the State's unemployment compensation fund. Children are eligible up to age 21. They have paid for funerals , for phone calls , for vans both new and retrofitted. It would be a great interview program for your show. I was an original member of the commission and served on it for 9 years. They can contacted throught the New Jerrsey Department of Children and Families. As a subject for a story,you will not be disappointed in what you find. Thanks.
Affordable Healthcare is important to all American's. Unfortunately the government is not an agency that can run a Universal Healthcare system. The systems that the government controls now are disfunction. Social Security, Medicare, Medi-cal, Welfare, the IRS - just to name a few. There is not a working example of a "model system"

Healthcare reform is important, however a Universal Healthcare system ran by the state or federal government is doomed for failure.

You will soon find a polluted Health Pool, similar to the numerous association plans that have failed. The sick participate, the healthy subsidize the risk and when the cost becomes higher than an individual health insurance policy, the healthy bolt leaving the insurance risk pool with uninsureable individuals.

There are already systems in place for the poor. The focus should be to provide tax incentives for all Americans and Business owners that purchase private health insurance plans.
Most multiple births nowadays are a result of in-vitro fertilization. Couples must realize there are inherent risks which can lead to devastating circumstances such as these. Perhaps we should be more patient and not try to control every single event like creation of life: and not try to command that it happens on our time schedule.
To even try and formulate an educated response concerning matters surrounding the complicated healthcare system in the United States is, indeed, a daunting task. How is it possible to lead a balanced life when the most significant and personal segment of it is under the control of someone else? From my perspective, the only answers seem to be Faith, Hope and Charity.
people in America don't know how much they are lagging behind in health care programms compared to the other developed countries. People pay way too much in America for the same kind of treatment, and yet the majority Americans do not know better, they are fooled by the interest groups, politicians of looking down on the other developed countries systems, and while all along they are way below the other countries in all sorts of medical care, I know, cause I've lived in both the US and the west Europe. It's really a shame that the general American people are so ignorant.

Tell your son to go to the hospital and tell him his story. More than likely they will settle for 40% of the original bill and give him lots of time to pay.

I have dealt with the health care systems in England, Portugal and Sweden. I'll take the USA any day.

What a sad, sad story. So sorry to read about this.

Here in South Africa, the cost of health insurance has also skyrocketed. So many folks simply can't afford to pay the fees. The state hospitals are totally overloaded as a result. Even urgent cancer cases often have to wait for months for treatment. Imagine knowing you kid has a life threatening illness, you don't have insurance and the hospital tells you to wait and wait for treatment.

Many folks who find themselves in financial trouble, allow their health insurance to lapse, only to discover too late that this was a huge mistake. I don't know what the solution is. I just know that money shouldn't be the overriding factor if a loved one needs medical care.
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