Imagine this: an emergency room nurse gives birth to a premature baby. She gets a bill for $898,984 from her employer. She thought she had insurance coverage. Her employer says she didn’t sign up in time for the baby. What is she to do?
This obviously is not an education issue. But it is an issue about what kind of society we are.
“Lauren Bard opened the hospital bill this month and her body went numb. In bold block letters it said, “AMOUNT DUE: $898,984.57.”
“Last fall, Bard’s daughter, Sadie, had arrived about three months prematurely; and as a nurse herself, Bard knew the costs for Sadie’s care would be high. But she’d assumed the bulk would be covered by the organization that owned the hospital where she worked: Dignity Health, whose marketing motto is “Hello humankindness.”
“She would be wrong.
“Bard, 30, had been caught up in an unforgiving trend. As health care costs continue to rise, employers are shifting the expense to their workers — cutting back on what they’ll cover or pumping up premiums and out-of-pocket costs. But a premature baby, delivered with gaspingly high medical claims, creates a sort of benefits bomb, the kind an employer — especially one funding its own benefits — might look for a way to dodge altogether….
“Bard’s saga began, traumatically, when she gave birth to Sadie at just 26 weeks on Sept. 21, 2018, at the University of California, Irvine Medical Center in Southern California. Weighing less than a pound and a half, tiny enough to fit into Bard’s cupped hands, Sadie was rushed to the neonatal intensive care unit. Three days after her birth, Bard called Anthem Blue Cross, which administers her health plan, to start coverage. Anthem and UC Irvine’s billing department assured her that Sadie was covered, Bard said.
”But Dignity’s plan, like many, requires employees to enroll newborns within 31 days through its website, or they won’t be covered — something Bard said she didn’t know at the time.
“Meanwhile, believing that everything with her health benefits was on track, Bard spent nine of those first 31 days recovering in her own hospital bed and then had to return to the emergency room because of a subsequent infection. She spent as much time as she could in the neonatal intensive care unit, where Sadie, in an incubator, attached to tubes and wires, battled a host of critical ailments related to extremely premature birth. At times, doctors gave her a 50-50 chance of survival.
“Right from birth she was a fighter,” Bard said.
“Then, eight days past the 31-day deadline, UC Irvine’s billing department alerted Bard to a problem with Sadie’s coverage. Anthem was saying it could not process the claims for the baby, who was still in the NICU.
“Bard, an emergency room nurse at St. Bernardine Medical Center in San Bernardino, called Dignity’s benefits department and made a sickening discovery. Sadie wasn’t enrolled in its health plan. It was too late, she was told, she could no longer add her baby.
”Dignity bills itself as the fifth-largest health system in the country, with services in 21 states. The massive nonprofit self-funds its benefits, meaning it bears the cost of bills like Sadie’s. And it doesn’t appear to be short on cash. In 2018, the organization reported $6.6 billion in net assets and paid its CEO $11.9 million in reportable compensation, according to tax filings. That same year, more than two dozen Dignity executives earned more than $1 million in compensation, records show.”
Bard was facing bankruptcy when ProPublica found out about her dire situation.
One reason I am posting this story is because I was moved by the injustice of it. Another is because a reader in the South chastised me for writing an appeal on behalf of the Southern Poverty Law Center. He sent me the SPLC 990 form for the IRS, showing that it has nearly $500 million in assets. There are many worthy organizations that need crowd-funding. ProPublica is one of them.
from Diane Ravitch's blog https://ift.tt/2L9Sh0Dvia IFTTT
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