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She Gets A Bill From Her HMO For The Helicopter Medivac Emergency Service
I recall being in Ithaca, NY, about 2 years ago and meeting a young woman who came to see me with a stack of medical records, literally a foot high, just desperate. She had been in a very dangerous, nearly fatal accident on one of those winding roads that go through that beautiful part of New York. Some of you may have traveled through Ithaca or may have gone to Cornell. You know what beautiful country it is, but it has also a lot of winding roads. She was in a devastating accident, lying unconscious on the side of the road. Luckily, someone came upon her and called for aid and they were able to medivac her out with a helicopter, save her life, and she was in hospital care and rehab for nearly a year. She gets out and what does she find? She gets a bill from her HMO for the helicopter medivac emergency service because--get this--she didn't call for permission first. She is unconscious on the side of the road and they want to charge her $10,000 because she didn't call for permission. So this is about getting the emergency care you need when you need it. It is about seeing a specialist when you need it, when your doctor says: I have gone as far as I can go; you need to go see a specialist. It is about women being able to designate their OB/GYN as their specialist, and about mothers and fathers being able to designate their pediatrician as their child's general practitioner as well. It is about all of these and more--the kinds of issues that are not just written somewhere in a headline but are lived with day in and day out, which are talked about around the kitchen table, around the water cooler--the life-and-death issues that really make a vital difference to families all over New York and America--families such as that of Susan Nealy, from the Bronx, whose husband had a serious heart condition but whose referral to a cardiologist was delayed a month. The day before the appointment was finally scheduled, Mr. Nealy died of a massive heart attack, leaving behind his widow and two young children, ages 5 and 3.
It is like the family of the 15-year-old boy from New York who developed complications from heart disease, but his health plan refused to allow him to see an out-of-network specialist familiar with the case and instead sent the teenager to a network provider who did not see him for 4 months, and then the boy's lungs were filling with blood, and 2 days later he collapsed in the street and died. These are just two of the stories I could pick from my innumerable conversations and letters that I have received. There are so many more we could tell. For every one of these stories, there are untold stories of families whose struggles for the care they needed were denied or delayed. According to patient reports, health plans delay needed care for 35,000 patients every day. In fact, delayed care and payment is a business practice that health plans have perfected
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Helicopter Accident Newsroom