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State of Denial

She had paid into her policy for many years, but according to the insurer she was ineligible for the one thing that might save her life.



Atropos was one of the three Fates in Greek mythology. Even the gods quaked when these women were mentioned. While her sisters spun and measured the thread of one's life, only Atropos could cut it with her shears, ending a life at any time she chose.

It's still happening.

A friend of my sister was diagnosed with a fast-growing and malignant tumor. Though she's insured by a major for-profit insurance company, she was denied coverage for a treatment the insurer deemed experimental because her specific cancer was not listed in the company's guidelines. It didn't matter that her oncologist recommended the treatment and the hospital where it would be performed, one of the world's leading cancer centers, considered it a standard next step. Denying this treatment was a likely death sentence.

She had paid into her policy for many years. And yet, according to the insurer, she was ineligible for the one thing that might save her life.


Many frantic e-mails flew back and forth between my sister, the cancer patient, and other friends. Because I scribble for the Back Page and write to my congressman, Rep. Eric Cantor, from time to time, they all assumed that I might open the insurance company's heart.

For a moment, I stopped squeezing blood from stones to consider the likelihood of getting any results from that camp. Cantor's making the same hay as Attorney General Ken Cuccinelli and all those with insurance who essentially say to the uninsured, “tough luck.” I figured social Darwinists wouldn't be much more compassionate toward someone who had staked her life on the private market and been rejected.

A letter to the editor seemed so 20th century. Perhaps I could also send a telegram or place my calling card in Atropos' brass dish in the company's lobby.

But this is America, land of the free. Well, free as long as we can afford lawyers' fees. I advised the woman to get a lawyer who would compose the right sort of letter.

A week later, after a local legal clinic prepared and delivered that letter, the insurer gave the go-ahead for the treatment. The woman's prognosis is now quite good.

Our dogged reliance on free-market solutions has led to enormous cruelties in what is considered a basic human right in other developed nations — the right to life-sustaining treatment. Yet we already have the so-called death panels that demagogues such as Sarah Palin decry when they bandy about ill-understood words such as socialism. The panelists are not government hires; they sit in offices measuring costs and benefits for the bottom line. Sometimes, driving by the insurer's local headquarters, I imagine these modern-day Fates, gimlet eyes always on a spreadsheet, a pair of shears on the desk.

Such matters awaken me sometimes, in the small hours when evil seems so much bigger than it does in the plain light of day. I lie there, wondering if the people making these decisions feel bigger than gods.

It's not as though my sister's friend were on her deathbed. She was still working at her job, still paying taxes to support a government that treats health care as merely another battlefield for the midterm election.

We rightly focus on the tens of millions of uninsured, the folks you'll see crammed into emergency rooms at any given time, whose medical bills are passed along to those of us with insurance. We don't, however, focus enough on those who have gotten sicker, even died, after foot-dragging by the for-profit insurance industry.

It would be poetic justice to see a few insurance executives or elected officials have a life-saving treatment denied. But that's not the way of a plutocracy, especially one in which radical anti-government conservatives and their minions on political television have won the rhetorical war time and again, convincing voters to uphold policies that hurt them. Our politicians, media pundits and insurance executives have excellent coverage, and if that fails, they have legal representation or, for national politicians and senior executives, ample financial resources to pay out of pocket.

It's considered sedition in some circles to claim that Britain's beloved National Health Service could be a model for America. It's my favored model, followed closely by turning all for-profit insurers into highly regulated nonprofits. But then I won't ever have to run for office in our toxic and broken political system.

Yes, Britons endure long waits they're attempting to reduce, but everyone gets care. It's that way across Europe. Nearly a decade ago, in an emergency room in Toledo, Spain, my wife limped in with a badly injured ankle. The bill arrived a year later: a mere $100 for two X-rays and an hour with the doctor. At the time of the injury, I recall how the nursing staff reacted when I pulled out my insurance and credit cards and said in Spanish that I could pay. In her haughty Castilian lilt a nurse told me: “SeAƱor, this is not America. Such things do not matter to us here. Everyone is treated.”

Until we figure out how to get all citizens coverage, here's the plan of choice. If you have the money to hire a lawyer, get to know one. Even as you read these words, Atropos sits in a comfortable office with a pair of shears, and she's carefully measuring your life's thread.

Joe Essid teaches writing at the University of Richmond.

Opinions expressed on the Back Page are those of the writer and not necessarily those of Style Weekly.


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