Managed health care can threaten financial and emotional health -- and your life, says cancer survivor Jo Joshua Godfrey, whose family has endured three generations of abuse at the hands of health insurers. She thought the healthcare system might have changed since she beat cancer, but last year her grandson was denied proper treatment for a serious condition. Godfrey knows she is not alone, and she is leading the charge to fight back against insurance abuse.
Stevenson Ranch, CA (PRWeb) June 23, 2009 -- "They figured it was cheaper to kill me than to treat me," says lung cancer survivor Jo Joshua Godfrey of California, who beat gross insurance mismanagement in the nineties -- and now lives to talk about it.
She testified before the California legislature and even helped deliver caskets to key legislators in protest. Now, after seeing a daughter and a grandson suffer at the hands of insurers, she is launching a non-profit to help patients reform health insurance, and plans to tell her story to local, state and federal legislators and other decision makers.
"The goal of United Patients of America is to give a voice to people and families who feel they have been abused by insurers. It's an organization for the people. We want to provide people with resources and, as we develop funding, help to intervene in some cases," Godfrey says. The website of the new non-profit patient organization includes testimonials as well as news on insurance runarounds and abuse.
"If Congress is going to reform healthcare, they need to understand the problem. This is not a political issue. It's an issue about people, profits and proper oversight like with the banks," says Godfrey, a controller for a group of real estate holding companies. "More government is not necessarily the answer," Godfrey says, pointing to a U.S. Supreme Court ruling (Aetna Health, Inc. v. Davila) (1) that she says cleared the way for HMOs to abuse consumers. "Government can impose policy caps and indemnities that do more to protect insurers than policyholders. --What we definitely do need," she emphasizes, "are clear rules and real oversight."
In her well documented case, after more than a dozen visits and x-rays for "breathing difficulties" at in-network medical clinics during a two-year span in the early nineties," Ms. Godfrey fought to see a physician outside the Cigna network. A Cigna employee stuck her neck out to give Godfrey her "lost" records. The outside physician quickly diagnosed the lung cancer -- and said it was evident on even the earliest images. The insurer also revealed that Ms. Godfrey had been treated at the clinics by physician assistants rather than physicians.
Ms. Godfrey underwent surgery to remove the tumor and lymph nodes, and has been cancer free ever since. "Health insurance should not be abusive," she says. Ms. Godfrey has hired a New York area PR agency and is working with HealthCareforAmerica.org to get the word out on Capitol Hill.
Need for Healthcare Reform
Systemic problems with health insurance abuse persist and can threaten people's lives and quality of life, says Godfrey -- including now two more generations of her family. During her ordeal, Ms. Godfrey's then teenager daughter, Shannon, suffered chronically from acute headaches. She was misdiagnosed and treated for sinus problems at Cigna clinics when in fact a diseased bone was pushing through the orbit of her eye, threatening her eyesight. Last summer, another insurer denied coverage for her year-old grandson, Dylan, even though his cranial defect would present long-term difficulties that early intervention could correct. California law forbids such refusals, according to Jamie Court, a consumer advocate familiar with the case.
Beyond care management, local access is another issue. In the case of two adult daughters, the nearest in-network doctor was more than an hour and a half's drive from a major city. Earlier this year, Vermont fined Cigna HealthCare and Magellan Health Services which contracts with Blue Cross Blue Shield, $20,000 for operating so called "phantom networks" of providers -- listing doctors not actually accepting new patients.(2) Vermont law requires insurers to update their lists every six months.
"It's the same old story," Godfrey says. "What we have today is a system of delays, disavowals and denials -- with little or no oversight. Instead of helping to ensure health, companies try to deny coverage, and if they must pay, they look for any reason to delay or minimize payment. They can be really heartless. They try to outlast patients with cancer and other terminal illnesses -- people who can least afford it financially or emotionally -- and hope they will just go away."
A determined smile crosses her lips. "They may be able to outlast some people, but as we get the truth out and we organize, they can't outlast us all."
(1) American Association for Justice. "Supreme Court Limits Patients' Right to Sue HMOs," 2004.
(2) Daniel Barlow, "Health Insurers Fined for Phantom Networks," Argus Times, May 26, 2009.
Chuck Bins, 201-664-6386
The Marketing PR Network
Jo Joshua Godfrey, 661-254-8445
United Patients of America
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