Tuesday, February 22, 2011

Surviving gunshots in Tucson; medical cost woes call attention to problems in private health care

The Tucson shooter victims are now facing tough medical bills.

New York Times informs us, in key excerpts:
Still, some of those who are following Ms. Giffords’s treatment, including her speedy transfer from Tucson to a top rehabilitation facility in Houston, can only wish their health plans were as responsive.

Monique Pomerleau, a mother of three from Northern California, suffered a traumatic brain injury in a traffic accident last February but has not yet undergone rehabilitation because her insurer, Health Net of California, said it lacked such services within the network. Her family has hired a lawyer to press the matter and recently received word that a 30-day rehabilitation program had been approved.

“We watched the congresswoman’s care and we thought, How marvelous, but there are real people out there like Monique who don’t get the same possibilities,” said Lisa Kantor, a lawyer who specializes in challenging insurance companies and was hired by Ms. Pomerleau’s father, Tom.

A spokesman for the insurer said federal privacy laws prevented it from commenting on individual patients’ cases.

After a tragedy like the Tucson shooting, billing is a topic that appears almost unseemly to raise. But with health costs spiraling, it is one that was on the minds of some victims, not to mention their care providers.

“We have to recover our costs so that we can provide the service to others,” said Craig Yale, vice president of corporate development for the Colorado-based Air Methods Corporation, which operates LifeNet helicopter service in Tucson, one of three private helicopter operators that were called to the shooting scene.

At University Medical Center, where the most seriously injured victims were treated, Misty Hansen, the hospital’s chief financial officer, said she did not anticipate any problems recovering costs. “It is my expectation that the bills will be paid and the hospital will be appropriately compensated,” she said.

Declining to discuss the case of individual patients, Ms. Hansen said 5 percent of patients were “self pay,” which means they lack insurance and are billed personally.
. . . .
The Federal Bureau of Investigation’s victim assistance fund cannot be used directly for medical care. But the money was used after the Tucson shooting to replace the eyeglasses of two injured victims and to fly relatives of victims to Tucson and the remains of one victim to her home state, said Kathryn Turman, director of the F.B.I.’s office for victim assistance.
. . . .
“My fund is too small to cover their medical bills,” said Carol Gaxiola, who is director of the survivors’ group. “But we’ll be able to pitch in to cover other costs.”

Besides the ambulance bill ($991.80 and $16.96 a mile for ground transport) and the hospital expenses, victims could face travel costs if they wish to follow the federal court proceedings against Mr. Loughner, especially if the trial is moved out of state.

There are also the costs of funeral expenses for the six people who died, as well as trauma counselors and loss of wages for the injured.

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