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Blog – Page 12 – Put People First! PA

When: Thursday November 12th, 6pm
Where: Kingsessing Recreation Center (49th St. and Kingsessing Ave. Philadelphia, PA)

Health insurance premiums on Affordable Care Act plans are increasing this year throughout Pennsylvania. Many of us are already struggling to get the health care we need for ourselves and our families. Premium increases on ACA Marketplace plans have been approved to take effect on January 1, 2016 ranging between 0 and 26.7%. Plans approved for increases of over 20%, including Geisinger, Highmark, and Keystone Health Plan West will impact over 150,000 people across the state. This means that over 1/3 of people currently enrolled in ACA plans will either be paying more or forced to navigate the marketplace to pick plans with lower prices which usually means higher deductibles and worse coverage. On Novermber 12th, the Southwest Philadelphia Organizing Committee is convening a Human Rights Town Hall in the Kingsessing neighborhood to examine the impacts of insurance companies’ power over our experience of healthcare.

We recently testified at a hearing on surprise medical billing held by the PA Insurance Department and asked Insurance Commissioner Teresa Miller to hold a hearing on the proposed rate increases but were told that the decisions were already made. She said that she is open to doing a public hearing next year. We decided to hold our own town hall and invite her and others to attend.

At the hearing, Philadelphia residents will receive information about how insurance operates in Pennsylvania and share their stories about coverage and care. We’ll shine a spotlight on the recent statewide insurance rate increases which happened without public input. Our intention is to build momentum for greater accountability and transparency moving forward.  We’ll also show how our human right to health care is connected to our struggles to win all of our human rights: to education, to housing, to good nutritious food, to a healthy environment, and others. You can RSVP for the Town Hall here.

Put People First! PA will also be offering support with getting enrolled in an Affordable Care Act/Obamacare insruance plan (enrollment opens November 1st) or in Medicaid (which was recently expanded in PA). Blood pressure and blood sugar level screenings will also be available.

This town hall is part of an ongoing series of community meetings and hearings around the state. The first was in Gettysburg in December 2014, and focused on the stories of immigrants and undocumented people. They’ll be a way for us to voice our common challenges, build up our vision of what a health care system based in our human rights and human needs would really look like, and build a strategy for collective power. They’re also a place for us to see that we’re not alone in our struggles, to support each other, and to continue coming together and getting organized to fight for our human rights.

The Kingsessing community is getting organized and speaking out on our experiences of the health care system and the nature of the insurance companies. We hope that with this hearing our Southwest Philly Organizing Committee can continue to grow and build deep connections with our community. Please join us on November 12th, and remember to RSVP!

Kingsessing Human Rights Town Hall New

If you have questions about the hearing or about the Southwest Philly Organizing Committee, you can email Sheila Quintana at sheila@putpeoplefirstpa.org You can also download a printable flyer for the Town Hall here.

On Thursday October 1, three members of Put People First attended a public hearing called by PA Insurance Commissioner Teresa Miller on “surprise billing”, which is when a person receives a bill that they weren’t expecting after getting medical care that they believed was covered by their insurance.

Stay tuned for more updates and information this fall on what’s happening on the insurance landscape and what we are doing about it.

This is the testimony of Nijmie, PPF co-founder and member from Philadelphia. Kim and Rich from York also attended the hearing:

Thank you very much for calling this hearing and having me here today.

I am a volunteer with Put People First! PA. I’m here today from Philadelphia along with two other members from York, PA. As our name suggests we are a people’s organization of individuals and families throughout the state who believe that people’s lives are more important than profit. We have members in 17 counties throughout the state.

I want to raise what I think is an important and necessary perspective which is that we are not merely consumers of healthcare we are human beings and we are trying to shift the paradigm of being labeled consumers and move to a model of healthcare as a human right.

In 2012 I transitioned out of a job and spent two years with no care. Luckily the worst thing that happened to me during that time was a really bad case of strep throat.

Last year I got an ACA plan – a silver plan that is really quite expensive. I may not be a good healthcare shopper – in reality i hate shopping unless it’s for shoes.

I found a provider and a doctor that I liked and finally I went after paying for the coverage for almost a year without even using it because I was out of the habit. I got a check up and some blood work done and I am happy to report that I am healthy and there are no major problems other than slightly elevated cholesterol levels.

Then about a week ago I got a bill that I really wasn’t expecting for $198.00. Evidently my bloodwork somehow wasn’t covered and it says in big bold lettering on my bill PATIENT RESPONSIBILITY.

So what have I learned from this experience? After being without insurance for two years, buying insurance on the marketplace, paying a significant amount every month for over a year and finally seeing a doctor only to end up with a surprise bill for about the amount I am paying for my plan in the course of a month, I basically ended up paying extra – almost a fine if you will – on top of the insurance that I already have to pay for.

I have learned that coverage is not the same as care. Our healthcare system is too complicated and I’m left with a basic question – is healthcare a right or a privilege? I believe, and we believe that it is a human right, we need care the way we need education, or the way we need water. It’s not an optional service, but a fundamental need and therefore, I believe, a human right.

I support and we support regulation on this matter, and we should also look to the root cause of this problem which is the existence of networks in the first place. Our system is way too complicated – for people as well as for healthcare providers who have to spend as much time negotiating with insurance companies as they do providing care. And I have also learned that I am not merely a healthcare consumer, I am first a human being.

Many people around Pennsylvania are waking up to the fact that healthcare is a right and not a privilege and we would be happy to support you on this issue and any others to protect people in our healthcare system.

Thanks again.

Check out the Put People First’s Fall/Winter Newsletter! This edition of the Keystone News features articles from our own Dinah DeWald, Nijmie Dzurinko, Roger Swartz, Rich Burrill and Eliel Acosta, with an interview with Kim J. Atland, and a poem by Javier Cotal. Click the link below to read on about PPF’s most recent work across the state!

Keystone News Fall/Winter 2015

Are you interested in contributing a reflection or art to the Spring/Summer 2016 issue? Contact Maddie Taterka at madeline [dot] taterka [at] gmail [dot] com.

by Nijmie Dzurinko

When Marie Funk, mother of PPF member Danelle Morrow, first spoke with a recruiter from Senior Life of Johnstown after moving there from Altoona in January 2015, she was told she “would never have another worry about her health.” That sounded pretty great to this 69-year old mother and grandmother.

marie

However, Senior Life did not follow through on its promise, instead creating roadblocks to care for Marie that meant that by the time she was diagnosed with lung cancer, it was terminal. Now, Marie is crowdfunding for her cremation because the expenses might leave her daughter and grandchildren homeless. On her GoFundMe page, she writes,

“I have recently been diagnosed with stage 4 lung Cancer. Since March my doctors have ignored my complaints about my pains. Now I am terminal, and I need help to pay for my cremation, as my family is going to have trouble funding the $1500-2000 it costs to simply cremate a body. I am not asking for a funeral, just simple cremation. Please help me ease my comfort knowing my family will not have to scramble trying to come up with these funds.”

Senior Life is a Medicare Program that, according to its website, is an alternative to nursing homes. The program claims to provide people with “a comprehensive homecare plan that allows them to live at home longer and more comfortably.”

Marie’s paperwork with Senior Life was not completed until March 1, but in the interim, she was not able to get x-rays of her lungs that had been scheduled with her previous medical provider in Altoona because of a lack of transportation.

When finally admitted to Senior Life, Marie requested the x-rays on a daily basis. When the x-rays were finally completed, her nurse told her that there was some fluid in her lung. A PET scan was scheduled, but while waiting for that appointment the pain because so severe that Marie’s daughter Danelle decided to take her mother to the emergency room. On the phone with staff at Senior Life before the ER trip, she was labeled “insubordinate” for making that choice.

At the ER, Marie was immediately given an IV of pain medication and told that she could have died from congestive heart failure. Marie was kept in the hospital for 10 days, and doctors removed three liters of fluid from her lung. A PET scan and biopsy was scheduled after her release from the hospital.

On her second visit to the ER, Marie was again admitted to the hospital for nine days and received a diagnosis of stage 4 lung cancer.

Marie grew up in the Bellefonte area. As a teenager she waited tables and some of her fondest memories were of waiting Joe Paterno’s table, who came in before all the games. Born in Maine, Marie moved to Pennsylvania at a young age. Danelle is her only child and she is the grandmother of four.

Senior Life did not follow through on their promise to Marie, it seems she’s probably not the only one. According to a review from a former employee of Senior Life on the website Glass Door: “Encourages identifying needs of [patients] and how to avoid obtaining them. They prey on weak minded, financially troubled, mostly demented elderly. The state should re-think this type of healthcare.”

Although she is in the process of removing her mother from Senior Life’s care, Danelle feels that company’s practices should be investigated by the state. “Maybe if they had caught this in February instead of July, my mother’s life would have been extended into 2016 or beyond,” remarked Danelle.

To pledge to Marie’s crowdfunding page and support her in finding comfort, go to Marie’s Pledge to My Family .