By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: When Pound Foolish Hurts
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > When Pound Foolish Hurts
Policy & LawSpecialties

When Pound Foolish Hurts

Jim Bliwas
Jim Bliwas
Share
6 Min Read
SHARE

The following story is by James Bliwas from Ohio , a winner of the 2012 Costs of Care Essay Contest.

When my 40-year old sister was diagnosed with terminal brain cancer, her one, overriding wish as the days ticked down was to die in her own home with her husband Steve and me sitting next to her, eating meals she liked that we cooked as opposed to coping with the institutional food she was being served, and for her three beloved cats to be lying on the bed with her.

The following story is by James Bliwas from Ohio , a winner of the 2012 Costs of Care Essay Contest.

When my 40-year old sister was diagnosed with terminal brain cancer, her one, overriding wish as the days ticked down was to die in her own home with her husband Steve and me sitting next to her, eating meals she liked that we cooked as opposed to coping with the institutional food she was being served, and for her three beloved cats to be lying on the bed with her.

More Read

small businesses and obamacare
Small Businesses and the Not-So-Affordable Care Act
Is Pharma “Educating” U.S. Patients in the Wrong Way?
Are Seniors Getting Too Many Tests?
Hospitals and Providers Using NHIN (Nationwide Health Information Network)
Try These Helpful Tips For Preventive Eye Maintenance

It was a simple enough request, one that would comfort the patient and save medicine a lot of money.

There wasn’t anything that could be done for Janice medically so she didn’t need hospitalization. Because the tumor was on the brain’s interior, surgery was impossible and radiation did nothing to stop its growth. About all that her family practitioner and oncologist could do was show us how to manage her pain when it came.

Her hospital stay was costing more than $10,000 a day, and I was helping pay non-covered costs. Yet when Janice told her HMO she wanted to die at home and asked it to pick up the cost of a daily visit by a visiting nurse or health care aide, she was turned down cold because, the insurer said, her group policy didn’t cover the expense. The ludicrousness of the situation didn’t occur to the HMO: It was willing to pay up to one hundred thousand dollars for her to die in a hospital sometime over the next ten or 15 days, all that she was expected to live, but it wouldn’t cover a couple thousand for daily home care so she could die peacefully in her own bed.

For Janice, Steve and me, this simply added to the nightmare we were living. Only four months earlier, my sister was a healthy woman who held a junior executive position, volunteered in her community, puttered in her gardens, spent time with friends and family, and played with the cats. When she started feeling “off,” her doctor couldn’t figure out what was wrong and tested her for everything from Lyme’s Disease to fibromyalgia and most kinds of ailments in between. Running out of ideas, she sent Janice to an oncologist in sheer desperation. The specialist had her own difficulty finding what was causing Janice problems. Brain cancer was discovered almost by accident because its source was hidden from the battery of almost daily tests she was enduring; brain cancer almost always begins somewhere else in the body. In the end, the cancer’s origin never was located.

Now, just ten weeks after being diagnosed, Janice was preparing to die yet her HMO was making a painful situation as difficult as possible.

I phoned Janice’s physician who was furious and promised to call the HMO. I recall her saying, “Not only is this best for the patient, it’s a whole lot cheaper for the HMO!”

Meanwhile, nearly beside himself with rage, Steve called Janice’s employer and begged for help. Fortunately, she worked for a company consistently rated as a “best employer” in Minneapolis, the city where they lived. When the head of the benefits department notified a senior vice president what was happening, the executive swung into action.

First, he called Steve and assured him that if the HMO wouldn’t cover the cost, the company would. Then he phoned the insurer and raised holy hell, insisting that the business had been paying for a top of the line benefit plan and if the HMO would not take care of Janice’s needs, they would find a new carrier when the policy was up for renewal. But the HMO refused to relent.

In the end, Janice got to come home for her final eight days, thanks to the employer that covered the cost of a visiting RN who showed up every morning and the health care assistant who arrived each afternoon. She died quietly one afternoon in late July, four days after her birthday. Steve was holding her hand as I read a book aloud to her, and the three cats were sleeping next to Janice as she passed away.

I said a painful goodbye to my kid sister that afternoon and recalled holding her in my lap the day she was brought home as an infant. And I cursed a pound foolish insurer that did its best to increase everyone’s suffering in Janice’s final days.

Original Post

 

TAGGED:cancerhealthcare costs
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

a woman walking on the hallway
6 Easy Healthcare Ways to Sit Less and Move More Every Day
Health
September 9, 2025
Clinical Expertise
Healthcare at a Crossroads: Why Leadership Matters More Than Ever
Global Healthcare
September 9, 2025
travel nurse in north carolina
Balancing Speed and Scope: Choosing the Nursing Degree That Fits Your Goals
Nursing
September 1, 2025
intimacy
How to Keep Intimacy Comfortable as You Age
Relationship and Lifestyle Senior Care
September 1, 2025

You Might also Like

Diabetes on the Rise Among Young People

June 12, 2012
CardiologySpecialties

Is It Time to See a Cardiologist?

February 13, 2019

SCOTUS and the ACA: Day 3 of Deliberations Get Underway

March 28, 2012

New Blood Test Could Help Doctors Figure Out Origins of Strokes

January 27, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?