[Congressional Record Volume 140, Number 21 (Wednesday, March 2, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 2, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                    FACES OF THE HEALTH CARE CRISIS

 Mr. RIEGLE. Mr. President, I rise this morning in my 
continuing effort to put real faces on the health care crisis 
confronting our Nation. Today I would like to share the story of Joseph 
Alessandrini from Redford, MI. In a letter he wrote to me in December 
of this past year, Joseph related his experience of having his health 
insurance terminated just 3 days before his open heart surgery. As a 
result, Joseph is currently uninsured and facing over $30,000 in unpaid 
medical bills.
  Joseph is a 25-year-old full-time student at Wayne State University 
where he is working toward a degree in physical therapy. His wife, 
Elisa, is 24 years old and works as a business manager for a local 
radio station. Fortunately, she has health care benefits for herself 
through her employer. Joseph did have excellent health benefits through 
his former employer, but when he left his position last August to go 
back to school full-time, he purchased an individual health insurance 
policy through a company that his insurance agent recommended. His new 
policy, which costs $106 per month, went into effect at the beginning 
of last September.
  The following month, Joseph was diagnosed with a heart condition 
called atrial septal defect--more commonly known as a hole in the 
heart. Joseph's medical condition was discovered as part of a routine 
physical by a family physician and further confirmed by a cardiologist. 
Joseph was referred to a surgeon who recommended open heart surgery as 
soon as possible. Joseph, being in the middle of his first semester 
back at school, asked the surgeon if he could have the procedure done 
during his Christmas break. The surgeon agreed but indicated that the 
surgery should be performed before the end of the year. The surgery was 
scheduled for December 30.
  After this diagnosis, Joseph's insurance company began to review his 
claims for a preexisting condition. During the 2 months before his 
surgery, Joseph and his doctors tried to convince the insurance company 
that his condition was not preexisting. But the insurance company 
claimed that the condition was related to an emergency room visit in 
June, when Joseph was covered under his former employer's insurance.
  Joseph had gone to the emergency room late one night in June because 
he was having symptoms of dizziness and vomiting. The emergency room 
doctor said that he was reacting to something he had eaten earlier that 
evening and that his blood sugar had dropped. The doctor did not 
indicate that anything was wrong with his heart.
  During the 2 months prior to his December surgery, Joseph and his 
doctors tried to get answers from the insurance company about the 
review process and his coverage. Joseph wanted to make sure that when 
he went into the operating room he would have the coverage he had 
purchased. A week and a half before his surgery, the insurance company 
sent Joseph a letter stating that they were sending his case to 
underwriting to review it for a possible misstatement on his 
application.

  On December 27, 3 days before his surgery, Joseph received a call 
from the insurance company to notify him that they were voiding his 
insurance contract because he did not fill out his application 
adequately. They claimed that Joseph's June emergency room visit 
qualified as a preexisting condition and since he did not indicate any 
preexisting conditions on his application, they were terminating his 
insurance. This is all very ironic, because the supposed preexisting 
condition was not diagnosed until 3 months after the emergency room 
visit and Joseph had no idea he even had the heart condition when he 
filled out the application.
  After having his insurance policy taken away, Joseph went into 
surgery with no insurance. He had to face the enormity of the hospital 
bills in addition to the embarrassment and discrimination of being 
uninsured. Just 2 hours before his surgery, Joseph was required to give 
the hospital a $2,000 deposit since he did not have health care 
coverage. Several days after Joseph returned home, he had to be 
readmitted to the hospital because of excess fluid developing around 
his heart. At first, the hospital would not admit him because he was 
uninsured. It took a call from the senior partner in his cardiologist's 
office to get Joseph readmitted to the hospital for the critically 
needed treatment.
  In his letter to me Joseph states: ``I feel that I am an honest 
person and I have done nothing wrong. [The insurance company] has 
caused my wife, my family, and myself a great deal of stress that we 
don't deserve.'' Not only has the insurance company given him a lot of 
stress, but they have also left him with a $30,000 hospital bill. This 
is a tremendous burden for a young, single-income family, and it is not 
fair to a hard-working young couple who are just starting their lives 
together.
  Joseph is a responsible person, and he took every measure possible to 
make sure he did not go without health insurance. Joseph is finding out 
what many Americans are experiencing--that the apparent security of 
health insurance under the current system is not real insurance, nor is 
it secure.
  Since Joseph's surgery, I have received another letter, this one from 
his mother-in-law. She writes that Joseph has experienced complications 
from the open heart surgery, but because he has no insurance he is 
being treated at home for a condition that would normally require 
hospitalization.
  Mr. President, we must enact comprehensive health care reform to keep 
insurance companies from taking advantage of honest people like Joseph 
Alessandrini. I will continue to work with my colleagues in the Senate 
and with the White House to make sure that health care reform is a 
reality this year.

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