Senate Speech

I have had a difficult, trying week, even by three-year-survived-cancer-patient, two-stem-cell transplant-survivor, mother-of-a-six-year-old-boy, standards.

As promised, below is my speech. Some last minute changes were made. I'll give you full details when I recover from this nasty virus (RSV?) turned bacterial infection with a dash of graft vs. host disease thrown in. I'll even give you the details of my nasal washing (if you don't know what this is, consider yourself lucky).

My statement is as follows:

Hello. My name is Hillary St.Pierre. I am a twenty-six year old married mother of one. I am a former critical care emergency department registered nurse with a bachelor’s degree in science. I am currently a writer and health care advocate. I am also a cancer patient.
I was diagnosed three years ago, at the age of twenty-three, with Hodgkin’s Lymphoma. Since my diagnosis, I have received all traditional chemotherapy and radiation treatments for my disease, as well as two stem cell transplants.
My last diagnostic scan was suspicious but not definitive for reoccurrence of my disease.
I am very fortunate that I am able to be here to speak and find a solution to NH’s problem of uncompensated care.
As a nurse, I was guided how to write patient progress notes and assessments in accordance with health language guided by insurance companies for fear a wrong word would result in failure of the insurance company to pay. Doctor’s are schooled in this as well. It is common practice to be asked to change the quality of a diagnosis for compensation.
As a patient, I know if my doctor requests a diagnostic scan, specifically a PET scan, and writes “Recurrent Hodgkin’s Lymphoma” as a reason for the study, the query will be refused. Insurance companies do not cover “Recurrent Hodgkin’s Lymphoma” or “Restaging for resistant lymphoma.”
They cover “nodular sclerosing.”
In PET scans alone, my insurance companies have denied, and then accepted on resubmittal, over $50,000.
A study in 2006 by “Cancer” found that 20% of cancer survivors chose to forgo recommended care. This is 20% of SURVIVORS, it doesn’t mention the dead cancer patients who lost their lives due to the inability to pay for, and therefore access, care.
I have been asked for my $100 co-payment prior to administration of antibiotics in an emergency room in one of the best hospitals in NH.
I presented with a fever of 102 with chills.
I had experienced respiratory failure requiring intubation and mechanical ventilation which had presented first with a fever of similar quality several weeks earlier. I had been discharged from in-patient status a week before.
I was still asked to submit my co-payment prior to treatment.
I do not fight for this coverage alone. Advocates at hospital billing departments call on my behalf.
I also have a relative who advocates for compensation of costs the insurance company is contractually obligated to pay.
She estimates she spends three to four hours weekly advocating for payment of care.
She has done this professionally for twenty-five years, and states she makes as much as a low level registered nurse.
At $32/per hour, for 3 hours, every week of the year (that’s 52), she would cost an astounding $4992.00 yearly to a hospital to seek compensation on my behalf alone.That’s the low end of the estimation. She spends three to four hours making phone calls, waiting on hold, and making return calls.
Four hours x $32/hr= $128 weekly x 52 weeks = $6656 to fight for compensation of one patient. That patient is me.
Without this assistance, I may be labeled as unable to pay.
These projected costs to hospitals could be saved.
In the late 1990s, the cost of term life insurance suddenly dropped dramatically. Consumers began saving 1 billion dollars yearly.
A study published in 2002 entitled “What happened to term life rates? In the Journal of Political Economy determined the cause was transparency in the purchasing process stemming from online comparison sites (“What Happened to Term-Life Rates?” See Jeffrey R. Brown and Austan Goolsbee, “Does Internet Make Markets More Competitive? Evidence from the Life Insurance Industry,” Journal of Political Economy 110, no. 3 (June 2002), pp.481-507)
Suddenly the difficult task of understanding which plan meets a person’s needs for the least amount of money was made easy. Competitors were forced to lower their prices to remain in business. The barrier of understanding the language and process of purchasing insurance was removed. The expert/consumer gap was narrowed
Consumers could now buy insurance, and make educated decisions regarding their needs efficiently.
This simple action put 1 billion dollars into American consumers pockets.
The study commission proposed by this bill will allow stakeholders and state leaders to determine how to improve the system for everyone with ideas and theories such as this, and hopefully, as a result, health care costs may decrease thus allowing to develop a fund, a safety net for NH residents, to help cover the cost of care delivered to the uninsured and underinsured.
Transparency has allowed money to remain in the hands of consumers before. It can happen again.
I hope and believe it will happen in NH, and that through support of SB 158 we can not only reform the current health care system, but revolutionize it.