THOSE "UNPROFITABLE" CANCER VICTIMS
For four years, Wilda Heil has been battling ovarian cancer, and at the same time battling to hold on to her medical insurance. Guess which fight she's winning.
Heil is one of an estimated 35,000 "medically uninsurable" Arizonans-those who either have been canceled or who can't find an insurer. (That doesn't include the estimated 465,000 others who can't afford to buy health insurance.)
Arizona, unlike two dozen other states, has no current plan that helps people like Wilda Heil.
Heil's battle for health insurance is not separate from her fight for life. Her doctors always tell her to remove stress from her life. But though she has scraped together the money to continue paying her insurance premiums, her insurance company is canceling her policy.
"Why are they dropping me?" she asks. "They put me through hell. For a period of time, they raised rates nearly every month. What am I supposed to do? Sit here and let the cancer take over and die because I don't have the money to pay for it?"
While other states have set up medical-risk pools of money to extend insurance to sick people like Heil, Arizona lawmakers voted down the idea last year. Even the few existing programs in Arizona for people like Heil are endangered. Earlier this month, Governor Fife Symington proposed cutting $80 million from existing Arizona Health Care Cost Containment System programs.
Heil's insurance broker, Bill Hayden, whose company found her the insurance company that now has canceled her policy, says that although it may not be illegal for insurance companies to dump people once they become sick, it's definitely unethical. "They should have to take their walking wounded with them," says Hayden, president of Western Health Services. "It's just unfair for them to say: `We know you bought the insurance because you might get sick, but now you're sick and we don't want you.'" Hayden, however, has not been able to find another insurer for Heil.
"I worked hard all my life for this ?" Heil says. "My doctors keep telling me: `If you want to get better, you've got to get rid of the stress and strain.' Well, how do you get rid of the stress?"
Now 58, Heil had worked as a ballroom-dance instructor and a waitress, among other jobs, before she earned her real estate license. She was self-employed, healthy and merely purchasing Ôpeace of mind," she says, when she bought her health-insurance policy in January 1988-through Hayden's insurance brokerage-from Mutual Services Life Insurance, a Minnesota-based company. Just two months later, she was sidelined by severe abdominal pain that her doctors later determined was ovarian cancer.
That was especially shocking, she says, because she had undergone what she thought was a complete hysterectomy 18 years earlier to prevent cancer. But when doctors removed a massive tumor from Heil's stomach in 1988, they found her Fallopian tubes and ovaries embedded in the growth.
While she was still recovering from the surgery, her insurance company denied her claims, saying there was no record that she had ever purchased a policy.
But Heil had her canceled checks as proof, and she received coverage. Her insurance agent-who worked for Hayden's Scottsdale-based brokerage-was fired after it was determined he hadn't sent her premiums to the company, says Hayden.
Meanwhile, Heil lost her waist-length hair-her "pride and joy"-to chemotherapy. Two rounds of the chemical treatments slowed the growth of cancer, but spurred the development of other diseases in Heil's body, such as arthritis, lupus and diabetes.
Finances got so tight that she almost lost the house she owns in the quiet, west Phoenix neighborhood between Northern and Dunlap avenues, near Manzanita Elementary School. She borrowed money from her kids and grandkids and was forced to apply for food stamps.
Now, when it comes to finding enough money to pay her health-insurance premiums, it doesn't matter. Last month, Mutual Services Life Insurance sent her a "nonrenewal" notice. Because she has cancer, she says, she can't buy another insurance policy.
Fourteen other Arizonans whose policies were canceled by the Minnesota insurer also have developed such serious medical problems that they can't buy other insurance policies, says Hayden. State insurance regulators say there's nothing they can do, because the Minnesota insurer didn't break any laws when it canceled the group of policies. Wilda Heil's policy was one of 271 in Arizona that were "not renewed" because they were "unprofitable," says Deb Cochrane, a spokesperson for the Minneapolis-based insurer.
"On a personal level, I feel very badly for those people," Cochrane says. "On the other hand, we can't stay in business if we're not making money." In four years, Cochrane points out, Heil paid premiums of $8,000, while the insurance company paid out $143,367 in claims to cover her medical costs.
Back in 1988, when the company started selling health insurance in Arizona, premiums were set too low, Cochrane admits. "Like many companies, we were caught by the rising health-care costs," she says. "What happened with these rate increases is the healthy people discontinued their policies."
That left people like Wilda Heil. This talk of company "profits," she says, makes Heil angry. She says the company should have done its homework when it was setting its premiums.
State insurance officials make Heil mad, too. "They haven't come up with anything," she says. "They just more or less ask the same questions over and over and over. They really haven't left me with the feeling that anything can be done. It's kind of hanging limbo."
Joe Hennelly, deputy director of the Arizona Insurance Department, says that's because nothing can be done. All of the Minnesota insurer's policies, including Heil's, included a standard nonrenewal clause, he says.
Besides Heil, Hayden's company represents 14 other former customers of the Minnesota insurer who are now too sick to get other insurance. There was another person, Hayden says, but she died of bone-marrow cancer.
"These people are not impoverished people," Hayden says. "They were just working folks, the middle class. But the only thing that these people can do now is become paupers. To qualify for the Arizona Health Care Cost Containment System, you have to be dead broke." Considering the proposed budget cuts, depending on AHCCCS may be a problem.
In the past five years, 24 states have set up risk pools to extend insurance coverage to people who are already sick and can't get other coverage. Arizona legislators turned down a similar plan last year.
That sounds like a heartless decision, but legislator Cindy Resnick argues that it wasn't. "The pooling issue doesn't seem to be the way to deal with it," says the Tucson Democrat, who chairs the Senate's Health, Welfare and Aging Committee. State pools require bigger and bigger subsidies every year, she says. In 1990, according to the insurer Blue Cross/Blue Shield (which opposes such setups), pools in other states required subsidies ranging from $220,000 in New Mexico to $1 million in Minnesota. Resnick terms those subsidies too "massive" for Arizona's pocketbook.
Resnick is sponsoring a bill that would require insurance companies to split up the medically uninsured among themselves. That plan has the support of Blue Cross/Blue Shield, Arizona's largest nonprofit health-insurance company.
All the talk by politicians does nothing to calm Wilda Heil's worries. Her medical insurance policy expires March 1.
"Right now, I go to three doctors," says the grandmother, who used to be a fixture in Phoenix softball and bowling leagues. "I can't sit too long. I can't stand too long. I can't walk too far."
Through it all, though, Wilda Heil has managed to cook festive holiday dinners at Thanksgiving and Christmas for her family, says Nancy Lee, the oldest of Heil's three daughters.
"She's a fighting lady," Lee says. "We call her the `Godmother' of our family. You know, like the `Godfather.'
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