For Tucson Survivors, Health Care Cost Is Concern
By MARC LACEY and SAM DOLNICK
Published: February 3, 2011
*TUCSON — Seconds after gunfire erupted outside a supermarket here last month, Randy Gardner, one of those struck during the barrage, said another looming crisis immediately entered his mind.
“I wondered, ‘How much is this going to cost me?’ ” he said. “It was a thought that went through my head right away.”
Tucson’s medical system quickly swung into action after the shootings, with ambulances and medical helicopters rushing victims to hospitals where trauma specialists awaited them. The life-saving treatment the victims received over the ensuing days carried a heavy cost though, and the bills — the costliest of which may be in the hundreds of thousands of dollars for Representative Gabrielle Giffords — are still being tallied.
But despite the fears of some victims, it does not appear that the shooting will ruin anybody financially. Interviews with victims as well as advocates assisting them suggest that most, if not all, of the 13 people wounded that morning had health insurance, and health care providers say they expect insurance companies to cover the bulk of the medical costs.
On top of that, the fact that federal charges have been filed against Jared L. Loughner in the shootings means that state victim-compensation money will be supplemented by federal help. Private charitable efforts to aid victims have also been created.
Ms. Giffords, who received a bullet wound to the head and was the most gravely injured of those who survived the shooting, also had probably the best insurance, a Congressional plan known for its comprehensive coverage that was held out as a model during last year’s debate over the health care overhaul.
Dr. Peter Rhee, chief trauma surgeon at Tucson’s University Medical Center, has repeatedly said that Ms. Giffords received the same care there as any other gunshot victim. “We don’t have time or luxury to ask for insurance cards or to know if they are a good guy or how they are going to pay,” he said. “We deal with whoever comes in the door. We don’t know if they are immigrants, if they are legal, illegal. We just treat them.”
Still, some of those who are following Ms. Giffords’s treatment, including her speedy transfer from Tucson to a top rehabilitation facility in Houston, can only wish their health plans were as responsive.
Monique Pomerleau, a mother of three from Northern California, suffered a traumatic brain injury in a traffic accident last February but has not yet undergone rehabilitation because her insurer, Health Net of California, said it lacked such services within the network.. Her family has hired a lawyer to press the matter and recently received word that a 30-day rehabilitation program had been approved. A spokesman for the insurer said federal privacy laws prevented it from commenting on individual patient’s cases.
“We watched the congresswoman’s care and we thought, How marvelous, but there are real people out there like Monique who don’t get the same possibilities,” said Lisa Kantor, a lawyer who specializes in challenging insurance companies and was hired by Ms. Pomerleau’s father, Tom.
After a tragedy like the Tucson shooting, billing is a topic that appears almost unseemly to raise. But with health costs spiraling, it is one that was on the minds of some victims, not to mention their care providers.
“We have to recover our costs so that we can provide the service to others,” said Craig Yale, vice president of corporate development for the Colorado-based Air Methods Corporation, which operates LifeNet helicopter service in Tucson, one of three private helicopter operators that were called to the shooting scene.
At University Medical Center, where the most seriously injured victims were treated, Misty Hansen, the hospital’s chief financial officer, said she did not anticipate any problems recovering costs. “It is my expectation that the bills will be paid and the hospital will be appropriately compensated,” she said.
Declining to discuss the case of individual patients, Ms. Hansen said 5 percent of patients were “self pay,” which means they lack insurance and are billed personally.
Even those like Mr. Gardner, who lost a solid health insurance plan when he retired five years ago and now has a deductible in the $10,000 range, will most likely benefit from the plethora of special public and private victim funds to fill gaps in his coverage.
The Federal Bureau of Investigation’s victim assistant fund cannot be used directly for medical care. But the money was used after the Tucson shooting to replace the eyeglasses of two injured victims and to fly relatives of victims to Tucson and the remains of one victim to her home state, said Kathryn Turman, director of the F.B.I.’s office for victim assistance.
The Safeway supermarket where Mr. Loughner is accused of spraying the crowd with bullets has begun a fund to aid victims, although company officials have not yet detailed how the money will be spent. A nonprofit victims rights group based in Tucson, Homicide Survivors, is similarly raising money on behalf of victims.
“My fund is too small to cover their medical bills,” said Carol Gaxiola, who is director of the survivors group. “But we’ll be able to pitch in to cover other costs.”
Besides the ambulance bill ($991.80 and $16.96 a mile for ground transport) and the hospital expenses, victims could face travel costs if they wish to follow the federal court proceedings against Mr. Loughner, especially if the trial is moved out of state.
There are also the costs of funeral expenses for the six people who died, as well as trauma counselors and loss of wages for the injured.
Mary Reed, who was shot three times that morning, said her insurer, through her husband’s job at the University of Arizona, had been unusually responsive and accommodating since the shooting, approving medicines and services in 24 hours, significantly faster than usual.
One concern she has, though, is whether her 17-year-old daughter, who was at the scene but was not hit — Ms. Reed threw herself on her daughter to protect her — will qualify as a victim. Her husband and son were there as well, and they ran for cover. They are undergoing counseling, but Ms. Reed is uncertain who will pick up their costs.
Kenneth Dorushka, 63, was struck in the arm by a bullet and is still awaiting word on how much of his costs will be covered by his insurer, United Healthcare. “It’s hard to tell because we haven’t gotten any bills yet, so you don’t know how much they’re going to cover or not,” said Mr. Dorushka, adding that he had spent about $100 so far on co-payments and other medical costs.
Ron Barber, district director for Ms. Giffords’s Congressional office who was hit twice in the shooting, said he expected to emerge from the shooting without any financial cost.
“I was thinking at first about what kind of deductible I’d have to pay, but then I learned that workers compensation will cover everything,” said Mr. Barber, who was working when he was shot.
Even as he recovers at home, Mr. Barber said he was trying to ensure that the shooting does not cause undo financial strain on those affected.
“It’s obvious that those of us who were shot are victims, but there are others,” he said. “I don’t know anyone who didn’t have medical coverage, but I’m interested in making sure no one continues to suffer from this.”
Reporting was contributed by Timothy Williams, Jennifer Medina, Ford Burkhart and Joseph Goldstein. |
