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No person or family is immune from the effects of a catastrophic illness or injury. It can hit anyone at anytime, but where a person happens to live has a great deal to do with additional problems that arise in conjunction with an infirmity. The following is the story of three sisters who have experienced differing and distinct medical problems. They grew up in the United States, but now live in three separate countries. The United States, Canada and Great Britain. Each woman is smart, educated, industrious and personable.
There is competent to exceptional medical care to be had in all industrialized nations. One doctor may be better or worse than his colleagues, a given hospital may be outstanding and another simply adequate, or worse. But in only one industrialized country can a person and family be left financially destitute because of an ailment. The United States. That is as true now as it was five years ago.
Robyn
Robyn Winkelman Medder lives in the United States and is suffering from brain cancer, which is now in remission. She has had good care until recently, but is finding it very difficult to continue that care. It is becoming cost prohibitive. The illness has made it impossible for her to continue working as a claims manager at one of the country’s largest construction companies. Besides the obvious time off for cancer treatments, she also suffers from diminished brain functions which make working in her chosen career impossible. She has been laid off from her job and is now dealing with COBRA payments that set the family back about $1,700.00 dollars per month. Her husband of twenty years is retired and Robyn is now on Supplemental Security Income. After COBRA and the mortgage are paid, the family of four has less than $600.00 dollars left to pay for food, car insurance, gas and all utilities. They have already declared bankruptcy once and are very close to losing their home.
Robyn grew up in the south suburbs of Chicago during the 1960’s and 1970’s. Her first job was selling inflatable furniture at the age of twelve. When economic hard times hit in the early 1980’s, Robyn joined the Army Reserves in order to stay off unemployment and continue working. She has worked consistently from that time until her brain surgery in April of 2008. Robyn’s family was close emotionally, but the siblings were several years apart in age. Hard work and the value of education were always stressed by her parents and as a result, all family members had good careers and remained close throughout adulthood. Robyn and her husband had their latter years planned out and were on track to having their plans realized when a routine scan was done prior to sinus surgery in 2005.
Robyn, her husband and their youngest son and youngest daughter now live in a more rural area southwest of Chicago. Their house is a two story home with a gable roof, front and back yard and a small front porch. They bought the house in a nice area and were happy about where their two youngest children were being raised. Robyn’s husband, named Wilson, – who is sixteen years older than Robyn - was able to retire from the railroad in 2002, at the age of sixty. He had some health issues, a bad back, problems with his legs, and suffered from myasthenia gravis; and working aggravated the difficulties. Robyn was making enough money by this time to allow him to retire a few years early and stay home with the children.
Following the normal stages of grief, Robyn’s first reaction upon being told of the anomalies on her sinus scan, was denial. “This has to be a problem with my sinuses, that’s what they’re seeing. I’m sure it’s nothing.” She had those and many other thoughts that put off the inevitable acceptance. She was reading articles on the Internet that confirmed what she wanted to believe - that sometimes sinus problems were misdiagnosed as brain cancer. Robyn decided to have the sinus surgery and see if that would resolve what the doctor had seen on the scan. She talked to her family and they agreed on that compromise; but shortly after that hospital visit, Robyn’s husband experienced an infection aggravated by the myasthenia gravis and spent forty-nine days in the hospital, in and out of ICU. This delayed her surgery further, she continued to work, but eventually she had the surgery. During the time between the first scan and the surgery, Robyn was quick to anger and had problems with her memory. Her friends and family noticed personality changes and became aware of behaviors that were out of character for her. It got to the point where previously very close step-children no longer wanted to speak to her.
Robyn had the surgery and was out of work for six months. Her surgeon described the cancer as forming a “spider web” on the left side of her brain. She has now lost many of the cognitive skills that she has taken for granted her entire life. The quickness to anger was gone after the surgery, but simple tasks are now more difficult and much of her short-term memory is gone – many times forgetting what year it is, for example. Even in this state of reduced mental capacity Robyn talked her doctor into allowing her to return to work. She was able to convince the doctor, rightly, that she could not afford the medical treatments and simultaneously support her family on disability alone. But within a few months, it was obvious that Robyn did not have the mental faculties to continue working in her career. Robyn’s family was very lucky to have neighbors who helped with meals and cleaning after the surgery, but Robyn also needed the type of help even the best of neighbors can’t provide.
After being laid off from her job, Robyn and her family were beset by an entirely new collection of problems. Her six thousand dollar severance pay was quickly deducted from her long-term disability payments. She battled with the Social Security Office, eventually needing her congressional representative’s help in securing benefits. Then came the battles with her insurance company, Liberty Mutual, who now claimed she wasn’t really disabled and has cut off her long-term disability payments. Robyn is also being told that she doesn’t qualify for Medicaid, because her husband’s pension puts them over the cutoff limit. Within the last year, Robyn’s family has gone through their savings, declared bankruptcy and given up one of their two cars. The family is also on track to lose their home soon. Robyn is scheduled for MRI scans every four months to evaluate her progress, or lack thereof. According to Robyn, that may not be possible unless something drastically changes with their finances.
Holly
Holly Winkelman Dalfen is Robyn Medder’s sister and is living just outside of London. The house Holly lives in is a brown colored 2 up 2 down, built in the nineteenth century. She grew up in Homewood, Illinois and attended the same high school as Robyn, just seven years prior to her younger sister’s class. She met her husband, a British national, in Israel before moving to his native land in 1979. Holly and her husband are now divorced, but she plans to remain in Great Britain. The main reason she gives for continuing to live abroad is the cost of health care in the United States.
Soon after arriving in Britain, Holly’s husband suffered a heart attack. He was thirty-two at the time. Five years later he had open-heart surgery and continues to have heart problems to this day. Although this causes many worries for him and his family, financial ruin due to heath care costs is not one of them. Holly has had asthma her entire life and is paying seven pounds thirty or a little over eleven dollars U.S. for her medication. The cost of the medication she is prescribed would be eighty pounds, or about one hundred and twenty-five dollars U.S. if paid for out of pocket.
According to Holly, the National Health Services (NHS) has some problems, or more accurately, minor inconveniences. For instance, it sometimes takes a week or two for a non-emergency appointment. The time involved for being seen by a doctor varies from location to location, of course, but the wait is never unduly long. Emergencies are taken in immediately. In Holly’s case, being seen for her asthma is routine and causes no difficulty. There is also private insurance offered at many places of employment and for those who can afford the extra cost, but it covers electives, cosmetics and offers private rooms for hospital stays. Basic medical care and emergencies are covered by NHS.
Holly worked in Information Technology for twenty-five years before changing careers and working for the school system. Now she is involved in ensuring that the high school she works for stays on budget and guaranties the school does not lose government funding. Certain programs required by the government necessitate the need for community participation by the school and it is Holly’s job to ensure they stay on track. One of the reasons Holly changed her career was the lack of security in IT. She had been laid off twice in her twenty-five year career; the last time forced her to look for a vocation that was dependable and not subject to market fluctuations.
The first time Holly was laid off from her job was twelve years into her career. It took two years to find a new position and during that time she was on unemployment. During that two year time period she broke her ankle. The hospital bill, including subsequent visits, like her husband’s procedures before, cost her nothing out of pocket. The stress she was feeling due to the lack of employment was not compounded by medical bills she could not afford.
Dawn
Dawn Winkelman Fuller is the oldest of the three Winkelman sisters. She has lived in Canada with her husband Chuck, a native of Louisiana since 1977. They met at Southern Illinois University while Chuck was teaching a class taken by Dawn’s younger sister, Holly. Dawn and her husband went through what would be a nightmare for any parent. And this nightmare went on for years. Dawn’s son, Joshua, was born in1979 with numerous heart defects. Her family’s story is laid out in detail in Dawn’s book titled, The Heart of Joshua.
Joshua was born with a ventricular septal defect, which are holes separating the left and right ventricles of the heart; and an arterial septal defect, which is a defect in the wall of the upper heart chambers. There was also a distorted mitral valve – the valve situated between the left atrium and the left ventricle of the heart. The most serious defect was a coarctation of the aorta, which is a narrowing of the aorta. Joshua’s first operation happened at just six weeks of age and his last happened at the age of nineteen. Joshua spent the majority of his first two and a half years of life in the hospital. There were four operations by the time Joshua was six months old. The longest time out of the hospital during that period was six weeks. While not in the hospital, he was seen by his general practitioner each week. The cost to the family for all that care was zero dollars.
Once when Dawn’s son was in cardiac surgery and her mother was visiting for support, Dawn and her mother, Judith, shared a waiting room with two other women whose husbands were also having cardiac surgery. Judith leaned into Dawn and said, “I feel sorrier for that woman over there.” “Why her, they’re both going through the same thing?” Dawn said. “Well, she obviously can’t afford as good a doctor as the other lady,” Judith answered. “Mom, you’re not in the United States now, they’ll both get the same care.” Dawn’s mother had what Dawn describes as a “typical American attitude.” “People just accept that your economic situation determines your level of care. It’s not right.” She said that people in Canada receive some television and radio programs from the United States. She also added that the picture many people in the U.S. have of Canada’s health care system is incorrect. Canadians like Dawn witnessed the debate over health care in the United States and was discouraged by the falsehoods perpetuated concerning Canada’s system. She has always been able to choose her doctor, and she has never heard of a case where someone had to wait for emergency care.
Dawn is a therapist who holds a Master’s degree and her husband Chuck is an audiologist. They now live in a very nice house on a three quarter acre lot, just a five minute drive from some beautiful wilderness areas. Both are highly educated and would make a good living in any industrialized nation, but in Dawn’s words, moving back to the United States “would have been economic suicide.” It was hard enough to deal with a child on the edge of life, without having to also worry about bankruptcy and economic ruin. “There wasn’t a day that went by that we didn’t thank God we now lived in Canada,” Dawn said.
Dawn is strong and she is the type of person that faces problems head on. She has worked in groups that fight violence against women, setting up homes for those battered women that need a place to stay. She also helped in Chilliwack’s fight to keep out the Aryan Nation when they announced their desire to build a church locally. The successful formula that Chilliwack used facing Nazi’s instead of ignoring them is now used as a model throughout Canada. But Dawn doesn’t know how she would have fared while dealing with two of life’s toughest problems thrown at her simultaneously.
Joshua is now doing fine at thirty-one years of age. Dawn and Chuck are also doing fine, and according to Dawn, this is due to the Canadian health care system. Otherwise, they still would not have recovered financially.
Summary:
Robyn was known for her competence and professionalism on the job. One attorney had even given her a nickname that stuck. “Right again, SWAMBO,” he said. “What does that mean?” Robyn asked. “She Who Always Must Be Obeyed.” There was never a question of desire to continue working, only ability. Her position, which dealt with insurance, offered not only medical coverage, but long-term disability, also. It seemed to Robyn and Wilson that they were prepared for any eventuality. But that was not the case. Her story could happen to anyone, anywhere, but the repercussions would be different in different locations. The financial ruin that Robyn and her family are experiencing would not happen to either of her sisters who live abroad. The Constitution states that it is the government’s function to promote the general welfare, and it is our charge to hold our government to account.
John Mathieu
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