Here Comes Trouble: Stories from My Life

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Wendell Potter

Wendell Potter is a health insurance industry whistleblower and author of 'Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans'

May 26th, 2013 8:05 PM

Help Health Care Advocate Donna Smith Get the Care She Needs -- And Pay the $855 Aetna Is Demanding

The first time I saw Donna Smith, I was in the back row of a Sacramento theater watching the first public screening of a movie I had flown nearly 3,000 miles to see. It was June 12, 2007 and the movie was Sicko, Michael Moore's indictment of the U.S. health care system. I had been sent to California on a reconnaissance mission to see first hand how the insurance company I worked for at the time was portrayed in the film.

I didn't actually meet Smith that day. She was on the big screen, having been selected by Moore because of the near desperate situation she found herself in because of her insurer's unwillingness to pay for the cancer care her doctor said she needed. She had been among the thousands who had responded to Moore's call a year earlier for health care "horror stories." To Moore's surprise, many of the most compelling and infuriating stories were not from the uninsured but from people who wrote about their exhausting and often futile battles to get their insurers to pay for necessary care.

Two weeks before that screening, as the documentary's official premiere at the Cannes Film Festival, Donna wrote this for The Huffington Post:

"For me, the past 20 years had been filled with fights about insurance coverage, humiliation about not being able to pay large deductibles and co-pays, and general strain on my marriage and my family that resulted from the financial pressure. Though we never, ever went without insurance, we had been bankrupted by the crushing medical costs not covered by insurance. Few people understood how we got into that financial boat, and we not only faced my husband's heart disease, my cancer and several major medical crises, but also the shame of failing financially. We felt so alone and lost."

Smith made such an impression in the film and in subsequent media interviews that the California Nurses Association, which along with Physicians for a National Health Program had sponsored the Sacramento screening, hired her to help generate support for a single-payer, "Medicare for All" kind of health care system. She also made an impression on me, as did the many others who told their stories to Moore.

Having dealt with a steady stream of similar horror stories during my two decades in the industry, I knew they were credible. It is not an exaggeration to say that Sicko contributed to my crisis of conscience and my decision to leave my job a few months later.

Smith and I met for the first time in 2009 after I became what some have called a whistleblower. We have become good friends and often find ourselves on the same stage advocating for more far-reaching health care reform than Congress was able to pass. It is because of that friendship that I am writing about her now.

After being cancer-free for more than five years, Smith is battling both the disease and her insurance company once again. And once again she needs help paying for the care she needs.
Smith's husband, Larry, wrote a few of their other friends a few days ago to ask for help in spreading the word about an effort he had started to raise money to pay her medical bills.

Donna changed jobs a few months ago and now works for Health Care for All Colorado, a smaller organization that can't afford to offer coverage to its employers. For a while she was insured through COBRA, but because of the high cost of the premiums -- $800 a month -- it quickly unaffordable.

"For the first time in many years, Donna is uninsured," her husband wrote. "Getting caught up on the premiums would take $4,018.20. That's just an impossibility right now. As if that were not scary enough, she received a billing from Aetna dunning her for payment of $855 in medications overpayments that they want right away or they are threatening more collective activity.

"So, against everything I would wish for her, she will not be receiving the cancer follow-up checks she was advised to do as the costs without insurance are just too high. She hopes that if the holds out until the Colorado exchange is up and running in January, there might be something to afford for coverage then.

"But for now, we did not budget for or plan on an additional $855 in medication repayment to Aetna that we have only a few days to cover. If you can help with this fundraiser I found a way to set up on the Internet that would be great. If you could share it within your circles, that would be great, too. Thanks much."

While the Smiths are only asking for $855, any money in excess of that will be used for her follow-up cancer testing.

Donna Smith has been -- and still is -- a tireless advocate for others who so desperately need care but can't afford it, including people who, like her, have what they thought was good insurance. Please consider helping her now by contributing at GiveForward. It would be great if enough money were raised to enable her to continue her COBRA coverage until January.

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