Democracy Soup

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Dawn Smith goes to the top in her fight against CIGNA to earn Wings of Justice

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Originally published on WingsofJustice.com on October 7, 2009

Dawn Smith

Dealing with nameless, faceless people on the phone with health insurance companies is one of the most frustrating parts of coping with the U.S. health care system.

Dawn Smith certainly knows this first hand. Smith has two brain tumors and only one insurance company (CIGNA). But she can’t get CIGNA to cover what she needs, and they’ve denied her care for two years.

Smith notes that after tests, three doctors agree that the cure lies in a specialist. But CIGNA won’t pay.

“CIGNA still refuses to answer even the most basic questions about why they’ve treated me so badly over the years. And they’re experts at giving me the run-around over the phone. So I’ve decided to go up to their headquarters in Philadelphia to demand answers to some basic questions.”

Doing a road trip sounds more like a lame idea for a screenplay. But in the current reality, attention gets results. And if driving to Philadelphia (Smith lives in Georgia) gets what she needs, then the ends really do justify the means.

This is the true untold story about health insurance companies and their patients: roll over and nothing good comes out of it. Fight back and you have a chance. Health insurance companies don’t want negative attention yet their policies by and large attract it like flies on rancid meat.

Her story’s exposure got CIGNA to pay for some of the tests, but that has been a rough road. Recently, Smith was told that the co-pay on her anti-epileptic medicine was increasing from $10 every two-and-a-half months to $1,115. That is not a misprint: an 11050% increase. After press attention shined some light, the cost was reduced back to where it was. CIGNA said Smith’s doctor misfiled the prescription. But the attention hasn’t hurt.

MoveOn.org, among others, has risen to her cause, and improvements — or in some cases, things didn’t get worse — have occurred.

Though all this attention didn’t help her earlier this year when CIGNA increased her monthly rate from $366.75 to $753.47, more than double the cost. And this isn’t one of the 46 million who don’t have coverage. Dawn Smith has health insurance, but not when she needs it most.

Even with all the attention, Dawn Smith still has a brain tumor problem and an insurance problem. As the theme of her Web site makes clear, It Could Happen To Anyone.

Her fight against CIGNA and the health insurance company isn’t just about a woman from Georgia with a brain tumor who can’t get help from her insurance company. Her fight extends to others in her predicament:

Why was I stuck in two years of bureaucratic hell while trying to get the health care I need? And what policies is CIGNA putting in place to make sure no one else faces what I’m going through?

Given her health circumstances, making a trip to Philadelphia won’t be easy, and certainly is the last thing a very sick person wants to consider doing. But this is America in 2009, and if making this trip brings a benefit or an explanation, then the trip is worthwhile.

The strength Dawn Smith needs to get through everyday life will have to supplemented with the courage and strength it will take to get her to Philadelphia so she can find out why all that time and effort on the phone couldn’t get her basic medical care.

For her courage in taking the fight to the top of the health insurance crisis, Dawn Smith wins our Wings of Justice award.

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Written by democracysoup

October 7, 2009 at 6:00 am

Posted in health care reform

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