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November 2009/Cheshvan 5770
A JOURNAL OF JEWISH RESPONSIBILITY
Healthcare Reform
Joan Leegant
Rescission: An Insidious
Industry Practice. . . . . . . 1
Elliot N. Dorff
& Aaron L. Mackler
Responsibilities for the
Provision of Health Care . 2
Ruth B. Balser
Access to Care
Is a Human Right . . . . . . 3
Susan Sered
The Critical Importance
of Relationships . . . . . . . 4
Arnold P. Gold
Nurturing Humanism
in Medicine. . . . . . . . . . . 6
William Cutter
The Pain, The Patient,
and Subjectivity . . . . . . . 7
David Eisenberg
& Elaine Zecher
Reflections on
Integrative Medicine . . . . 8
Susan Harris
Chaplaincy: Separate
Conversations . . . . . . . . . 9
Jaclyn Herzlinger
Congregational
Nursing. . . . . . . . . . . . . 11
Gila S. Silverman
& David J. Lane
Shleimut. . . . . . . . . . . . 12
Geoffrey Dennis
NiSh’ma. . . . . . . . . . . . 13
Jonah Pesner
& Barbara Weinstein
Health Care Reform: A
Jewish Communal Voice 14
Peter S. Knobel
Thinking Backward
and Forward. . . . . . . . . 16
Critical problems with sky-rocketing medical costs and a problematic delivery system are focusing the attention of politicians, health care personnel, and religious leaders. This issue of Sh’ma — updated from the March 2003 issue with articles by Joan Leegant
and Jonah Pesner — addresses the current crisis in health care, the need for a more affordable
and humane health care system, training medical staff in integrative delivery, treating patients
more holistically, and making health care more accessible to all. This issue is being republished
for the 2009 General Assembly of the United Jewish Communities. We hope that it will be a
helpful resource for the Jewish community. If you are interested in using this issue as part of a
Sh’ma salon on health care, please contact Sh’ma at SBerrin@shma.com. —Susan Berrin
We did what any attentive parents would do. When our son graduated from college and moved to California
to find work in the film industry, we researched
health plans and found one that was being marketed to the young: bright orange backdrops, hip
graphics of “twenty-somethings” in dreadlocks
and jeans. Snappy packaging aside, the plan
looked solid — as good as the plan we had at
home in Massachusetts. Our son signed up.
Five months later he was diagnosed with lymphoma. Twelve weeks after starting chemotherapy,
he received a letter from the insurance company
notifying him that his case was under review for
“rescission.” We had no idea what constituted
“rescission.” They immediately froze payment of
all claims and demanded voluminous documentation about his prior health history. They provided
no information as to how long the investigation
would take or what they were looking for. It didn’t
take long for tens of thousands of dollars of bills to
accumulate. All this occurred while enduring the
physical and emotional toll of cancer treatment.
Rescission, we soon learned, is the cancellation of an individual’s coverage by an insurance
company, often in the midst of a costly and life-threatening illness, on the grounds that the company was misled about the customer’s medical
history. Twenty thousand Americans — with cancer, heart disease, and up to 2,000 other conditions
— lost their health insurance between 2003 and
2007 due to rescission. Insurers defend the practice on the grounds that people lie on their applications and withhold vital information, but in fact
Rescission: An Insidious Industry Practice
JOAN LEEGANT
policies are rescinded for clerical errors or honest
mistakes of fact, or if the insurance company finds
anything in your medical record even remotely
linked to your current disease. A Texas nurse with
breast cancer was dropped by her insurer days before a scheduled mastectomy because of a minor
notation in her record by a dermatologist she’d
once seen for acne. A South Carolina man lost his
insurance because a medical assistant entered an
erroneous date into his record. Yet when asked in
June by a Congressional committee investigating
rescission if they would limit rescission only to instances of intentional fraud, the CEOs of three of
the largest insurance companies refused.
Faced with mounting bills and a sick child,
we were terrified. Had our son forgotten something in his application? His presenting symptom
for lymphoma was swollen glands. What if he’d
seen a physician in recent years for a sore throat,
or even a cold?
Fortunately our son had rarely seen a doctor
before getting cancer, so there was little for the
insurance company to find in his history that
would correlate to his disease. Luckier still is that
the person assigned to his case had a son who’d
recently been diagnosed with the same cancer.
Coverage resumed. Had it gone otherwise, we’d
have faced catastrophic losses from medical and
legal bills, and endured years of delay. And we
would have been among the fortunate. Others
faced with rescission cannot afford critical treatment. Their conditions worsen, many die, and
their financial resources vanish. A study in Illinois
showed that half of all bankruptcies in the state
