Paralyzed former prep athlete sees health coverage run out
This makes me just see red. He can no longer afford to have helpers take him to his former school to give pep talks or volunteer as a coach. Somehow, I don't see either of those as medically necessary. Did he really need nurses in his home round the clock the entire time? Does he think someone is just going to pop up and give him another $5 million? Where was the insurance company in all of this, making sure that $5 million went as far as it possibly could? Guess what, Mr. Clark... not everyone who has a spinal cord injury gets this golden ticket.
Paralyzed former prep athlete sees premium health coverage run out
After nearly a decade, $5 million insurance policy has come to an end
March 01, 2011 | By Lolly Bowean, Tribune reporter
In the days after a football injury left Eisenhower High School running back Rasul "Rocky" Clark paralyzed from the neck down, he was showered with attention from medical professionals and assured by school officials that he would be well taken care of, he said.
For nearly a decade Clark enjoyed superb medical care — nurses in his home around the clock, access to pain medicines and prescriptions and a storeroom of supplies.
Now the $5 million insurance policy that once covered Clark's medical care has reached its lifetime maximum and come to an end — and along with it, many of the benefits he once enjoyed. Those benefits may have kept him healthy enough to surpass the life expectancy for most quadriplegics, his mother and primary physician said.
"I was told I'd be taken care of all of my life," Clark, 27, said from his bed in his modest house in south suburban Robbins. "That was one thing that brought me comfort. I knew I'd be OK. Now it seems like I'm being penalized for living too long. That's how I see it."
Clark is covered by Medicaid and has some state support, but he no longer can afford the gold-star coverage he has had for the last decade.
Clark's case touches on a larger conversation the nation is having about capping health care costs and rationing care, the push and pull between everyone wanting a top-of-the-line policy but not wanting to pay sky-high premiums. Insurance experts say lifetime maximums keep costs down for consumers, and there are policies available with no coverage limit, but those come at a price.
Although it wouldn't affect Clark, under the health reform legislation, lifetime limits are banned for health insurance plans. Because the regulation became effective on Sept. 23, 2010, after Clark's policy expired, it would not benefit him. Still the goal was to make sure that seriously ill consumers didn't find themselves running through coverage with no other options.
For Clark and his family, it's hard to see beyond the specifics of their situation.
Clark can no longer afford to have helpers take him to his former school to give pep talks or volunteer as a coach. Although he'd like to enroll in college art classes, he cannot pay for it now. So Clark stays in bed most of the time.
His mother, who quit her job at a nursing home several years ago, gets a salary from a state program to care for her son. Clark's father visits, and his two sisters help out when they can, but his mother is doing the work three nurses used to do.
