“I think I’d be dead if I’d stayed with the first provider.”

Today's NY Times has an in-depth article on cancer care that provides a window into the dysfunctional health care system in America. The subject of the article, Karen Pasqualetto, describes her fight for treatment:

Look for other opinions, her family urged. Her husband had a new job that provided better health coverage, and they switched to a different insurer.

“I think I’d be dead if I’d stayed with the first provider,” she said.

Ms. Pasqualetto, a self-described Type A go-getter, knew better than most how to find information. She has a law degree and worked for several technology start-ups. She had made enough money to quit that career and do something she loved, teaching sixth grade at a Catholic school in Seattle.

Get that? She'd be dead if she stuck with her insurance company. In the United States of America, our health care system fails us. And, our leaders still haven't come up with solutions. That's what this health care debate is about. Real people really suffering and really dying.

The problem is palpable among real people. John Edwards' answer to the health care question during the CNN/YouTube debate got the best response of the night. Meanwhile, Hillary Clinton had to remind us that she bears the "scars" of her failed health care reform effort in 1993. We know. So get something done.

Almost everyone I know has an anecdote about how their insurance company screwed them over somehow. Maybe if one lives in the rarefied world of Presidents and U.S. Senators, those struggles and frustrations don't come up in conversation.

Over the Memorial Day weekend, I ended up in the emergency room because of an allergic reaction. "Anaphylaxis" is the term I learned. Since then, I've gotten several different bills that don't make sense. My favorite story is that my insurance company wouldn't pay for the "Twinject" that I'll need in the event of another episode. My allergist, who is a doctor in my health care plan, described that possibility as a "potentially life threatening" situation. (Admittedly, those words freaked me out.) Anyway, the insurance company wouldn't pay for the Twinject (which I'll only need to use if my life is in danger) because the doctor in their system didn't pre-approve it. Every call I make to my health insurance company is almost comical -- tragically comical. Apparently, my doctor needed to fill out an extra form for my prescription to be covered. See, it doesn't matter if my doctor is in their system. The insurance company tried to blame him. I don't really want my doctor worrying about what forms to fill out -- I like the idea that he's an expert in allergies, not forms. (And, it turns out I am allergic to nuts even though I always ate them. But it's exercise induced...who knew such a thing existed?) We truly have a health care system designed to prevent coverage. What happened on a very small scale to me happens to people with far worse conditions every single day.

Which brings me back to Karen Pasqualetto, who is fighting for her life every single day. She's been smart, aggressive and tenacious in her bid to survive. But, in the United States of America in the year 2007, if you're not an elected official, you need those skills -- and financial resources -- to survive the health care system. Is that the best we can do? Does it have to be this complicated to survive?:

Karen Pasqualetto is exceptional not only for her determination and confidence in dealing with problems that would intimidate many other people, but also for her financial wherewithal. So far her treatment has cost more than $400,000, almost all of it covered by health insurance from Starbucks, where her husband works in disaster-response planning.

When she joined a cancer support group, she recalled, “It was amazing to me the different experiences people were having based on what they could afford or who their provider was. I was able to say, ‘If the provider won’t pay, my family will. I don’t care, I’m going for a second opinion.’ ”

In the support group, it saddened her to hear other patients with advanced disease take the word of a single oncologist, because she believes that if she had done that, she would already be dead. She has come to think that survival may depend on money and access, and, she said, on “your own drive and motivation — are you Type A? — your education and your ability to sort through the medical world and the insurance world terminology.”

Ms. Pasqualetto’s doctors have accepted her insurance payments, but if they had not, she said, “I would find resources. I would get people to pay. I do have resources. I have access to people who wouldn’t sit by and let me die because of $200,000.”

I really, really hope Ms. Pasqualetto beats her cancer. She's become a champion in a battle she didn't choose.

Unfortunately, many Americans will die because they don't have the resources for even the very basic health care. There's no hope that the Republicans will deliver a better health care system for America. No way. Bush is even going to veto the SCHIP bill to get more kids covered. That's why the pressure is on the Democratic candidates for President. On health care, they'll need to deliver.