My daughter could have died. I blame the US insurance companies | Melody Schreiber
SUnited Healthcare hasn’t left my thoughts since Thursday morning – but not for the reason you might think.
On Thursday, my pediatrician told me to take my 18-month-old daughter to the emergency room immediately. My baby needed breathing treatments that she could only receive in the hospital.
But after hours of being in distress, she did not get better. The only question was whether she should be admitted to the pediatric ward or transferred to a hospital with a pediatric intensive care unit (PICU). My husband and I asked to stay here, close to home and our oldest son, and after four days she seems to be finally leaving the danger zone of a PICU transfer. But she is still on oxygen and still receiving albuterol every two hours. We don’t know when she will come home or how many months it will take for her to fully recover; she is already small for her age, she has lost weight and we see her ribs with every breath.
The worst part is: this was preventable.
My daughter’s respiratory panel was positive for RSV (respiratory syncytial virus), a respiratory infection that can be fatal in children under two years of age, especially premature ones like my baby.
Her brother, now seven, was admitted to the same hospital almost exactly five years ago, in the room next to where we are now. He too fought for every breath as RSV wreaked havoc on his underdeveloped lungs. One night I woke up in a panic, with my son’s body next to me burning with fever, and ran to my phone because I forgot to check if the hospital was in network before bringing him here. Then I cried, because that was not a thought that should ever enter a parent’s mind at a time like this – Can we afford to save him? – and yet it happened.
This fall, as RSV season approached, I asked the pediatrician for a shot of Beyfortus, a very effective RSV medication approved for babies. This medicine is recommended for all babies under eight months and babies under 19 months with certain health problems. At first the doctor enthusiastically agreed. But then she checked my insurance company’s coverage and her face fell. We did not qualify. My daughter had no heart disease and did not require oxygen support or chronic steroids for the past six months.
A friend of mine had twins at 33 weeks, and they are a few months older than my baby. They got the photos easily, no questions asked. My friend was in disbelief when she learned that our shots were not covered when my daughter was even more vulnerable.
Now I blame myself for not paying out of my own pocket. I hadn’t realized it was an option, but of course it was – $1,300 would have been more than worth it. I can’t help but think United Healthcare lost their bet. This hospitalization will cost them much more than the medication would have cost.
Take away all the stress of this week, take away the fear, regret and anger, even take away the hours of lost work for us and school time for our son, and it’s clear that there are undeniable financial incentives that insurers can cover. Medicines like these can save significant costs over time – and it’s not just about the price of hospital admissions. There is a possible link between RSV infection at a young age and asthma, which could have enormous lifelong costs.
At the very least, insurers could expand coverage to babies with other serious underlying conditions, such as premature birth and a family history of RSV hospitalization or asthma, for example. Still, this kind of reporting could become even harder to find under the second Trump administration.
I’m not the only person with United Healthcare top of mind this week. Americans have emphasized in recent days how broken the health insurance system is, and how unacceptable it is for vulnerable children, like my baby, to fall through the cracks — only to now be open to a lifetime of avoidable risks.
As I write this, I lie in a hospital bed next to the smallest, most powerful person I have ever met. I can’t bear her pain. Only a change in our country’s health care policies will prevent other babies from reaching this point.