Sara Kurtz & Healthcare by Zip Code? Really?

1/22/2023 

Many of you have been very generous in the past. Please think about making a donation to the GoFundMe account of Sara Kurtz. Donate here. 

Who is Sara? She’s a friend of my niece Susan.

Susan, as many of you know because you follow her on FB, is a speech teacher of little kids in the Los Angeles public school system. She often posts what she is thankful for, her observations are witty and perspicacious. If you don’t know what perspicacious means, sign up for Susan’s FB page and after a while, you will. This is her FB page. You will have to ask to be admitted so feel free to tell her Ant MB sent you. https://www.facebook.com/susan.lawrence.568

Susan and I were texting and happened to light upon the topic of Health Care in America Today. AKA How Insurance CEOs cater to stockholders by “streamlining” medical care to maximize profits. It’s an industry in which illness, pain, and suffering become grist for the wealth of others.

Am I cynical? You betcha - but medical care providers are often more cynical than me. Too many are overworked, under-paid, under-respected, and under-supported.

In this conversation Susan mentioned that her friend Sara has cancer and is already thousands of dollars in debt even though she has a job and health insurance. Also, the insurance company was saying it won’t cover the particular chemo and other scans and medications her doctor was recommending.

So this is why today we are going to meet Sara Kurtz. Because ordinary Americans with health insurance, who would prefer to live their private lives privately, need GoFundMe pages.

…

I expected to interview Sara for about a half hour. Two hours later we hung up, both laughing. She’s in her 40’s with college and master level degrees related to social work, marriage and family therapy, and cross-cultural studies. She’s lived in Los Angeles since 2006 when she moved there to attend grad school. Upon graduation, she began working at a non-profit which provided substance use and mental health treatment services. Within that organization she was involved in founding a treatment program contracted with LA Department of Mental Health, which offered an alternative to incarceration of court-involved men with mental illness and substance abuse disorders. Additionally, she joined a Presbyterian-connected community named Beloved Everybody which is an ability-inclusive organization that connects people with and without intellectual disabilities in friendship. 

In 2021 Sara left her job of 10 years for work that would allow her to prioritize her relationships and community outside of the occupational setting. She eventually settled at a smaller organization where she provides counseling for people with substance use and mental health issues, while teaching an occasional class at her former grad school.

After a mammogram in August, her doctor, assigned by her insurance provider, United Health Care, informed her that she had cancer. To start treatment she would need some tests and scans to determine what kind of treatment her cancer would need. Here’s the thing - due to various denials by her insurance’s “authorizations department” for standard services such as an MRI and for chemotherapy itself, and due to months-long wait times for appointments, her treatment was delayed. She spent hours on the phone contacting the insurance company and scheduling departments to coordinate care. Had she not received a recommendation to place a grievance with the state of California’s Department of Managed Care, which she needed to do twice (!), the process would have taken even longer.

To make her long story short, she was told she had breast cancer in August – and she received her first chemo in November. Then she was hit by strong side effects and needed to go to urgent care on multiple occasions on a weekend. Prior to the start of treatment, her doctor informed her that he did not want calls on the weekend for issues with side effects. During a follow-up appointment when she reported one of the issues that had necessitated urgent care, he conveyed there was nothing for concern. However, the next weekend she was at urgent care again for the same issue.

Additionally, when she was prescribed an Rx or referred to a specialist by urgent care, she couldn’t receive the treatment or specialty care until a primary care physician authorized it. This required scheduling an appointment and then waiting weeks to be seen. Sara spent large amounts of money and time researching and obtaining home remedies while managing discomfort as she awaited care. At one point, she could not swallow anything beyond liquids for days and lost weight which was discouraged by her doctors. When she appealed to her oncologist to obtain a medication commonly prescribed to cancer patients, her insurance denied it. She was encouraged by the nurse at her oncologist’s office to call the insurance company to try to sway them otherwise and she also provided a phone number to contact a formulary where she could pay out-of-pocket for the medication. She learned the alternative was expensive and would involve additional calls between pharmacies. At this point, after months of calls to move the insurance company to act, her energy was limited. 

Throughout the experience she had a nurse practitioner friend in Virginia who was very helpful, often alerting her that her care was far from standard. This friend tapped her connections to assist Sara to obtain the kind support of a California breast surgeon who reiterated this concern. 

Her friend also connected her with Tim Jost, a national expert who is influential in health care reform. Tim heard of Sara’s situation, offered to consult, and validated that her care was less than excellent. She shared with him that one solution her insurance company had provided was to use her workplace’s zip code rather than her own in south Los Angeles. Tim speaks to the relationship of poverty and zip codes to health outcomes. Because she chose to live in a “poor” zip code she received poorer and more frustrating care. (Google ‘health outcomes by zip codes’ for an eye-opening read.)

In December she changed insurance from United to Kaiser. Last week, she was feeling optimistic. She’d seen her new primary care doctor in the morning; specialist appointments were authorized immediately and phone calls to schedule were received within hours. No need to wait weeks to hear if the authorization had been approved or get a letter in the mail notifying her could schedule appointments.

Why does this adult professional woman with a loving family, partner and good friends, need a GoFundMe?

Deductibles. Copays. Limited sick time accrued after that job change. She is too involved recovering from chemo and managing her insurance to be able to work more than a few hours per week. Also, catalytic convertors have been stolen from her car FOUR TIMES.  She has waited for the cost of used cars to come down somewhat and is now looking to buy a car without a catalytic convertor (Yes, she bought the locks and shield, but thieves got past those fast.)

In the meantime, she is living on peanuts, savings, and disability insurance payments that ought to kick in soon. And there is this. “I’m single. Who will I automatically lean on? I’m not eager to give up my adult life to move back across the country to live with my mom and dad.” 

Sara reports she has learned some patience in the midst of all this, and the importance of speaking up for yourself and others when it comes to health care - but she is truly in a struggle to maintain her health and life.

Can you help?

I will check in with her from time to time and let you know how she’s doing.

Please check out her GoFundMe page here.