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Steve Lopez of LA Times on Melanie Winter's operation

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  • asncalert
    http://www.latimes.com/features/health/medicine/la-me-lopez1aug01,1,4157795.column Steve Lopez: She s hip to health insurance reform August 1, 2007 It s
    Message 1 of 1 , Aug 1, 2007
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      Steve Lopez:
      She's hip to health insurance reform
      August 1, 2007

      "It's probably not a good idea to go into surgery without having paid
      the anesthesiologist yet," Melanie Winter joked in the admissions
      office at Cedars-Sinai Medical Center on Monday. But her options were

      Winter had kidded that she might have to marry one of the volunteers
      at her nonprofit agency so she could use his health insurance to get a
      new hip.

      A friend had suggested she move to Canada for a while and take
      advantage of its national healthcare system.

      Instead, having gone nearly 20 years without insurance and unable to
      buy it because of her preexisting condition, Winter hobbled up to the
      doors of Cedars-Sinai with the help of a walker, prepared to pay
      $40,000 for hip replacement surgery.

      "Your doctor's name?" asked a clerk.

      "Penenberg," said Winter, 49, a lanky former dancer and actress, as
      she winced away the pain.

      David Brunk, a Mount Washington resident and volunteer at Winter's
      agency, the River Project, had driven her to the hospital and helped
      with her bags. He said he and others were grateful for the lead role
      Winter had played in turning the Taylor Yard railroad property in
      Cypress Park into Rio de Los Angeles State Park.

      "She has a great spirit and has been doing this work for not much pay,
      and she doesn't even live near the park," Brunk said of the Studio
      City resident, who has worked on open-space and river preservation
      projects for years.

      That's why, when Winter needed surgery, people came through, Brunk
      said. Grateful Cypress Park residents and other supporters held a
      fundraising party with live mariachi music. Friends set up the Melanie
      Winter Medical Fund at http://www.hip4mel.net .

      It's crazy that it came to this, but with roughly $25,000 raised,
      Winter had enough to make a down payment and schedule the surgery.

      In the admissions office, a clerk said she needed to pony up a $250
      fee before she would be taken to pre-op. Winter insisted she had made
      arrangements to pay it later, and after a bit of back-and-forth, the
      clerk relented.

      Winter says she earns too much to qualify for Medicaid but not enough
      to be able to afford a good health insurance plan, even if she could
      find a company willing to cover her.

      "It's insane," Winter said, telling me she was last covered as a
      member of the Screen Actors Guild. Since then, she has tried to live a
      healthy lifestyle and avoided medical care except when absolutely
      necessary. In rare cases, she paid cash for doctor visits or went to
      an L.A. County hospital.

      As her hip problem grew worse, Winter ruled out county hospitals for
      surgery. Even if they would agree to treat her, it would take months
      to get in, and she was leery of trusting a public hospital for a
      procedure that would determine how well she gets around the rest of
      her life.

      "Among my friends and colleagues, there are so many similar stories,"
      Winter said. Just trying to navigate the healthcare system is enough
      to make you ill, she said, adding that she doesn't trust any reform
      plan that doesn't remove the profiteering of the insurance and
      pharmaceutical industries.

      "Hillary [Clinton] has backed way off," Brunk said, referring to the
      New York senator and presidential candidate who has gone from brave
      reformer to a favorite recipient of donations from the health
      insurance lobby.

      In California, Gov. Arnold Schwarzenegger and key legislators are
      darlings of the same special interests, which explains why there's
      often talk of reform, much of it halfhearted, but little follow-through.

      Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights
      noted that two of the biggest state senate recipients of insurance
      company donations, Democrats Gloria Negrete McLeod of Chino and Leland
      Yee of San Francisco, did not cast votes last month on a bill that
      would have regulated insurance premiums. The bill died in the Senate
      Health Committee.

      Flanagan is drafting an initiative that would give voters a chance to
      do what legislators don't have the stomach for, despite growing,
      multibillion-dollar profits by the insurance industry and consumer

      The initiative calls for a 20% rollback of health insurance rates and
      regulation of future increases. It would bar insurance companies from
      refusing to sell policies based on a person's health, something that's
      already law in nine other states. And it would phase in universal care
      by offering all residents access to a public insurance pool, forcing
      private companies to lower their rates to stay competitive.

      "If you don't have coverage from your employer, in California,
      insurance companies can refuse to sell you insurance for any price,"
      Flanagan said. "If you've had allergies or asthma, you could be denied."

      You can read the initiative and offer your own comments by going to

      dog.org and clicking on "Patient Revolt." Flanagan, who is still
      tinkering with it, said he expected to submit the initiative to the
      state in the next couple of weeks, and it could be circulated for
      signatures by late summer or early fall. If it qualifies, it would be
      on the ballot in 2008, either in June or November.

      Winter, by the way, said an initiative might be the only way to
      restore sanity. And if California can show the way, maybe the rest of
      the nation will follow.

      With a little more time to heal and retire her debt, Winter might be
      able to lead the parade. She reports that Monday's surgery went well,
      and on Tuesday afternoon she took her first steps with the new hip.

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