Tuesday, March 11, 1997 | 11:59 a.m.
CARSON CITY -- For Patty Barrows, the hardest part was not the 22 pounds she lost on an already thin frame in two months because of stress. The ultimate insult was the time a doctor chided her for bearing children.
"'As a carrier of cystic fibrosis, you shouldn't have had children in the first place,' " she says a doctor told her.
For Michelle Bogue, a former $21,000-a-year bartender at the Smuggle-Inn in Las Vegas, the humiliating part was using food stamps to feed her three children, including a 12-year-old quadriplegic son whom she cares for around the clock. Even now she's apologetic about smoking cut-rate Austin cigarettes.
What makes all that even worse, say the two Las Vegas mothers in their 30s, is the run-around they receive from managed care organizations whose bottom-line concerns are driving them deeper into debt -- and worry -- at a time when they need help the most.
Barrows and Bogue spoke at length about their predicaments after joining other health-care reform advocates at a three-hour hearing Monday before the Assembly Commerce Committee on legislation to curb managed-care abuses.
Testimony centered on legislation sponsored by Assemblywoman Barbara Buckley, D-Las Vegas. No action was taken on that or a measure also heard Monday in the Assembly Health and Human Services Committee to create an advocate for managed-care patients.
Buckley's bill would prohibit companies from deciding what doctors can say to patients, outlaw the payment of incentives to doctors for denying appropriate medical care and require each company to establish a grievance board to resolve complaints within 30 days.
Nevada's managed-care organizations cover more than 323,000 patients.
"The health insurance business is running rampant without any regulations to protect the patient," Ruth Mills, of the Nevada Health Care Reform Project, told the Commerce Committee.
Jim Wadhams, a spokesman for the managed-care industry, said during a break that most patients with complaints, while facing genuine concerns, are directing their anger at the wrong source.
Instead of being upset with their managed-care organization, they should be mad at their employer for buying a low-budget health-care plan, he said.
"It's like the kid who says, 'I want to go to Harvard, but my old man's only paying for UNR,'" Wadhams said.
That argument doesn't sit will with reform advocates, who say most employees don't know whether their company's coverage is comprehensive.
"It's a brilliant spin," Buckley said during a break. "But most of the complaints have been about things that were covered but were denied."
Diana Lombardo, president of the Nevada Nurses Association, said a customer's coverage may change when one managed care organization buys another.
"What you may have one day, you may not have the next day," she said.
During a break, Buckley said she would amend the bill to require managed care organizations to provide a comparative list of all their services.
"They're trying to cut corners," she said of managed care organizations.
Among those who agree are Barrows and Bogue, whose sons have cystic fibrosis.
Bogue, who has received an outpouring of support after her story recently first appeared in the SUN, said she had to fight to get her son admitted to the hospital for a life-saving procedure that her health maintenance organization originally said was too costly.
Barrows, who earned $23,000 a year as a legal secretary before quitting to care for her 15-year-old terminally ill son, said she was told she'd have to pay the cost of a lung specialist after her husband switched jobs, creating a foul-up with their coverage.
Now he's making $32,000 as a Henderson cab driver, and the family is scraping by, while continuing to confront bureaucratic snafus. Her son is still waiting to see the specialist.
The committee also heard from a reform advocate who said the system especially punishes those who don't have much money.
Las Vegas lawyer Lenard Schwartzer said his health maintenance organization denied a $48,000 bone-marrow transplant for his 3-year-old daughter in 1986, so he paid for it himself.
"Luckily, I'm a pretty successful attorney, and I wrote out the checks," he said, adding that his daughter is alive today.
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