With the help of my original urologist’s staff, Kay and I applied for, were interviewed for and were accepted to be among the rarified few who have a CICP card. CICP stands for Colorado Indigent Care Program. Isn’t that something a hard working, well educated, activist citizen like me would want to be a part of -“Indigent”.
For the first 30 years of my career I only worked 90 hours a week. For the last 10 or 11 years I got lazy and slowed to first 70 hours and now only 50 or 60. One of their questions was whether I was employed or self-employed. The answer is neither. I am a sculptor.
OK I digress.
What is the Colorado Indigent Care Program (CICP)?
“The CICP provides discounted health care services to low income individuals at participating providers. CICP is not a health insurance program. The CICP is funded with federal and state dollars to partially compensate participating providers who provide health care to the uninsured and underinsured at or below 250 percent of the Federal Poverty Level. The Colorado Department of Health Care Policy and Financing administers the CICP. Health care services are provided throughout the state by hospitals and clinics that participate in the CICP. Not all hospitals and clinics participate in the program.” Colorado Department of Health Care and Financing.
Having the CICP card helps in many ways. But there are at least two reasons why it sometimes does not help at all.
First, the program is voluntary.
Second, the federal and state reimbursement levels are hideously low.
Both of these reasons factored strongly into my story. As we were not overly thrilled with the guidance (or lack thereof) of my first urologist, it was pretty easy for us to look further upon learning he did not accept the CICP card (even though his people helped us get it). We were also a bit nonplussed with the local hospital in Canon City. Although they did accept CICP they did not have the facilities or equipment to even do the biopsy, I was not letting them anywhere near my prostate.
Extensive research took us to University Hospital in Denver. They not only accepted CICP they were the primary CICP hospital in the state. They also were one of the top prostate cancer hospitals in the nation and their Chief Urologist is supposed to be the number one prostate surgeon in the country. We had all of my records sent to University for evaluation.
Their response was swift when we called, “You have been denied. There is no appeal.”
After that shock dulled a bit we got back to work. My sister, Dr. Cindy Parker is on the faculty of Johns Hopkins Hospital in Baltimore. Cindy was trying to find somewhere we might have an edge. She remembered we have a cousin who is the Chief Cardiologist at Denver Health Medical Center. Then she checked the credentials of the Chief Urologist, Dr. Fernando Kim, and found not only was he cutting edge in the field with his doctorate at San Paula, Brazil, and his residency at Loyola, but his specialty training in urology was –yes you guessed it- Johns Hopkins.
Cindy immediately called me and told me to call Dr. Kim’s office. I did, left a message and waited for some secretary to call me back. A short while later while in the middle of finding change for a gallery customer the phone rang. Harried and distracted I answered.
“This is Dr. Kim calling. Is this Robert Parker?” The Chief Urologist was calling me personally? Wow. Only problem was I was in the middle of a sales transaction with a customer and could not talk. I explained and apologized and he actually called me back shortly thereafter. I was hooked.
Dr. Kim immediately accepted me. After questioning extensively he told me he wanted to do Cryosurgery on me and freeze the prostate twice to 40 degrees below zero. In the same operation he would laproscopically remove my lymph nodes. He immediately scheduled me for the next week and we were set. This is cutting edge with an excellent history of results. His surgery would, if not cure me, give me a much longer and better quality of life.
Kay and Cindy, and the rest of the family and I were way happy
The following statements are written in the Denver Health Medical Center’s Mission Statement:
“Welcome to Denver Health
Denver Health is Colorado's primary “safety net” institution, providing billions of care for the uninsured; Provide access to the highest quality health care, whether for prevention, or acute and chronic diseases regardless of ability to pay; Provide life-saving emergency medicine and trauma services to Denver and the Rocky Mountain region.”
Denver Health Medical Center not only takes CICP but Dr. Kim is on salary and he had already accepted me. WRONG! Once Financial Office thought about it for a couple of minutes they too decided to reject us. Their reason was that I did not live in Denver County even though CICP is a Colorado state program. They decided they would charge me $27,400.00 for the surgery. They wanted $16,000 down and the rest in a year. However reasonable in medical terms this was, it still was a huge out of pocket expense for us. Remember we have qualified as medical indigents. My sister, Dr. Cindy Parker who is a faculty member at Johns Hopkins University, called the administration and worked her way up through the ranks until she was able to talk with a leading administrator. They discussed my case for awhile and the administrator who is a compassionate and reasonable man agreed to lower the price to $17,810.00. He wanted $4,000.00 down and the rest in a year and a half. This was wonderful news. The cost was still terribly high for us but do-able. With the help of family and friends and by selling our car we could do it! The next day, Friday July 30, I talked to the administrator’s assistant and agreed formally to their terms.
An hour later another person called and told me I was being rejected from care. The time was 5:30 PM, half hour after closing on Friday.
Every professional bureaucrat we know told us this had to be a simple error and we should still go to Denver for our consultation Monday morning.
Upon arrival we could tell bureaucratic alarm bells were going off all over. People were amazed we hadn’t gone off to die quietly. We were shuffled off to the, Director of Ambulatory Care who was sent to deal with us. She told us the administrator had not followed process. She repeatedly told us this was not personal, it was a process issue.
A Doctor was the man responsible for canceling us. His title is Director of out of county CICP Services. His job description is to deny all out of County CICP cases. (Really –I didn’t make this up).
While we were talking with the Ambulatory Care Director and she was pretending an agreement had never been made, a secretary entered the room and handed me some papers. The top sheet was my contract, all typed up and ready for me to sign. The Director literally ripped the contract from my hands and said “You can’t have this!”
We were then told the hospital would take us under consideration and we would be notified in 24 to 48 hours.
The out of county director called my sister and told her he was putting the kibosh on the whole thing because it might be against the law to accept money from a CICP patient. So they wouldn’t accept me as a CICP patient because I live out of county, and they would not accept payment from me because I have a CICP card. These people are doctors, professional hospital business people, maybe lawyers and social workers. These people have all of this education and talent yet they cannot figure a way to give one person a life saving or life extending operation—even if he had found a way to pay almost $18,000 for it?
Throughout all of this we met many folks who really wanted to help us, but as they all said, the system is broken and their hands are tied. The system is indeed broken and because of it our lives were being jerked out of our hands. It’s wrong. It’s really wrong when a hospital whose mission statement is to treat the uninsured in the Rocky Mountain Region, makes a verbal agreement with us and then one man crosses us off. We worked hard all our lives and deserve good medical care which we were not asking for free. We were greatly disheartened.
And then came Obamacare!