By Consumers For Quality Care, on July 2, 2019
In the latest installment of its “Life and Debt” series on consumers who turn to GoFundMe to help pay for medical care, HuffPost highlights the story of Kirstyn and Mark Livingston. Both work in health care; Mark is a family physician and Kirstyn is a psychologist. They work and live, with their two children, in the U.S. Virgin Islands.
Just two months after Hurricanes Irma and Maria destroyed the family’s home, Mark needed emergency heart surgery while the family was in Iowa. Just over a year later, Mark needed a second heart surgery. This time, the surgery was preformed in Texas. During the surgery, Mark had a stroke.
He needed to spend time in the intensive care unit and undergo months of rehabilitation. His family returned home, but Mark remained in Texas for treatment.
“We know we have this crippling, potentially financially devastating debt coming at us, and I have no idea what it is,” said Kirstyn. “I don’t even know if it’s something we can tackle and fight, or is it something that’s going to just take us down.”
While the USVI are a U.S. territory, many of the Affordable Care Act’s central provisions, such as protections for
those with preexisting conditions, do not extend to the territories. U.S. territories do not have insurance exchanges for individuals or small businesses either. The limited protections for Americans living in territories meant that the family had to turn to other options for their health insurance.
So, in 2017, the Livingstons enrolled in a plan from a British company, which sells health insurance to expatriates. The company denied many of the claims for Mark’s first surgery, contributing to the family’s debts. In 2018, the family was able to enroll in a plan from a major American insurance company. The coverage, however, is still less robust than what they would receive if they lived in another state.
The Livingstons turned to GoFundMe to raise money for medical bills. Even though the family has barely started to receive Mark’s medical bills, they know there will be big charges for major heart surgeries, weeks in the ICU, and months of rehabilitation.
Kristyn says their new insurer has already denied coverage for Mark’s residential rehabilitation. After the denial, Mark’s doctors figured that outpatient rehabilitation could suffice, but the insurance denied that too. The family is paying out-of-pocket.
There’s a certain dark irony in Mark Livingston getting caught up in the worst parts of the health care system. As a physician, he has a reputation for devoting extra attention to his patients, Kirstyn said.
“One of the reasons people like him as a doctor is because he doesn’t fit the way that modern medicine has become,” Kirstyn said. “One of the issues that he’s had in his practices in the past is that he spends too much time with his patients. You know, he’s always getting hassled by administration that he needs to see more people and move through his visits.”
Kirstyn says that the support from their community has been a bright spot in an otherwise dark period.
For now, Kirstyn says the money from GoFundMe has allowed her to pay their mortgage. She knows the money will run out, she’s just not sure when. They still owe roughly $150,000 for Mark’s first heart surgery. The medical bills alone would be devastating but Kirstyn is worried about construction costs and lost income too.
While the ordeal has been hard for the whole family, it has been especially unnerving for their children, who are 10 and 11.
“My son was worried about money. Like, ‘Are we going to end up on the streets?’” Kirstyn said. While she tried to assure him they’d be OK, she knew she didn’t have answers that would eliminate his fears, she said.