Care nightmare

SUMMERVILLE -- Whenever Dawn and Matthew Sechevich hear how health care reform might lead to government intervention in matters of life and death, the thought doesn't bother them much.

That's because they feel their health insurance company let them down profoundly a few years ago, after their 2-year-old son's cancer had returned in his spine and paralyzed him from the waist down. The company refused to pay for Luke's stem-cell transplant on the grounds that it was too experimental.

"They said basically that they were telling us it was time to give up. We weren't ready to give up," Dawn Sechevich said.

"It was as if they were an insurance company 'death panel' that decided the survivability wasn't worth it," Matthew Sechevich added. "I can tell you that you shouldn't be afraid of the government like you should the insurance companies."

The Secheviches are among several hundred Lowcountry voters expected to attend U.S. Rep. Henry Brown's town hall meeting at 7 tonight at the Charleston Area Convention Center.

The topic is so hot that Charleston County Democrats also are devoting their own dinner meeting tonight to a forum with health care experts.

The Secheviches hope to explain to Brown and to the audience that they ultimately received a waiver through Medicaid that picked up the $200,000-plus tab for their son's stem-cell treatment.

That saved them from having to hold fundraisers while caring for their gravely ill child, or possibly from declaring bankruptcy.

They said they realize that they aren't entitled to every experimental treatment, and ultimately opted not to take Luke for further treatment after the stem-cell procedure failed to cure him. He died in January 2008.

"Everybody is complaining about government-run health care, but the government health care gave us the opportunity for Luke to spend an extra five months with us," Dawn Sechevich said.

What really irks the Secheviches is that the company rejected the treatment even though its 80-page policy indicated that it would be covered. "We had a lot of lawyers who were really interested in this, but the last thing on your mind is a lawsuit when you're dealing with a family member," he said.

"Matt and I aren't lawsuit kind of people," Dawn Sechevich said. "We just wanted our son to be healthy."

Their story also helps illustrate the complexity of the health care reform debate, which is expected to resume in force as Congress returns Tuesday.

The debate largely focuses on how to insure the 46 million Americans with no insurance, as well as the rising cost of care and how the quality of care fluctuates around the country, said Bill Erwin, communications director for Alliance for Health Reform.

Erwin said people who have had bad experiences with private insurance also are upset.

"One problem that comes up with private health insurance is most people don't actually know what's included in their insurance policy," he said. The interpretation often is left up to the companies and can be vague.

Erwin said insurance companies would argue that they need reasonable rules to keep costs down and make insurance affordable to more people.

"The percentage of claims that are denied is quite small, but those are the ones that are upsetting to people and those are the ones you hear about," he said.

"These usually involve tens or hundreds of thousands of dollars, so the insurance companies are naturally eager not to have many $100,000 claims."

Reach Robert Behre at 937-5771 or at rbehre@postandcourier.com.