Paying the price of eating disorders

I’m dying. I am the single mother of two small girls who are truly my inspiration. I am leaving these amazing little people in two days for an entire month to travel to Philadelphia to obtain lifesaving treatment for my disease. Over the course of last year, approximately, I have watched all of my body fat disappear and see that, due to having no more body fat, my muscles are now being digested.

I have been monitored for cardiac damage, been hospitalized for a potentially ulcerated colon and have had to cut my almost-all-my-life-long hair to just below my chin because it was falling out so much that my shower drains clogged weekly, and my linoleum bathroom floor looked like a rug. And then feeling my heart break when I see the fear in my 7-year-old’s eyes as she looks down at that floor and says, “Just how sick are you mommy?”

I have tried for the last year to fight this and continue to work full time and be the mother my children need. But the battle is all but lost, so this trip to Philadelphia is my last hope for survival. Am I going to a cancer treatment center? Am I getting some new drug for my disease that can’t be obtained in Bangor? Am I going someplace to try a course of not yet FDA approved treatment? No to all of the above. I am going to the Renfrew Center for treatment of eating disorders. I am anorexic and bulimic.

So, God bless Linda Bright (BDN, May 3) for her timely commentary on equal insurance coverage for eating disorders. I have been in outpatient therapy since September 2000, but recovery has eluded me and I know that to save my life I need inpatient treatment. So, I chose the Renfrew Center because of its stellar reputation for treating those insidious diseases. But a dedicated, proven program does not come cheap, nor should it. I am a nurse and receive insurance through the workplace, and the insurance carrier has authorized to pay 80 percent of my stay at Renfrew, leaving the out-of-pocket cost to me at $9,000.

Yes, I have a decent job, but I also have a mortgage, car payment, utilities and day care. I don’t have this kind of cash readily available to me at any point or time. Renfrew, thankfully, has a scholarship program and due in large part to letters written by some of the doctors I work with and a review of my financial situation, I did receive financial aid from Renfrew and now only have to pay $2,800 out-of-pocket. A much more tolerable price tag for my survival.

Bright brought up a number of valid points in her article stressing the physical devastation wrought by this mental disorder and that eating disorders have the highest mortality rate of all mental illnesses. Despite this seemingly bleak outlook, she also stressed that a full course of treatment is cost-effective, but that most policies cover mental illnesses at a lower extent than medical illnesses, if at all. I have been told by my employer that eating disorders have only been included in the mental health coverage over the last three to four years.

I have a copy of LD 482, the bill which the Banking and Insurance Committee has killed. The bill uses the language “biologically based mental illness,” i.e. – any mental condition caused by a biological disorder of the brain that results in a clinically significant syndrome that substantially limits the person’s functionality. From this definition there appears to be a very fine line between many mental and physical conditions. So, why the fight about equal coverage? Bright again presents a valid argument about why this bill is continually shot down.

When the December 1999 bureau report gave the costs of the treatment in maximum percentage terms instead of the actual dollars required to add to a premium to provide this coverage. If any group with more than 20 employees was told that to treat people who suffer from eating disorders, each premium would be increased by a certain percentage, it sounds like a lot more money than the actual $6 per policy-holder per year for fee-for service plans and $2 per policy-holder per year for managed care plans.

During times like these when many households live paycheck to paycheck, who wouldn’t be opposed to increasing costs? If the country as a whole, however, agreed to maintain mental health insurance equally, would I miss that extra $6 per year? As I sit as close to the functioning dead that I can become, I realize that I may be biased. Does my mother (also a nurse) think she will miss that $6 a year? I don’t think so, especially if it meant that she would never again have to watch her child kick at death’s door. Maybe another biased source, but the problem of eating disorders and resultant deaths is not declining, not going away.

Chances are, if you work long enough, your life will somehow be touched by one of these disorders and you won’t miss that $6 a year either. Thank you, Ms. Bright, for bringing the actual dollar amount to the forefront. If just one company somewhere recognizes mental health insurance coverage equally, you may have saved countless lives.

Michelle Amaro of Bangor is a labor and delivery nurse.