After psychiatrist Carol A. Paris started wondering after hearing the story of Donna and Larry Smith. The Smiths lost their health insurance after Larry diagnosed with chronic coronary disease and Donna contracted uterine cancer. After being forced to sell their house, the Smiths moved into the basement of their daughter’s home. They were finally able to get treatment in Cuba.
“I heard her talk,” Paris said, “and I thought, ‘That’s an amazing story.’ I see patients every day being pushed around by the health insurance industry and that story just pissed me off.” The more she thought about it, the more she realized that people dealing with health insurers exhibit some of the same symptoms as patients with post-traumatic stress disorder.
Back at her office in Leonardtown, Md., she took down her copy of the DSM-IV, the Diagnostic and Statistical Manual published by the American Psychiatric Association. It is the standard reference for describing and classifying mental disorders. She looked up PTSD and used it as a template for PIISD.
“The essential feature (she wrote) of private insurance induced stress disorder (PIISD) is the development of characteristic symptoms following exposure to an insurance-induced traumatic stressor involving direct personal experience of an event or witnessing an event that threatens another person. Traumatic events include, but are not limited to, rescission [termination] of health insurance after developing a costly illness, denial of health insurance due to a pre-existing condition such as being female and fertile or delay of needed treatment or medication due to requirements for pre-authorization.
“In the case of physicians, traumatic events include witnessing the deterioration of patients due to financial ruin resulting from uncovered costs of care. Similar to some forms of PTSD, this disorder is prone to be severe because the stressor is of human/corporate design. Note: this diagnosis is not currently reimbursed by health insurance carriers.”
Horrigan: Victims of health insurance
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