WASHINGTON -- President Barack Obama, seeking to make a case for health-insurance regulation, told a poignant story to a joint session of Congress last week. An Illinois man getting chemotherapy was dropped from his insurance plan when his insurer discovered an unreported gallstone the patient hadn't known about.
"They delayed his treatment, and he died because of it," the president said in the nationally televised address.
In fact, the man, Otto S. Raddatz, didn't die because the insurance company rescinded his coverage once he became ill, an act known as recission. The efforts of his sister and the office of Illinois Attorney General Lisa Madigan got Raddatz's policy reinstated within three weeks of his April 2005 rescission and secured a life-extending stem-cell transplant for him. Raddatz died this year, nearly four years after the insurance showdown.
Obama aides say the president got the essence of the story correct. Raddatz was dropped from his insurance plan weeks before a scheduled stem-cell transplant.
In a letter, Babs Waldman, medical director of the Illinois attorney general's office, excoriated the insurer, Fortis Health, which is now Assurant Health. Raddatz "suddenly faces not only life-threatening illness but now the inability to afford the only treatment that may help him," Dr. Waldman wrote to the insurer May 3, 2005.
Peter Duckler, a spokesman for Assurant Health, said the company "can never comment on an insured's coverage due to confidentiality issues."
The patient's sister, Peggy M. Raddatz, testified before the House Energy and Commerce oversight subcommittee June 16 that her brother ultimately received treatment that "extended his life approximately three years." Nowhere in the hearing did she say her brother died because of the delay. Ms. Raddatz didn't return calls seeking comment.