It can happen when Keith Molinari is working his midnight to 8 a.m. shift with the sheriff's department. Or when he's making the three-hour trip from Roscoe to Columbia Presbyterian Hospital. Or when he's looking into the eyes of his 22-month-old-son. He has to stop in disbelief. "No parent should ever have to deal with this on top of everything else," he says. "We didn't choose this."
By that, he means it's bad enough to find your baby has cancer It's bad enough to have to decide that, to save his life, it's best to have his leg amputated. But when you find out your insurance company regards your son's artificial leg like a wheelchair or a pair of crutches, it's a rude awakening. It's ruder still when you find they'll pay only $1,500 a year and that a prosthesis will cost $15,000 and that your son will need one every year until he's grown.
Then came the news that insurance problems are common among amputees. And with that, the full impact of his son's future was laid out. "His cancer, losing his leg is not the worst end of his problem," Keith says. "His problem will be insurance ...Chase will spend the rest of his life battling the insurance . " companies.
But this is not a story about sympathy for Chase Molinari and his mom and dad. It's not about the money they need to close the gap. (They know they'll get by;people have been so good to them.) It's about a lingering question of justice that Keith and Carrie Molinari cannot let rest. Luckily,neither can Doug McCormack.
In a series of connections that go from community to surgeons to prosthetic device makers, McCormack found the Molinaris last year .A lawyer for a high powered Washington, D.C., law firm and counsel for the Amputee Coalition of America, he wants to help them. And he also thinks Chase Molinari, though he's only 2 years old, can help a lot of other people. Doug McCormack thinks Chase Molinari can change the healthcare system in New York.
The way McCormack sees it, it's pretty clear there's something very wrong here. The Molinaris are working people. Chase's dad has worked 10years in the Sullivan County Sheriff's Department.
McCormack helped through two levels of appeals with GHI-HMO, both of which failed. They failed even though everyone from Jake Gunther, state assemblyman, to John Bonacic, state senator, to Maurice Hinchey, U.S. representative, pressured theHMO.
McCormack and the Molinaris will now appeal to the state Insurance Department and then directly to the Legislature. It will come down to changing the law, they believe.
Back when Doug McCormack was 14, had cancer and had his leg amputated, he didn't have to go through any of this. His is the story of a time when health insurance was very different in America. His dad worked for an airline, his mom was a teacher."It was one thing that never came up," says McCormack. He got his prosthetic leg and went on to become a 31-year-old lawyer good enough to be able to take Chase's case for free.
And this kind of thing just burns him. "Even patients on
Medicaid have better access to care Frankly, people shouldn't
have to go through this," McCormack says.And so he says: "It
really only takes one case."
Add the skill of the lawyer to the faith of a father and mother and you have the case. The case of Chase Molinari. Call him biased, but Keith Molinari believes this is possible. "Because if you see this little guy,he's the cutest little guy in the whole wide world. And his smile will melt your heart."
Get into a case like this with the insurance company and you can guess it's a losing battle. There it is,in black and white. The prosthesis, the amount, the category. In the world of HMOs, prosthetic coverage is all about the same: Not enough.
Plus, not many people read the fine print about prosthetics. Such a thing only becomes painfully important when you or -worse -your baby needs one. Many veterans or older folks may need one; very few babies do.
On top of this, there's plain reality: Insurance is business, it's competitive, they keep these sorts of coverage low. Even John Baackes, executive director of GHI-HMO, knows the score when you talk coverage limits to a family that's been hit by some rare sickness: "It's awful. ..." But, he says, "There is a contract involved. And who wants to hear that at a time like this."
Baackes and other insurance executives see dozens of bills go before the state legislature every year. Some make it, some don't. It could be a tough one, he said. Not manly people need prosthetic device sand all of the mandates drive costs up - usually for consumers.
None of this is news to the Molinaris or to McCormack, but they're still fighting.
Thirteen years ago, Keith was a hunter from Long Island stopping off with his buddy for a bite to eat in the Red Rose restaurant up in Delaware County. The waitress was Carrie Neer. About two years later, she was Mrs. Molinari.
Keith and Carrie had two girls,Heather and Samantha. Then came Chase. Last May, as he learned to walk, he fell on the front porch and broke his leg. Thank God, the Molinaris now say.It was the only way they would have known that Ewing's sarcoma, a rare and devastating form of cancer, had invaded their son's thigh. Doctors believe Chase is the youngest child ever to have it.
In an II-hour surgery this fall, doctors removed his thigh, then reattached his lower leg facing backward. They attached Chase's knee to his hip, taking care to reattach bone, muscle and arteries. With this procedure, Chase's foot, facing backward and down ("ballerina style") will hold an artificial leg and function as a knee.
For three days after the operation, the baby lay unconscious in a New York hospital. Keith and Carrie stayed with him the whole time, massaging the leg to keep the blood flowing, to keep the limb alive. Doctors didn't know if the operation, a very unusual rotation plasty, would work on one so young.
Even for all their troubles, the Molinaris are grateful. Yes,it is true that Chase would look at his missing leg and cry and that he'd sometimes hold his remaining, backward-facing leg like he was ashamed when it all first happened. And, yes, Carrie fears this: "He may wake up one morning and say why did you do this to me?"
But doctors believe there is no cancer left in Chase. Seventeen courses of chemotherapy that ended recently will help to ensure that. They've seen parents go into the hospital and walk out with empty arms. They've known some of these kids who have died. So, they know this: "No matter what condition he's in, we're still walking out of the hospital with him each and every time," says Carrie. It's that gratitude plus some other kind of faith that fuels them as they make sure Chase somehow changes the system. The Molinaris figure maybe this has all happened for a reason. "For something good to come out of something so bad," says Carrie."It's almost like there was a purpose.
Doug McCormack thinks he knows what that purpose is. "We don't want to have to fight this fight again."
Update: At press time, we learned that legislation is pending before the N.Y. Senate (Bill No. 4533) that will mandate insurance companies to cover prosthetic costs equal to those covered by Medicare. For more information visit Chase's Website www.chaseslaw.com
Reprinted by permission of The Times Herald-Record, Newburgh, NY. The Molinari family may be contacted at Po. Box 472, Roscoe, NY 12776.
