In better days, he strode into a Capitol Hill hearing room
exuding the charm and confidence that made him one of Hollywood's
favorite leading men -- the unmistakable Superman speaking on behalf of
funding for the arts.
Now, Christopher Reeve sits in a wheelchair in his suburban New
York home hooked up to a respirator, his powerful voice reduced to short
gasps of eight to 10 words at a time. Paralyzed in a horseback-riding
accident in May and facing a lifetime of disability, he has become one
of the millions of Americans trying to plan uncertain futures around the
fine print of health insurance policies.
Reeve does not suggest that his financial picture is that of the
average person and his ability to negotiate with the web of insurers now
involved in his personal crisis is far greater than most. But his injury
clearly has brought home to his family the fragile nature of fortunes
and futures based on expectations of health and continued employment.
Reeve has approached his problem in typical fashion. He is fighting
back, using his political clout to position himself as an activist for
changing national policy.
"A year or two ago we seemed to be very well off," said Reeve,
talking into a speaker phone from his home in Pound Ridge, N.Y., where
he lives with his wife and his 3-year-old son, Will. Now, "the picture
has changed. And there are so many other people who are in this
situation whose positions are so much worse."
Reeve's principal health insurance -- bought 20 years ago when his
career was blossoming through the American Federation of Television and
Radio Artists -- is rapidly running out. Care for his catastrophic
injury will cost about $400,000 a year, an extraordinary cost faced by
relatively few Americans. His main policy (through an insurer he
declines to name) has a $1.2 million lifetime cap on payments for
catastrophic injury, slightly more than the typical $1 million, industry
statistics show). This gives Reeve about three years of coverage.
Business groups call such caps "regrettable but necessary,"
designed to keep insurance costs from skyrocketing. About 70 percent of
the nation's health insurance policies have lifetime caps, often never
noticed by the policyholder until disaster strikes.
Reeve's wife, Dana, described discovering their policy's cap as a
"one-two punch. When I really got into depth looking at the policy, to
be quite honest, it was . . . as horrifying to me as when Chris first
had his accident. It was one of the worst days, when I realized what our
financial situation would be and what Chris's care would cost."
Reeve is now writing to every U.S. senator endorsing legislation by
Sen. James M. Jeffords (R-Vt.) that would change the lifetime cap.
Jeffords sought him out for the help, knowing of Reeve's situation.
Under the amendment, no insurance company would be allowed to set a cap
of less than $10 million.
Debate over the issue has been bitter and -- up to now -- largely
hidden in the grinding health reform fight on Capitol Hill.
The amendment would be added to a health care reform measure being
pushed by Sen. Nancy Landon Kassebaum (R-Kan.) and Sen. Edward M.
Kennedy (D-Mass.), which would stop insurance companies from dropping
people when they change jobs or denying coverage for preexisting
conditions. That measure unanimously passed the Senate Labor and Human
Relations Committee in August, but it has been stalled ever since by
secret parliamentary tactics.
The basic Kassebaum bill has run headlong into opposition from some
powerful insurance companies. Amendments like the one endorsed by Reeve
have encountered even more visceral reaction from the larger business
community.
James Klein, the president of the Association of Private Pension
and Welfare Plans, said Reeve presented a "tremendously compelling fact
situation" and expressed profound sympathy for Reeve's "extraordinary
tragedy." But, he said, "limits are a regrettable but necessary part of
many health plans. Without them, many employers -- those who are
voluntarily providing health care benefits to their employees --
wouldn't be able to provide health care coverage at all."
Reeve said that dropping the lifetime limits on medical payments
and spreading the cost of the few catastrophic cases across all
policyholders would add about $8 a year to a typical policy's cost, a
figure disputed by some in the industry. Klein said cost increases would
vary depending on the benefits provided by a company but could be
financially ruinous.
Once these insurance caps are reached, taxpayers often pick up the
liability through the federal Medicaid program. About one-third of total
Medicaid costs go to the disabled, who compose less than 15 percent of
those enrolled. And a disproportionate share of those resources go to a
relative handful of severely incapacitated individuals whose intensive
care costs hundreds of thousands of dollars a year.
"Their costs are so high that if left unchecked they will bankrupt
the country," Reeve said.
Personally, he said, he had sufficient resources not to need
Medicaid. But his voice bristling, he said, "You're mistaken if you
think" he could support costs of $400,000 a year "unless I find work."
Reeve has no memory of falling off his horse on Memorial Day
weekend at a riding exhibition in Culpeper, Va. He never has flashbacks
or nightmares. Unconscious for four days, he woke up to learn that he
was paralyzed and would need an operation to stabilize his head and
spine as soon as his lungs were clear of pneumonia.
He broke his first two cervical vertebrae, crushing his spinal cord
where it exits from his brain, in effect cutting off his body from his
mind. Earlier this century, he said, he would not have stood a chance of
living. Even five years ago, he probably would not have survived or
would have ended up in a nursing home, he said.
Only gradually did he become aware of what his family already knew:
In addition to the massive injuries, he didn't have enough insurance to
pay for his medical care. He needs nurses 24 hours a day, aides to lift
him in and out of his wheelchair and therapists to keep his body from
atrophying -- possibly forever, unless a cure is found.
"I'm going to go back to work," he said repeatedly. He hopes to
be able to take advantage of some directing offers next fall, and he
could command substantial fees for speaking around the country. His
agent said a widely circulated report that actor Robin Williams, a close
friend of Reeve, has offered to pay his medical expenses is untrue.
Since the accident, Reeve said, he has "experienced some very slow
recovery. I have increased sensation in my left leg and increased
movement in my shoulders."
He said that in early November he was not able to take one breath
without the ventilator, "but as recently as last week I was able to be
off the ventilator for 90 minutes, and I think that will increase."
Two weeks before Christmas, Reeve was discharged from the Kessler
Institute for Rehabilitation in New Jersey. But his health remains
precarious. He was rushed to Northern Westchester Medical Center two
weeks ago with autonomic dysreflexia, an erratic blood pressure
condition caused, in this case, by a urinary tract infection.
He still depends on the ventilator to breathe, and it occasionally
stops. "If there were a malfunction in the ventilator, I would not
survive unless there were somebody there."
His insurance company rules important aspects of his life. It
refused, for example, to let him leave the Kessler Rehabilitation
Hospital overnight to spend Thanksgiving with his family. But he
understands the companies better than most; his great-grandfather was
board chairman of the Prudential Insurance Company. "I remember him
saying they felt an obligation to their customers from the cradle to the
grave," he said.
Reeve appears absolutely confident that a cure will be found for
spinal cord injuries in 10 years. Researchers are working to regenerate
crushed nerves, possibly allowing victims to walk again. A $40
million-a-year government investment in research, Reeve said, could save
billions in Medicaid and Medicare costs.
It is the "proper humanitarian and economic thing to do. All people
in my situation are desperate not to be a burden to their families, to
government or to the insurance companies," he said.
