It’s a diagnosis nobody in grad school would ever expect.
Arijit Guha, who’s working on a doctorate at Arizona State, felt sick after coming back from a trip to India in early 2011. His severe stomach pain, which he thought was probably from a bug he caught on the journey, turned out to be caused by colon cancer. He was 30.
He’s had a bunch of operations and lots of chemo since his diagnosis in February 2011. Within a year, the cost of his care had passed $300,000, the lifetime limit of his university health insurance policy from Aetna.
The Washington Post’s Sarah Kliff told the story of how Guha has raised money for his care. The centerpiece is a website — Poop Strong — that is a takeoff on Lance Armstrong’s LiveStrong cancer project.
Guha has harnessed the Web to sell T-shirts and tote bags and to raffle off items donated by celebrities.
A friend told Guha once he was running “the world’s most important bake sale,” the Post reported. And some supporters have held bake sales to help him. “It sometimes feels like this weird joke, that I’m selling tee shirts to pay for chemotherapy.”
Last week, the power of social media helped Guha get results from Aetna. In a fascinating and often testy conversation on Twitter, Guha, tweeting as Poop_Strong, Aetna CEO Mark Bertolini and others went back and forth about lifetime limits on care, insurance industry profits and a solution for Guha’s shortfall in coverage.
Here’s are some highlights.
Poop Strong Meets Aetna CEO Online:
What would you do if you were sick with late-stage colon cancer and your insurance coverage was tapped out?
Washingtonpost
And here are some of the tweets that flew last week.
Poop_Strong
.@mtbert @nhojelttil @sean_dougall @AetnaHelp True or False?: I am in this situation because your company offers a crappy product.
Poop Strong
This comment advising Guha to look at the fine print on his policy didn’t go over very well.
mtbert
@Poop_Strong @aetnahelp False. Why do you think the premium was so low? Do u look at your policy limits when u buy other insurance (auto)?
Mark T. Bertolini
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mtbert
@ItsLerema @aetna We did not kick @poopstrong off his insurance. We are on the phone with him now to find a solution to his financial issue
Mark T. Bertolini
7 days ago
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Under the Accountable Care Act, lifetime caps will be prohibited.
mtbert@ponderbop @aemayo @poop_strong Fortunately that problem is going away with the ACA. The system doesn’t work. I really am trying to fix it.
Mark T. Bertolini
7 days ago
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mtbert
@sean_dougall @aemayo We are working to come up with a solution. We will f/u w/ @Poop_Strong. The system is broken. I’m trying to fix it.
Mark T. Bertolini
7 days ago
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Beyond Guha’s case, the debate also raged over the profits of health insurers.
AEMayo
@mtbert @poop_strong The one or two really sick people in your giant pool of healthy students is going to cost what in premiums per month?
Andrea Mayo
7 days ago
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mtbert
@AEMayo @poop_strong Unfortunately it’s not 1 or 2. Just 5% of the 19MM people we cover drive more than 50% of the $64B we spend on care.
Mark T. Bertolini
7 days ago
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AEMayo
@mtbert @poop_strong Yes, risk-pooling. We pay premiums now so that when we’re sick we get needed care. That’s a lot of healthy premium $.
Andrea Mayo
7 days ago
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mtbert
@AEMayo The $2B in earnings would cover health care for 11 days. Industry profits would provide ins. for 10% of the uninsured.
Mark T. Bertolini
7 days ago
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AEMayo
@AEMayo @mtbert @poop_strong With your $2 billion profits you could cover the costs Arijit had accrued since January 16,949 times
Andrea Mayo
7 days ago
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mtbert
@AEMayo Only 34% of our members drive 75% of our costs. Profits are 5% of revenue, not nearly enough to cover the uninsured.
Mark T. Bertolini
7 days ago
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mtbert
@nhojelttil @poop_strong @aetnahelp …and unfortunately the result will be higher premiums than the current policies. Premiums track cost.
Mark T. Bertolini
7 days ago
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More from Bertolini on Aetna and the changing landscape for health insurance after the Affordable Care Act.
Aetna: Insuring the Future?
CNBC
5 days ago
And on Twitter, we learn that Aetna will cover Guha’s care.
mtbert
@Chris_Ashworth @aetna I get it and own it. There is a lot to do to make it right. First things first, to solve Arijit’s problem.
Mark T. Bertolini
7 days ago
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Poop_Strong
Congrats, Twitter hordes! @Aetna just agreed to cover the full extent of my bills. Every last penny. Thanks, @mtbert, for listening.
Poop Strong
6 days ago
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Poop_Strong
Since I don’t need the money to cover my bills (thanks again, @mtbert!), all the money we’ve raised will now go to charity.
Poop Strong
6 days ago
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mtbert
@Poop_Strong I am glad we connected today and got this issue solved. I appreciate the dialog no matter how pointed. I’ve got it and own it!
Mark T. Bertolini
6 days ago
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mtbert
@AEMayo @Poop_Strong This chapter is another step in the journey. The system is broken, and I am committed to fixing it.
Mark T. Bertolini
Aetna shared a statement with Shots on the outcome:
“We were able to connect with Mr. Guha through our social media channels and heard his concerns. Although he reached the limits of his plan, Aetna care managers have continued to provide support and we have worked to develop a solution. As a result, we will be able to cover Mr. Guha’s medical costs through the end of the plan year. It’s important to note that the school’s health plan for next year has significantly higher plan maximums.
While we are pleased to have found a solution for Mr. Guha, we recognize that there is much more work to be done to fix the problems in our health care system. We are committed to reforms that make the system work better for everyone.”