An initiative of Allegheny County Controller Chelsa Wagner
An initiative of Allegheny County Controller Chelsa Wagner

Chelsa’s Story

Because I am encouraging all of our residents to speak up and tell your stories to give meaning to how we are all affected, I want to take a moment to share how I and my family have already been harmed:

Days after my second son was born in 2012 (just one month after I was sworn into my first term as Allegheny County Controller), my left eye had swollen to the point where I couldn’t open it. I was diagnosed with “periorbital cellulitus,” resulting in a four-day hospital stay.  Two months later, I suffered a reoccurrence requiring daily visits from a home-nurse over the Easter holiday. During the same period, my newborn was hospitalized for four days for an unknown virus, which appears to have been connected to mine. As I later learned, my primary care physician’s office had received the lab results during my first hospital stay, which indicated the virus was MRSA.  However, they never followed up with me, so I did not know to take the necessary precautions to prevent further harm. Both I and my son fully recovered, but that experience was my main impetus to embark on a dogged effort to find the best healthcare providers and routines so that I and my family would never unnecessarily suffer something like that again.

Over the last several years, my husband and I have measurably improved our own health, collectively losing almost 100 pounds, being more active, and teaching our children better habits.  We have been able to reverse many of the miscellaneous problems we have both encountered by prioritizing our health—from what we do and what we eat to identifying the network of care that best addressed our needs and concerns.  But after we finally reached a point where we achieved real synergies to improve our health, we have been rocked by massive disruption. Though we found practitioners who were able to treat our whole persons and to whom we weren’t simply a number, but who understood our needs and objectives, we have been forced to play a game of Russian roulette, choosing which among them are going to stay a part of our healthcare and which are not; severing ties to providers we spent years finding and establishing relationships with.   

For the past two years, we have tried different health plans and new doctors, experiencing the difficulty—and sometimes impossibility—of finding replacements for care we could no longer access.  However, just last year, we finally gave in and changed our insurance to UPMC so that I would not lose access to some of the providers who have been integral to my own health journey: specifically, my general practitioner and midwives for well-woman care.  This meant my husband lost his general practitioner so I could stay with mine. I lost my physical therapist, chiropractor, and dermatologist: all caregivers who have been integral to my wellness journey. Our relationships with these caregivers were personal. They were not commodities and not simply replaceable.  As our own health advocates, we have spent time and money to establish a level of care, now only to have it ripped away in the name of profit and spite.

We can no longer go to the pharmacy that has filled our prescriptions for years, and instead often pay double – that is if we can even access them. We often learn that medicines ordered for us or our children are not covered, incurring significant out-of-pocket expense. In the most recent instance, we could not get a prescription for my son unless we “chose” to pay $550.  This past year has cost us more than $3,500 extra out of pocket.

This collateral damage of the UPMC-Highmark battle—which UPMC calls “pro-consumer”—is contrary to any concept of “healthcare,” as the stress that it is causing families is antithetical to the very concept of health.

But here’s the worst part:  relatively speaking, my family and I are in good health.  Knock-on-wood, our problems do not hold a candle to the life-altering chronic or critical conditions many in our region face, conditions that are being exacerbated by this reign of terror.
Some of the stories that I have heard and those that have been shared here are truly unnerving and enraging.  Collectively, the impacts on all of us, be they large or small, represent a massive impact on our residents’ health and financial security.  Our residents are being denied dignity, justice and autonomy by institutions that we built and continue to fund.