Audio High-cost transplant rallies community (story audio) Photos Several benefits have been held for ElsieAnn Schlapkohl ElsieAnn Schlapkohl Joan Pratt of Lake Benton View full slideshow (4 images) Resources Minnesota Health Department Your Voice Join the conversation with other MPR listeners in the News Forum.

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High-cost transplant rallies community
by Mark Steil, Minnesota Public Radio
March 8, 2004

A sign in a downtown intersection announces the latest benefit for ElsieAnn Schlapkohl, 12, who needs a kidney transplant. (MPR Photo/Mark Steil)

It seems the higher medical costs rise, the more fundraisers there are for people who can't pay all their bills. Dinners, raffles and auctions are a few of the ways people donate money. Fundraisers used to be for people who didn't have insurance. Today, even those with insurance sometimes need help.

Lake Benton, Minn. — A large crowd at a benefit dinner in Lake Benton illustrates a couple of truths about life in the southwest corner of Minnesota -- small town people are generous, and medical care is expensive.

"Anyone that's had any health problems knows that insurance is not going to cover it all. It's insurmountable. Just go to the doctor and you find out in a hurry," says Lake Benton resident Joan Pratt.

	ElsieAnn Schlapkohl

Pratt is among some 500 people who turned out to support ElsieAnn Schlapkohl, 12, who needs a kidney transplant. This dinner is one of several events which have raised more than 15,000 dollars for Schlapkohl.

It seems everyone's helping. At a recent high school basketball game in Lake Benton, the visiting fans heard what was going on. Before they left the gym that night, the group from Dawson-Boyd collected $1,000 for the family. The young girl's mother, Caryl Schlapkohl, says the donated money is a godsend.

"The people in the community have been great," says Schlapkohl. "And it's not just our community. It's going to help tremendously and we love them all. And you know, it'll be fine."

The family has insurance, but it doesn't cover everything. The kidney transplant will cost more than $150,000. Schlapkohl says the family pays what it can toward the uncovered costs, and uses the donated funds for the rest.

"You are kind of surprised at what everything costs," says Schlapkohl. "But we really don't look at the amounts, because we know this has to be done. And we just work with the system."

	Caryl Schlapkohl

It's a system where the costs have become as amazing as the care. Kent Peterson of the state health department says many insured people are surprised at how much they have to pay in major medical cases. Peterson says the administrative side of medicine is intimidating. He says people have the right to challenge their medical bills.

"If there's any difference of opinion between the consumer and the health plan about whether something should be covered or not, the first place to go is to the appeal mechanism within the health plan," says Peterson.

He says all insurance plans must provide this recourse. If a person is not happy with the result of the first appeal, there's another step available.

"The state has set up a system whereby expert medical reviewers, not associated with the health plan, will look at both sides," says Peterson.

	Joan Pratt of Lake Benton

The state handles about 100 cases like this a year. The insurance company's position is overturned about one-third of the time. Peterson says the relatively small number of complaints means that overall, most people are satisfied with their insurance plans.

Count the Schlapkohls of Lake Benton among that group. They keep track of the bills, but are far more concerned with their daughter's medical progress. ElsieAnn Schlapkohl has a disease which scars the filters in her kidneys. It's the same illness pro basketball star Alonzo Mourning contracted. ElsieAnn says she was sick for a year before the disease was diagnosed.

"It scares me really bad, but after I get it all done it'll be all worth it," she says.

As if to prove she can handle it, the 7th grader lights up the room with a big smile when it's her turn to be photographed. Her brother will donate a kidney for the operation, which should take place in the next couple of months.

After that, the 12-year-old will take anti-rejection drugs for the rest of her life. They cost at least $2,000 a month, and it's unclear whether insurance will cover the bill. It's another unknown in a system where too often, the financial diagnosis is almost as painful as the medical one.

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