Coping With High Costs of Severe Injury

A horseback riding accident last year left actor Christopher Reeve a quadriplegic needing $400,000 a year in health-care costs to survive and rehabilitate.

But Reeve’s insurance policy has a lifetime cap of $1.2 million, typical of many policies for catastrophic injuries. The actor is now lobbying for a bill in Congress that would ban insurance companies from setting lifetime caps at less than $10 million.

Business groups, however, say a lower cap is regrettable but necessary in order to keep the price of insurance policies at a reasonable level.

Should catastrophic insurance policies be restricted from having lifetime caps of less than $10 million?

Anne McLean, founder of Project Headway in Northridge:

“When the insurance is finished, these people just have to be sent somewhere. They have no more money; they are either sent home or to a group like Project Headway. They get their Social Security and they cannot afford anything else . . . They have a very low quality of life. They have something like $614 to support them. After that these people have nothing. . . . We don’t have room in Project Headway and we don’t have enough funding.”

Kirk Kilgour, Van Nuys, former U.S. Olympic volleyball player and quadriplegic:

“The costs of catastrophic injuries are so high you almost can’t put a limit on it. [Reeve] is a real good story for the disabled because people don’t realize the costs . . . If he’s going to run into problems, the average person is going to run into problems too . . . . . . It’s cheaper to have better medical care--especially acute care--in the early stages than down the road . . . The better the medical care, the healthier it is for you, because you’re not always going back to the hospital.”

Richard Coorsh, spokesman for the Health Insurance Assn. of America

“Additional costs for any type of coverage are always passed on . . . [the legislation] affects us and it affects our customers . . . I certainly feel for Christopher Reeve. Obviously, he’s in a very difficult situation as with anybody faced with going against their cap . . . [But] it really is an issue of concern for the employment community. They and their employees would have to pay any increase.”

Norma Vescovo, executive director of the Independent Living Center of Southern California in Van Nuys.

“As a rule, with someone entering a hospital with a catastrophic injury . . . it’s going to cost anywhere from one to two million [dollars] just from the initial period in the hospital . . . When we were fighting for helmet requirements, we were finding that 99% of the people with head injuries were going over their insurance and going on MediCal. We were pushing so hard, not just for their sake but for the taxpayers . . . Most people end up leaving the hospital early, before they should. They don’t get the therapy they need. In the end, it costs everyone.”

David Langness, vice president, Health Care Assn. of Southern California:

“Insurance companies absolutely have to set some kind of lifetime cap. It’s conceivable one case could bankrupt the entire company. On the other hand, as Christopher Reeve found out, a million dollars doesn’t go very far . . . It’s time, we think, to begin thinking about raising the catastrophic insurance caps.”