Utah woman lives without portion of skull for months as insurance snags

Hooray for American health care…

One morning in January, the 22-year-old woke up in the hospital with her long hair pulled up on one side into a ponytail. On the other, she was bald, with only skin and sutures covering an area where nearly half her skull had been removed. She stayed that way for almost four months, a dent in her head showing where her skull had been taken out to save her life following a car accident.

After Lane was released from hospital in February, her skull remained in a hospital freezer while paperwork changed hands between the hospital and Medicaid to determine who’d pay for the surgery to make Lane whole again.

“When you think of weird things happening to people you don’t think of that,” said the former waitress. “It’s like taking out someone’s heart – you need that!”

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Waking up in the morning, she would notice how her brain had shifted during the night to one side. She was given a plastic street hockey helmet to wear during the day for protection.

“You’d think they could give me something better protective,” said Lane. “Like a skull, perhaps.”

Lane blames the delay in her surgery to bureaucratic red tape between the University of Utah Health Sciences Center and Medicaid. Without funds to pay for the surgery herself, a frustrated and unemployed Lane eventually contacted a local television station, a move which she believes hastened the surgery.

“All of a sudden – top of the list!” she said.

But, she said, an uninsured, low-income patient in Lane’s situation must wait for a Medicaid disability ruling to come through, a process that takes 90 days from the time of the initial discharge from hospital. Alternately, the physician could expedite surgery by considering it an emergency and signing a certificate of need, but the patient would still be responsible for payment. The hospital did not initially consider the second surgery an emergency, Brillinger said.

Medicaid refused to pay after it was decided Lane did not meet the insurance program’s disability requirements, said Robert Knudson, Utah Department of Health’s director of eligibility services.