Grace scaling back health benefits

By BRENT SHRUM Western News Reporter

Letters to members of W.R. Grace's medical plan implying a potential loss of benefits is sparking renewed interest in the creation of a locally managed medical trust for victims of asbestos-related disease.

The letters, mailed to an estimated 700 area residents enrolled in Grace's health plan for asbestos victims, were the focus of discussion at last Thursday's Community Advisory Group meeting.

According to Center for Asbestos-Related Disease outreach coordinator Tanis Hernandez, the letters came in two forms. One letter informed plan members that a review by medical experts indicated that they had no asbestos-related condition, but that they would be kept on the plan. The second letter acknowledged the presence of an asbestos-related "condition or illness" and provided a synopsis of what benefits are available. Benefits have been scaled back, including a reduction in the number of chest X-rays covered to one per year, Hernandez said.

Grace's medical experts continue to use guidelines developed for people exposed to chrysotile asbestos, which differs significantly from the amphibole asbestos found alongside the vermiculite formerly mined near Libby, said the CARD's Dr. Alan Whitehouse. Those guidelines draw a distinction between asbestosis, which is scarring of the lungs from asbestos fibers, and pleural plaquing on the outside of the lungs, which isn't considered a significant health risk for people exposed to chrysotile asbestos.

Amphibole asbestos affects the lungs differently, Whitehouse said. Most Libby asbestos patients suffer from pleural disease, which can progress rapidly and have major health impacts as the plaque encompasses the lung "like an orange rind" and restricts breathing, he said.

Grace's experts make their decisions based on X-rays alone, which don't tell the whole story, Whitehouse said. He called the letters telling patients they don't have asbestosis "nonsense."

"That's an attempt to minimize what you have," he said.

The distinction serves only as a tool to avoid paying benefits, Whitehouse said.

"The insurance company in this situation is using that to manipulate the situation and say you don't have much wrong with you," he said.

CARD medical director Dr. Brad Black said the clinic will be looking for new funding sources.

"The CARD's not going to go away, and one way or another we're going to take care of people," he said.

CARD board vice chairman LeRoy Thom called Grace's medical experts "prostitutes of industry" and urged the community to hold the company accountable. He said Grace should not be in charge of its own health plan and advocated the establishment of a medical trust fund run by the community.

The idea of a trust has been discussed before, Thom said.

"It's just never evolved into it happening," he said.

A trust could be placed under the auspices of the Asbestos-Related Health Care Project, which oversees the Libby Asbestos Medical Plan, Thom suggested. LAMP was funded by a $2.75 million court settlement between W.R. Grace and the Environmental Protection Agency over access to former mining and processing sites in the Libby area. The funds were earmarked to help pay for health care needs not covered by the Grace medical plan. Over the past three years, LAMP has paid out more than $330,000 in benefits, but the fund is limited and benefits are capped at $25,000, Thom said.

Black suggested that Thom head up a working group to start setting up a trust. Having a trust in place could serve as an incentive for future donations, he said.

"If there's a place for money to be sent, a trust, you don't know what might show up at the door," he said.

The CAG also agreed to write a letter to U.S. Sen. Max Baucus to express the community's concerns about the Grace health plan letter and seek congressional support. Baucus has already promised to attach a rider to legislation to help remedy the situation, said Lincoln County Commissioner Marianne Roose.