1997Commentary

Crushed under the bottom line

By: 
Eileen McNamara
May 29, 1996
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Lisa Sampson has to skip her therapy session today. She isn't feeling suicidal enough to satisfy her insurance company.

Lisa is the 31-year-old widow of Daniel Sampson, the Whitman man who police say was mowed down by a repeat drunk driver last December as he walked his dog a block from home.

While Leah Crounse waits in Framingham State Prison for her manslaughter trial to begin next month, Lisa Sampson waits in Whitman for her life to begin again.

The Department of Correction is making the wait a whole lot easier for Crounse than Harvard Pilgrim Health Care is making it for Sampson.

It took only eight counseling sessions for Lisa to exhaust her policy's mental health coverage and the compassion of the insurance giant created last year by the merger of two of Massachusetts' largest HMOs.

Unless she can demonstrate that she is poised either to kill herself or to check into a psychiatric hospital, bean counters at Harvard Pilgrim told Lisa Sampson, she should consider that little depression of hers lifted.

"I'm not trying to find my inner child or anything; I'm just trying to cope with what happened," says Lisa, who appealed to her insurer to extend her counseling benefits at least through the trial, which begins June 27. "Why do they make you fight so hard when you are already so beaten down?"

It is not as though the paper pushers at Harvard Pilgrim are unaware of what sent Lisa into therapy -- more than one told her that they'd read all about her tragedy in the newspapers.

It's just a bottom line thing.

Massachusetts law mandates that HMOs provide a minimum of $500 in mental health coverage to subscribers but, more often than not, that minimum is the maximum a subscriber can get.

It is simply discriminatory for insurers to treat depression differently from diabetes. The US Senate acknowledged as much this month when it voted unanimously to mandate equivalent coverage for mental and physical illness.

However, that provision is unlikely to survive the scrutiny of the US House, where a less enlightened view more accurately reflects this nation's ambivalence about psychological problems.

On the one hand, the culture revels in the psychobabble of the confessional TV talk show; on the other, it embraces self-reliance as a national ideal.

Well, they don't come more self-reliant than Lisa Sampson. A seamstress since adolescence, she opened her first bridal shop in Dorchester at age 21. A year later, she moved to a larger store in Braintree, where she expanded twice in the next decade as her reputation and her business grew.

It all came crashing down Dec. 3 when a 1992 white Buick Century bounced off a utility pole and slammed into Lisa Sampson's husband of three months. Daniel Sampson, 37 and the father of two young sons from a previous marriage, was dead at the scene, 100 yards from his front door.

Lisa went from newlywed to widow in the blink of an eye. The 57-year-old woman charged is facing her third count of driving under the influence of alcohol. It was only 10:30 in the morning when, police say, she killed Danny Sampson. Her license had been revoked. The car she was driving was unregistered. She was still on probation for her last drunken-driving offense.

"It isn't just the loss," says Rick Savignano, the prosecutor who will try the case in Brockton Superior Court. "These are decent, hard-working people who have never been exposed to the system, whether it is the insurance company or the courts, that can be so frustrating. It must be very hard."

Hard enough that Lisa reluctantly closed her shop last January, selling off most of her inventory to competitors, sending the rest to Goodwill. "Dealing with all those brides, so happy and everything, I just couldn't handle it," she says.

She has tried to move, but finding a landlord willing to take Chelsea, the large brown Chow who escaped injury in the crash, takes more energy than she has just now.

It is hard to remain in the apartment she and Danny called home for so brief a time, but most days she can pass the spot where the Buick struck without tears. She places fresh flowers there every week.

"I feel like I'm living in a nightmare that won't end," she says. "Some days when I see how much I have to fight, I think about Leah Crounse. She probably has a better life in jail."

In jail, Leah Crounse gets her counseling at public expense.

Commentary 1997