Burn survivors face enormous medical debts from the government
San Juan, Puerto Rico
Leaving Puerto Rico in January 2019 to study medicine in Mexico was the culmination of a lifelong dream for 23-year-old Alexis Hernández. For as long as he can remember, the young man from the coastal town of Camuy wanted to be a doctor.
“I have always felt called to serve others,” he said. “And medicine has a huge impact on people’s quality of life.”
Hernández arrived in Guadalajara, the ornate capital of the western state of Jalisco, to familiarize himself with the city and prepare for the academic year. Other students from the island lived in his building and also attended the university, so he quickly felt part of a community.
But hours before his first class began, Hernández nearly died in an explosion that left him with second- and third-degree burns 70% of his body, and a nearly $2 million medical debt that he said even left him wondering if he should have survived. Now, with the help of Puerto Rican lawmakers, he is campaigning to get his debt forgiven.
In his new apartment, after saying goodbye to his parents, Hernández turned on the kettle to take a shower. The heating system exploded, engulfing him and his apartment in a violent fire.
“The pain I felt was beyond words,” he wrote on his Facebook page, where he regularly posts about his recovery. “I don’t know how, but I said that everything would be fine (I wasn’t wrong). I wanted to turn that pain off, even if it cost me my life.”
Doctors managed to stabilize Hernández in a Mexican hospital and then transferred him to the US Army’s Institute for Surgical Research, a military facility in San Antonio, Texas that specializes in treating burn victims.
Hernández spent 20 days in a coma and about two months in intensive care. He then began the rehabilitation process to learn to live independently again.
“The burns were so painful I couldn’t walk, I couldn’t do anything. I had to relearn everything,” he told the Miami Herald.
Even his daily routine of showering and changing bandages was torture, he said. Some of his days at the facility were so busy with procedures, testing and therapy, he said, that he got up at 6 a.m. and went to bed at 2 a.m.
But Hernández was undeterred. He did not lose his eyesight, as doctors feared. He underwent 19 surgeries and learned to walk and eat again. Other young hospital burn victims who were further along in the rehabilitation process than he was kept his hope alive.
“In them I saw an example that I would be able to overcome this,” he said.
After about seven months, Hernández was released and returned to Puerto Rico. He had left the island in a healthy 20-year-old to pursue his passion and returned in frail health. Family and friends greeted him at the airport with Puerto Rican flags, placards, balloons and even live music.
“When I arrived, it seemed like all of Puerto Rico came,” he said. “I had fought so hard to get out of the hospital and to come home. It was beautiful to see them so happy and to share that with them.”
Hernández began receiving medical treatment on the island and settled into a new routine. But a surprise letter from the US government arrived at his home in Camuy, saying the cremation survivor owed the federal government over $1 million for his treatment.
Hernández contacted First Medical, his insurance company. The company responded that they had an analyst handling his case, he told the Herald.
“I called the insurance company in tears and asked for an answer because they didn’t say anything,” he said. “Then they gave me an appointment with the vice president, who was with a lawyer. He said they were sorry but they couldn’t pay the bill.”
First Medical denied him coverage on the grounds that the accident occurred in Mexico, Hernández said. Meanwhile, medical expenses incurred in Mexico were paid for by donations.
For the burn survivor, the experience was instructive about the complexities and challenges of America’s healthcare system.
“It is very sad to find yourself in an economic situation where you are wondering whether or not it is worth surviving. I feel so full of life, so hopeful, and this situation has been awful,” he said.
Hernández took to social media to speak up for himself and draw attention to his situation.
“Governor, what can be done in my case to stop insurance abuse?” he wrote in a post to then-Governor Wanda Vázquez last summer. “First Medical, the largest provider of healthcare services to government employees, led me to believe that they would foot the bill for the hospital.”
Some Washington officials have spoken out in his favour. Rep. Jenniffer González, the island’s sole representative in Congress, recently wrote to President Joe Biden after a CBS News report aired about Hernández’s plight.
“I respectfully ask that you apologize for the expenses incurred by Alexis in this horrific accident,” she said wrote.
Nydia Velázquez, the first Puerto Rican woman in Congress, wrote to Janet Yellen, Secretary of the Treasury, Ask the agency to review Hernández’s request for forgiveness of his debt.
In response to a June 2020 letter from González, an army official said that the Department of Justice was the “competent agency for resolution” due to the high debt. According to the response, the hospital made efforts to facilitate any information it could use to apply for debt relief.
The Defense Department and Treasury Department did not immediately respond to a request for comment. The insurance company declined to comment, citing patients’ privacy policies.
The debt, which totaled over $1.7 million as of June 2020, currently remains unresolved.
Hernández, now 25, said the emotional toll of his sky-high medical bills hampered his recovery. But despite his medical and economic woes, Hernández remains focused on healing, calling the date of the blast “his anniversary of his life.”
“I was born again,” he said, “and that’s why I decided to celebrate this day. I’ll always.”
He visits several specialist doctors and participates in physical therapy several times a week. He has prosthetic hands for his fingers. In September, Hernández was able to re-tie his shoes, which he described as “passing another test.”
“His positivism, his belief in God moves me,” said Idalysa Morales, a physical therapist who has worked with Hernández since September 2019. “I feel like I’m working with a miracle from God.”
Since they worked together, his improvement has been “significant,” she said. He can sit up straight without falling backwards and has become more independent at home. He can walk longer distances and has better balance and coordination. Sometimes grieving over his debts can affect his concentration.
One day the former medical student hopes to go back to school and study medicine.
“I can now see the pain patients feel, the problems they face every day, being in a bed, being dependent on others,” he said. “It gives me more tools to be a better doctor.”
This story was originally published April 16, 2021 7:30 am.