Asbestos victims feel betrayed: 'They ought to be ashamed'

By Carol Smith, Seattle Post-Intelligencer

Jerry and Edna Oikle sit motionless, side by side in their daughter's Kirkland home, conserving energy to breathe.

Edna, her grandmotherly face framed in silver curls, is tethered to an oxygen tank the size of a small oil drum.

Jerry, his head bald from chemotherapy, wears a paper mask to prevent his cancer-riddled body from succumbing to a respiratory infection.

This is not how they expected to spend their retirement.

Both suffer from illnesses triggered by asbestos from years of living in Libby, Mont., where W.R. Grace & Co. operated a vermiculite mine that spewed contaminated dust over an unsuspecting town for decades. Now they're concerned that Grace, which had promised to pay the medical expenses of those who got sick, may not pay for Edna's care.

Since January, the company administering Grace's medical plan has turned away at least 17 people who, according to their doctors, are suffering from asbestos disease. And the company is reviewing the records of those already receiving benefits to determine whether some may no longer be eligible to receive them.

The move to review, and possibly remove people already on the medical plan, has outraged community activists and doctors treating the nearly 1,200 people already diagnosed with asbestosis, lung cancer and mesothelioma.

"They ought to be ashamed of this," said Dr. Brad Black, the county health officer who runs the Center for Asbestos-Related Disease clinic in Libby. "It demonstrates a lack of concern and caring."

According to Health Network America, which administers the medical plan, no one who qualifies will be turned down.

The problem is figuring out who qualifies.

In January 2000, Grace agreed to pay the medical expenses for sickened Libby residents as a goodwill gesture after a Seattle Post-Intelligencer investigation reported hundred of people were dead or dying of asbestos-related diseases stemming from the company's operations.

Until recently, Grace allowed people into the plan based simply on a doctor's recommendation. Now, however, company officials are exercising their right to have an outside party review X-rays and make an independent determination of disease.

"There have been some issues in the reports supplied (to the health plan) versus the diagnoses, and we're informing people of that," said Alan Stringer, Grace's representative in Libby. "Our intent was to provide health services to people with valid and true asbestos-related disease, and we're still committed to that."

People who worked in the Libby mine or mill, were married to workers, or lived or worked within a 20-mile radius of the mill for at least 12 months prior to 2000 are eligible for the plan. Benefits include medical costs, prescriptions, in-home and hospice care for afflicted workers, but only for conditions specifically linked to asbestos exposure. The cost of caring for a patient with lung cancer can be hundreds of thousands of dollars.

The cost of caring for all those who will eventually get sick as a result of the Grace's now-defunct mining operation is staggering - by some estimates more than $100 million.

The vermiculite, which was milled into products ranging from insulation to garden additives, was shipped all over the country and is still lodged in millions of attics around the country. A year ago, Grace filed for Chapter 11 bankruptcy, a move that pushed the costs of cleaning up the town onto taxpayers, but left the medical plan intact.

Nationwide, companies liable for causing asbestos-related disease and the patients dying of it have been fighting for decades over the diagnosis of the disease. According to doctors who treat asbestos-related diseases, X-rays are unreliable as the main determinant of the extent of damage to the lungs. Company doctors, however, insist that without changes showing up in an X-ray, the patient isn't sick.

"Sometimes the most subtle and insignificant-looking changes on X-rays are the most compromising to the patient's breathing," said Black, a pediatrician who has handled hundred of asbestos-related cases in Libby.

"X-rays are hard to interpret and subject to variability," he said. Frequently, it takes multiple chest-film "readers" to make a final assessment. Dr. Alan Whitehouse, a Spokane physician who treats about 400 patients from Libby, is alarmed at the trend.

"I reread all the X-rays (of those who have been turned down) and every one of them is abnormal and shows asbestos-related changes," he said. "Denying those people is just ridiculous."

"Here's the nitty-gritty," said Dr. Stephen Kardos, chief executive officer of Health Network America. "If you lived in Libby - or anywhere in the world - and have normal physical findings (in your chest X-rays), then you aren't sick, and there's no reason for you to be in this kind of plan."

Sherry Cohenour, 47, of Columbia Falls, Mont., is one of the patients recently denied medical services under the plan. Cohenour, whose father worked at the mill, used to help him sweep the loading dock. Her father died of asbestos-related disease at the age of 50.

A few months ago, she started gasping for breath. Tests showed scarring in her lungs. Her doctor prescribed medication to help her breathe and told her to apply for the plan.

She found out a week ago that she'd been turned down.

"I was furious and then scared," she said. "We can't afford the doctor's bill."

Cohenour, who can no longer work as a housekeeper because of shortness of breath, has no other insurance.

"This is an issue of accountability," said Whitehouse. "Grace did it. They should be paying for it."

The Oikles feel fortunate that they have other private insurance, but between prescription costs and Medicare deductibles, they still spend nearly $1,000 a month on premiums and prescriptions.

Jerry Oikle, 77, worked in the mine in the early '50s, then moved his family back to Libby in 1966, where they lived until last year. Edna, 75, believes her only exposure was from washing her husband's clothes and living in a trailer court in the shadow of the mining operation.

"Libby's always dusty," she said between breaths of high-flow oxygen. "It used to blow right through the court. You'd wash your car and put it in the garage, and it would still be dusty the next morning."

For their daughter, Julie Randles, the worst part is watching asbestos rob her parents of even small gestures of affection. The couple, who met at the Sunshine Biscuit Co. in Spokane where Edna sacked candy and Jerry rolled out peanut brittle, have been married 55 years.

"They still want to take care of each other, and they can't," Randles said. "They can't even hold hands because of (concerns about) infection."

For now, the two are confined mainly to the house, their only outings to the hospital or doctor's office.

"We don't know where this is going to end," said Gayla Benefield, whose parents both died of asbestosis.

Benefield, who also has been diagnosed with asbestos-related disease, has fought for a quarter of a century to bring attention to the victims of asbestos in Libby. More than three dozen of her own extended family members are showing signs of disease. Her goal is to live long enough to see the clinic go out of business for lack of patients.

"But I don't think that's going to happen," she said. "Every year, a new batch of people gets sick."

Black, who runs the Libby clinic, has lived in the town of 12,000 for 25 years. He knows most of the patients he is now treating for asbestos-related disease and saw many of them as children.

"That's the painful part. Some of them are showing up at age 35 and 40 with this. Those are the tough ones, no question," he said.

"This exposure happened on my watch as the county health officer, so I want to make sure we take care of it right this time."

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