Fighting insurance companies can make you feel invisible. I have two benign brain tumors. One causes electric shock-like pain and seizures. CIGNA, my insurance provider, will not allow out-of- network treatment at a comprehensive epilepsy center. On April 1, CIGNA will increase my monthly rate from 366.75 to 753.47 with only two months notice. I do not have money for this rate hike and will eventually give up coverage. "That's just the way it is," a representative said without emotion when I asked them to reconsider. Your administration brings citizens' stories to the forefront. I also challenge you to make our stories the concern of policymakers and insurance providers.

Giant questions lay ahead for your administration and Congress as you reform the healthcare system. Will it restrict doctors from treating patients? How much will it cost? Something gets lost in the search for these answers--the Citizen Factor. Our compelling stories no longer ring in decision makers' ears; our faces fade into one another. Eventually, the healthcare problem becomes just that. Without the Citizen Factor, insurance providers and policymakers have no incentive to fight for a solution past the credible issues such as cost and government involvement.

I want them to know about a man from my brain tumor tele-support group with the deadliest form of brain cancer. Your healthcare plan gave him a renewed sense of hope. When he asked for healthcare assistance, he learned there was a two-year waiting list. I wept when he told the tele-support group that he did not expect to live long enough to receive the assistance he desperately needed. He voted for you knowing that it might be too late for him. Maybe change would come to others like him.

They should know my struggles. I work from my bed as freelance writer splitting the time between meeting client obligations and finding a way to get treatment. My days and nights find me trying to fight my symptoms or having my mother wheel me to the bathroom or the bed. I might have to work through some tears, but I do not miss a deadline, and I know I will emerge from this a better person.

My friend, a cancer survivor now struggling with lupus, recently read me poem. The poem--a play on the movie catchphrase, "I will be back"--defiantly tells her career, family and friends that she will return stronger than before.

Mr. President, insured, underinsured and uninsured citizens have to tell each other that when insurance providers will not own up to their end of the bargain, when employers refuse to make reasonable accommodations for the disabled, or while we are waiting for the creation of a nationwide high-risk insurance pool. The catchphrase, "I will be back," becomes more than the just a cliché. "I will be back," becomes a strong battle cry that keeps us going even when our bodies are weak.

Citizens must also understand insurance providers and policymakers' concerns. As a self-employed professional, I know the importance of the bottom line. Departmental overlap, wasteful spending, antiquated paper-filing systems and unnecessary claims contribute to bloated budgets and the overall erosion of the American economy. (Careless oversight led to my doctors failing to tell me that I had a second brain tumor.) I know that in their haste to reduce waste, insurance providers deny many worthy claims for treatment. CIGNA, my current provider, opts to pay to treat me from the symptomatic approach, but denies out of network treatment with a specialist that could completely rid me of my symptoms.

This financially irresponsible decision is commonplace. We need universal healthcare or at least a national high-risk insurance pool for people with pre-existing conditions. When others refer to universal healthcare as socialized medicine, they forget about people like us. They forget the Citizen Factor--hard working people who depend on having a fair healthcare system that works.

We deserve a seat at the table. I am confident our stories will be in your heart as you sit down to discuss the National Healthcare Plan. Please remind insurance providers and policymakers it is not impossible for both sides to consider every side of the argument and hold true to their concerns. I pray you will encourage them to listen to our stories, so we can have a seat at the table. Mr. President, I am willing to help in any way I can to get the National Healthcare Plan passed. I look forward to the day when we can all feel like giants again.

Sincerely,

Dawn S. Smith