Sharon Williams, 58, overheard some concerning talk among the residents at the apartment complex where she lives with her mother.

Some of the residents at Homer G. Phillips Senior Apartments in St. Louis said they turned their heat off during the day because they didn’t want their utility bills getting too high. In the Midwest, where temperatures can quickly drop below freezing, this can be life-threatening for older people, who are much more susceptible to hypothermia.

Williams, who is the president of the residents association, reached out to a representative of Ameren, the power company serving St. Louis, whom she had met at a senior fair. She asked her to help the residents in her complex sign up for the Low Income Home Energy Assistance Program (LIHEAP), a federally funded initiative that provides eligible households with financial help for energy costs.

Williams explained that the residents were unlikely to have learned about the program on their own: “Most of them don’t have vehicles or use the internet regularly,” she said. Ameren agreed to send a representative with applications for the program. Williams set up a table in the lobby, brought a printer so people could print out their bills and assured the skeptics that it wasn’t a scam.

That event was three years ago, and it was such a success that Williams has kept it up ever since. She and her mom qualify for a small monthly subsidy, as well.

“It’s been a tremendous help because my mother has a lot of medications, and I have a lot of mobility issues,” she said.

Sandy Padgett, executive director of the Consumers Council of Missouri, a consumer advocacy nonprofit, wants more people to be aware that they can do something about the rising cost of utilities, which have outpaced inflation and wages in recent years.

She points out that many Missouri utility companies are again asking for rate increases: Ameren has asked for a 15% rate increase from the Missouri Public Service Commission; Missouri American Water is seeking a 41% increase for households, plus doubling their monthly customer charge; natural gas company Spire has proposed an 18% rate increase and a 20% increase in the monthly customer charge; the Metropolitan (St. Louis) Sewer District has begun initiating a 32% increase over the next four years; the St. Louis Water Division increased rates by 20% in July 2023 and by another 24% in January.

There’s always tension surrounding utilities, many of which have a monopoly on the services residents need to survive. But the Consumers Council fears the utility companies are heavily favored in Missouri, Padgett said.

“We are concerned about the amount of influence utilities may have on incoming Gov. Mike Kehoe, given the political donations he’s received from them,” she said. Kehoe has received about $600,000 in donations from utilities during his political career.

The council is pushing for better assistance programs for consumers, easier access to financial help, and transparency in the number and locations of disconnections.

Every state requires a public hearing before granting a rate hike. Showing up to testify at these hearings is one way to influence the decisions.

“That testimony is meaningful,” Padgett said. Unfortunately, she added, “some hearings only have a handful of people,” which doesn't reflect the scale of the affordability problem.

Ameren disconnected more than 16,000 Missouri households in September, and more than 17,000 in October. “That shows people are having trouble paying their bills,” Padgett said.

People experiencing financial hardship or surviving on limited incomes may try to ration heating or cooling in ways that could lead to hospitalization or even death, in extreme cases. Beyond poor health outcomes, access to utilities is tied to the ability to survive in many other ways. Those cut off from electricity cannot refrigerate food, for instance. If a home is excessively cold or hot, children cannot do their schoolwork.

Williams, who recognized the challenges facing residents in her building, took action to make sure they could access the assistance available. Utility companies ought to take a proactive approach in sending representatives to areas with high disconnection rates or delinquencies to make sure customers enroll -- and stay enrolled -- in programs that can help them.

Prioritize keeping vulnerable people warm during the winter over seeking even greater profits.

The shocking murder of UnitedHealthcare CEO Brian Thompson opened the floodgates of people sharing how health insurance companies’ denials have devastated their lives.

Most of us have heard stories of callous and capricious decisions by health insurance providers. I didn’t realize how common and cruel these denials can be until this past week.

I asked a Facebook group of moms if any of them could share a personal experience with a health insurance claim. I was taken aback by the outpouring of responses.

Ashley Berhorst, 43, of Wentzville, Missouri, was diagnosed with an aggressive form of breast cancer in February. She underwent 16 rounds of chemotherapy, followed by a tougher type of chemo known as the “red devil” for its often-vicious side effects.

UHC denied her a shot, Neulasta, that is commonly administered during chemo to protect from infection. Her oncologist was stunned. After all, a fever is a potentially deadly situation for a cancer patient with a port. After going back and forth between the doctor’s office and a peer-to-peer review board, UHC still denied the shot.

The next week, Berhorst ended up in the ER with a fever and low white blood cell count.

“It put me in a very vulnerable position that I shouldn’t have been put in,” she said. “They don’t care if I die. But my kids do. And my family does.”

UHC finally approved the shot after Berhorst's hospitalization. She survived that close call, but how many others aren’t so lucky?

Jennifer Grotpeter, 57, splits her time between Webster Groves, Missouri, and Lawrence, Kansas. While driving on the highway in May, her vision turned into a kaleidoscope. She made her way over to the shoulder, hitting the guardrail.

“It was terrifying,” she said.

Based on her symptoms, her doctor suggested she see a specialist for POTS, a blood circulation disorder. The specialist in St. Louis was not accepting new patients, so she found a POTS clinic at the University of Kansas Medical Center -- only to learn that Anthem Blue Cross Blue Shield would not cover treatment.

Grotpeter, who is retired, spent hours on the phone every day for a week with her insurance company. She waited on hold for hours at a time. Her doctor filled out all the necessary paperwork. She sent reams of faxes of her medical records. Of all the people she eventually spoke to on the phone, no two ever told her the same thing.

She asked one representative: “How do people who are not retired do this? Do you just let them be sick?”

When a representative told her to call back the next day, Grotpeter ran out of patience.

“I would rather let this condition kill me than ever call the number on the back of that card again,” she said. She switched to an insurance provider that cost her twice as much, but covered her care.

Her biggest issue with her POTS is low blood pressure, which can cause a medical emergency while driving.

“Maybe Anthem was trying to cure me by having their total s--- ‘customer service’ shoot my blood pressure through the roof,” she said sarcastically.

Laura Pogue, 42, of O’Fallon, Missouri, had a badly needed surgery in 2017 to repair a severe diastasis recti and an umbilical hernia. After giving birth, the fascia that encased her abdomen were shredded. Her abdominal muscles separated so far that she could feel her own intestines. It also caused terrible back pain.

After several meetings between her doctors and Blue Cross Blue Shield, her insurance provider said the surgeries would be covered. But after surgery, they denied the claims because of how the surgeon described the procedure in a report.

“It was not considered a complete repair of the hernia,” she said.

Pogue appealed the decision. It was denied. Her only option was to hire a lawyer, which she didn’t have the money to do. She fought the insurance company for a total of two years.

“Even when you do your homework and do all the things (they) tell you to do ... I jumped through all of their hoops, and I did everything right,” she said. She was still stuck with a $10,000 bill that took four years to pay off.

“So many people don’t realize this can happen to you,” she said.

These nightmare scenarios of near death and financial ruin should serve as a wakeup call for legislators, the insurance industry and all of us who put our health in their hands.

Tony Ramirez approached me 15 years ago at a journalism job fair after he had taken a buyout at The New York Times.

He had a blue-chip resume: He had also worked at the Los Angeles Times, The Wall Street Journal and Fortune magazine. He asked if the St. Louis Post-Dispatch was hiring, and I offered to pass along his resume.

At the time, I couldn’t fathom why he would consider moving to St. Louis. Now, I better understand the realities of job hunting in one’s 50s.

That was the only time we ever met in person. But that single interaction led to a friendship unlike any other I’ve had.

Tony was born in Manila and came to the United States as a young child for medical treatment for polio. He ended up studying at the University of California, Berkeley, focusing on political science and history, along with some Greek and Latin.

He was one of those people who had read, and seemingly understood, every important book. He was chronically online, and consumed all the news he could.

He sent me a couple of emails to follow up about a job at the Post-Dispatch. He would also email me in response to things I had tweeted, which struck me as odd. A mutual friend assured me that Tony was a strange bird, but harmless, kind and whip-smart.

We connected on Facebook, as well, keeping in touch through Tony's next couple of moves: a brief stint at the Las Vegas Review Journal, and then to Arizona to take care of his mom.

In the years when I did much of my work in the wee hours when most people were sleeping, Tony was usually awake. If I needed a quick edit on an essay, he was happy to do it. If I needed to rant about politics, he was there to commiserate. Back before our news site had a strict paywall, he would read my columns and offer edits after they had run.

He was direct -- and sometimes brusque -- in his comments. He was also witty and compassionate.

His Facebook feed was a firehose of information about politics, news and movies. He never shared stuff about his personal life with me, nor did he ask any personal questions. The closest he ever came to complimenting my writing was when I would discover he had shared one of my columns on his feed.

That he considered something I had written worthy of sharing was compliment enough.

In the olden days, I suppose we would have considered one another pen pals. But in this modern, digital age, we didn’t have to wait on letters or pen one-sided monologues. There was no small talk in our voluminous correspondence. Imagine having a brilliant and informed friend with whom you could discuss politics, art, writing, sports and more -- someone who shared your values and interests, yet never made a single demand on your time or attention. He sent a lot of messages to many friends, but I don’t think he ever expected a reply.

In an age when technology frequently divides and isolates us, it brought Tony and me together. There are limits to an online friendship, but there can also be a depth missing in casual face-to-face encounters.

In recent years, as my children got older and busier and I felt more settled in my career, Tony and I corresponded less frequently. We still occasionally commented on each other’s social media posts, and I read the mass messages he sent to a large group of people.

On Nov. 17, police found Tony dead in his home. He was 71. One of his best friends and a neighbor had called the police for a welfare check when he had been unusually quiet. Police said he likely died of a medical incident.

I found out several days later through an email from the journalism organization we both belonged to -- the same one that hosted the job fair where we'd met years ago. The group included a tribute to Tony in its weekly newsletter.

I wonder if he knew how much I valued his correspondence and friendship.

I hope he did.

When I told my son about Tony, and about his death, I said that I didn’t have another friendship quite like that one.

“You probably never will,” he said. The truth of that comment hit me.

I didn’t realize how rare it was until it was gone.