Oh, the Humanity

In February 2011 I had health insurance.  I did not have a great, comprehensive plan because my employer did not offer benefits and I was no longer married.  What I had was an affordable, catastrophic health coverage policy because I was young and healthy.  And because a comprehensive plan was going to cost $375/month.

On February 28th, 2011, I went to the doctor for biopsy results and she told me I had cancer.  We talked about treatment and scans needed and I got the pink bag full of information.  Then the scheduler came in and told me that my insurance was not going to be helpful because it didn’t offer enough coverage and that I was better off dropping it, becoming uninsured and applying for one of the programs for cancer patients who need health care.  And she said to call their office when I had payment figured out so that they could schedule the scans and we could get started on treatment.  Oh and that I should hurry because my cancer was very fast-growing.

My boyfriend at the time and my ex-husband both offered to marry me that day if it meant I could get health care.  It would not have helped because it would not have covered a pre-existing condition.  That week I received a bill for almost $6,000 from the doctors’ office for the biopsies.  And I got a call from the lab that had analyzed the biopsies saying that my crappy insurance was not going to cover them and that I would be getting a bill for $11,000.  Luckily I have an uncle with financial means and he offered to pay the $6,000 for the MRI and BRCA gene testing so we could at least get moving on that while I was trying to figure out how to pay for surgeries and treatment.  That’s $23,000 before I ever had any treatment for cancer.

I was able to qualify for a charity program sponsored by Komen called The Bridge Breast Network.  The Bridge helps women with stages 0-2 cancer.  When I was first diagnosed we thought I had Stage II cancer so I met that requirement.  I made more money than would allow me to be in their program, though, so I took a pay cut so that I would qualify.  I had more scans, port placement surgery and  started neoadjuvant chemotherapy because I was inoperable at diagnosis.

After my fourth round of chemo (I had six total) my case worker called and said that I was running out of funds for their program and needed to find another option.  The only one available at that point was Medicaid.  Texas has a special fund for breast and cervical cancer patients so I set about researching if I could qualify for that.  I had to take another pay cut because our household income for a family of four could not exceed $44,000 (including child support) in order to qualify.  But if you have to choose between potentially life-saving treatments and financial security you choose treatment because all the money in the world does not matter if you are dead.  Plus I’d love for my children to grow up with their mother.

Fast-forward to today.  I’m slowly paying off my medical debt and still living on less than $44,000 a year so that I can stay on Medicaid. Although I think the limit is being raised to $47,000 for next year so maybe there’s room for a little more financial prosperity next year.

Unless you live under a rock you are probably aware of all the health care talk in the last few months with the issue of the Affordable Care Act.  I had decided before the market opened on October 1st that it would be in my best interest to hang back and see how it shakes out a bit before I try to change my situation.  As it is, I can stay on Medicaid as long as I’m in treatment for side effects or cancer and meet the financial requirements.

Medicaid has rejected many scans that my doctors would like me to have.  My medical oncologist told me to have a chest MRI every six months for the rest of my life because of my Stage IV recurrence and Medicaid will not cover another one unless I develop an overt symptom of metastasis (which would make it a little late in the game for swift treatment!).  But Medicaid is better than nothing.

Because if you have nothing doctors do not have to treat you.  Emergency rooms are required to treat emergent problems but doctors do not have to see you in their offices.  And why should they?  They have bills to pay just like the rest of us.  People say there is not an easy solution.  But I think that’s a bullshit copout.  There is a solution.

According to The World Health Report 2000, as reported by The New England Journal of Medicine, the US health care system ranks 37th in world.  We rank 36 for life expectancy.  39th in infant mortality.  43rd for adult female mortality and 42nd for adult male mortality.  Yet we spend the most money per capita on health care.  The countries that rank higher than we do and spend less include  Canada, Great Britain, Germany, Netherlands, Australia, New Zealand.  They all have socialized medicine.

People try to make this issue about politics.  Or about the Constitution.  Or about democracy.  But health care is not about those things.  It’s about humanity.  It’s easy to dehumanize this issue, just like it’s easy to dehumanize welfare in general, and make it about people not doing the right things to take care of themselves financially.  But so often it is not the sick or hungry people’s faults that they are sick or hungry.  It’s not that I didn’t plan enough.  I was being as responsible as I could have been, with my body and my finances.  And yet, I was in the position of needing welfare to get health care.  I am working to overcome the shame associated with my situation.  A shame I would not have if I lived in a place where health care was given to all.

I’m still taking that welfare to get my health care because I’m still a cancer patient.  I am not lazy.  I work as much as I can.  I am not out buying fancy clothes – I buy most of my clothes at the Thrift Store or go without new ones.  I drive a van that has almost 160,000 miles on it because I cannot afford a car payment and the van is paid off.  I can’t roll down the driver window anymore because it will not roll up.  I have never had less financial prosperity in my adult life than I have at this exact moment.  And it is directly a result of my cancer diagnosis and the hoops I have had to jump through to save my life.  I am not being dramatic.  This is reality for many of us.

The Affordable Care Act might help some people.  But even that won’t help cancer patients who want to get off Medicaid because Texas Oncology doesn’t take the insurance that’s offered through it and almost ALL of our providers in DFW are with Texas Oncology.  Insurers cannot turn you away, but doctors don’t have to take all of the insurance plans.  So I continue to be on the dole.  Just like many other Americans who’s kids go to your school, or who live next door to you.  I hope we can all work to see this issue clearly as an issue of humanity.  We can do a better job in our great country to take care of our sick and our hungry.  In the words of the late Nelson Mandela,  “It always seems impossible until it’s done.”

Photo credit to Stacie Albrecht

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