Cancer: A Death Sentence if You're Poor

Elizabeth Edwards was lucky.  She and her husband can afford the best health care. 

I was diagnosed with breast cancer December 14, 2004. The cancer was Stage 1 DCIS, but there were 2 sites on my left breast, one at about 5 o’clock and one at about 10 o’clock, so it was decided that I should have a modified radical mastectomy. (In the workups my doctor did before surgery, it was discovered that I have a natural narrowing in one of the blood vessels leading to my heart.) But, the job I had just started said they’d hold my position open for me till I recovered from surgery.

I had the mastectomy on Jan 3, 2005. Less than a week after the drains were removed, I had to have emergency surgery to remove my gall bladder. My workplace then said they “didn’t feel comfortable” with holding my job open any longer, so they let me go. At the end of January, the COBRA I had from a previous job ran out. So, there I was with the “launch window” to commence chemo closing and no insurance to pay for it. Thank God for “Project Access”, a program for low-income people who need medical help. They got an oncologist to agree to treat me for free till I could get on Medicaid. Also, one of the coordinators I had spoken to suggested I apply for temporary disability with Social Security. It was on the basis of disability that I got on Medicaid.

During all this, I kept telling myself, “Just get through this, and you can get reconstructive surgery.” This would include reconstruction of my left breast and, since I have very large breasts, a reduction of the right one. After all, it was my understanding that practically all insurances approve this surgery since it impacts a woman’s emotional and mental health. I made an appointment with a reconstructive surgeon, and was scheduled for surgery on her first available date -- May 9, 2006.

In January, 2006, I got a letter saying that my Medicaid was approved through January 2007. Then, in March, I got another letter saying that, since I hadn’t completed and returned their eligibility renewal form, I was being cut off. I had never received the form, and called to tell them so. I got another form and returned it completed. In April, they told me I was being cut off because I wasn’t disabled and never was; Medicaid had been granted in error. In fact, I should consider myself lucky if they didn’t bill me to recoup the money that had been paid on my behalf. I asked for a “fair hearing” to dispute the decision. (When a fair hearing is requested, no action is taken till the hearing has been held.)

On May 8, I called the hospital to see when I needed to report the next day. They suggested I call my reconstructive surgeon’s office. I was told by the receptionist that the surgery had been cancelled since I had no insurance. That was how I found out that my Medicaid had been cancelled. To this day, I have heard nothing regarding the requested fair hearing, except that I have not been covered since May of 2006.

I applied for Washington state’s Basic Health program. (I should mention that my husband and I are supporting his 3 adult children, only one of whom contributes to the household financially.) Since we don’t have any legal dependants, only actual ones, they want to charge me $140 a month premium plus $15 co-pays for office visits and meds. Plus more if the hospital enters the picture. My disabled husband makes $1104 a month SSD, and I work for ($7.63) minimum wage, 20 hours a week. (The eldest child gives us $300 a month for her room and board.) There is no way we can afford to insure me.

So, I feel betrayed by the system all the way around. Until recently, I was looking for a new job (Thank goodness, I found one.  It's temporary, so no insurance.) Most employers see on my resume that I didn’t work between 12/29/04 (I had an angiogram and couldn’t work the next day) and 12/12/06. They don’t seem to care why, they just aren’t interested in hiring me. My present employer would love to hire me permanently, but they are under-funded and can’t afford me. The two bras I got while covered by Medicaid are wearing out, and I can’t afford to replace them. I have tried to remain positive throughout all this, but it’s getting harder all the time.

When one is looking death in the face, the last thing one should have to think of is how to pay for the necessary treatments.  There are a lot of people coming down on the Edwardses because they decided to keep on with their lives after the cancer recurred.  At least they had the choice; those of us on the other end of the  income spectrum have none.  Plus, "keeping on with life" probably won't include going to a doctor for treatment until it's too late.  Poor people are MUCH more likely to die of preventable conditions.