Friday, October 30, 2009

Cancer Care in America

Yesterday, I had to tell a woman that she has endometrial cancer (cancer of the uterus). That obviously is a very difficult condition to discuss. Once a patient hears the “CANCER” word, they often hear nothing else that you say. These patients take a lot of time and effort to explain the next step they need to take when they leave your office. The next step logically for a woman, if this were a moral country that cares for its citizens, is to get a second opinion or get an oncology consult and surgery very soon. But wait! This is the United States of America!  In the U.S., whether a cancer patient gets proper care depends upon a myriad of conditions, including whether she has health insurance, how much coverage she has, whether she has met her deductible, whether the oncologist is within her insurance network, etc. ad nauseaum.  This woman had no health insurance. Though she was a college graduate and had worked all of her life, her health insurance was cancelled along with her job almost a year ago. Though she has had abnormal bleeding for months, her biopsy to screen for endometrial cancer was delayed because of her lack of insurance.
So, one would think in a great country likes this, getting cancer care should be easy. It should be, but it is not. I gave her the women’s health Medicaid numbers to apply so we could refer her.  She later called me back:  It seems she doesn’t qualify for the women’s Breast and Cervical Cancer Program, because though she does have a reproductive cancer, and this cancer is centimeters away from her cervix, it is neither breast nor cervical so she doesn't qualify.  She was told that she needs to apply for a different program. I gave her the cancer state aid numbers and told her to call Legal Aid in Atlanta (ALAS) if they didn’t get her immediate assistance. But, how many overworked doctor’s offices have time to give patients social services assistance? How many Georgia women never receive proper treatment or have their treatment delayed because they don’t know where to find assistance with public benefits programs?
When I talked with an ALAS attorney about the above women: she told me this story of another woman we recently assisted. A woman was on Medicaid after her breast cancer diagnosis about two years ago. She had bilateral breast cancer and had a double mastectomy. After her chemo was finished, so was her Medicaid. She has recently found that her cancer has returned-this time in her brain. She called the Breast and Cervical Cancer Program back and was told that she no longer qualifies for assistance under that program, because she no longer has breasts. She could find no help until she called the ALAS.
Who is advocating for the women of Georgia? I hear these stories daily; denials of care because of insurance and stories of our public health departments that are not assisting our low income or uninsured women. Listen to the latest recording from today (check back later--blogger won't let me upload for some reason-here is what one woman said: "I have no insurance and I've been trying to get an appointment for a Pap Smear through the health dept. and I can't get anybody to answer or call me back and I'm already overdue for my Pap . . . ). Read some of the other stories I’ve written at, (particularly this one!) about how hard it is to get cancer preventative care in Georgia and please get involved. Please join us at the Rome library, 11/8/09 at 3 pm for a discussion about health care reform and the problems facing our low income or uninsured citizens.

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