Politics, Healthcare and your life

There are over 10,000 children diagnosed with cancer ever year. In 2004, 64,800 young adults, 15 to 39 years old, were diagnosed with cancer.

You know these people and you know me.  I’m the Mom you see at daycare drop off or at the PTA meeting. The kid you know from church on Sunday.  I’m the woman that works with you or your son’s soccer coach. I am just like everyone else. I am also a breast cancer survivor diagnosed at age 38. I had no family history. I had only had one mammogram, because I was 38.

I had lots of treatments. Two surgeries, 12 rounds of chemotherapy, 35 doses of radiation, physical therapy and more vials of blood than I care to remember. I have health insurance and I believe that I am alive because of it.

Like many of you I have been watching the coverage of the Presidential candidates. While I pay close attention to the health care proposals because of what I’ve gone through, I know they resonate just as strongly with others as well.  If you’re diabetic or have lupus, MS or asthma I know, or at least hope you’re listening.

I am fortunate to be insured through my workplace. I don’t personally write a check for my coverage but I was interested in what a $5,000 tax credit would buy. I had heard the horror stories but never checked it out for myself. I called some insurance companies today to get an estimate of what it would cost me to purchase individual health insurance.

Of four companies, three would treat the breast cancer as a pre-existing condition. No coverage for any services related to the breast cancer. No coverage for follow up appointments, annual PET scans ($3,000), no Femara ($381 per month for 5 years).

I found one company that offers a guarantee issue insurance.  The rates?  The least expensive plan that would cover me with a $5,000 deductible and a 50% copay would cost $1,400 per month. That’s the bargain plan.  The high end coverage with a $250 deductible and 100% copay would cost just over $4,000 per month.  I expect to live a long time and rates will increase as I age.

One plan is selling a $5,000 refundable tax credit.  But that would not touch the price of insurance and here is the really terrifying part.  If I were out shopping in the market for health insurance at 38 years old and healthy, I wouldn’t look for a policy with good cancer coverage. Cheap prescriptions maybe or maternity coverage but not cancer. Cancer doesn’t  happen to us. I’d be looking for a rate I could pay for and still pay off student loans and make car payments.  The only reason I have good coverage is because it is through my employer and is designed to cover everyone, young and old, healthy and the not so healthy.

If this is something that is important to you or to someone you love, I urge you to take the time to understand the plans that are being proposed.  It is more complex than a sound bite or a slogan can address. It may well be a matter of life or death.

Information about  both plans at  Dallas NewsHealth Affairs,

Barack Obama.com,   John McCain.com Kaiser Family Foundation Health08

(If you want the names of the insurance companies referenced e-mail me at aftercancer@yahoo.com)

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Zometa and me

So yesterday was my appointment with my oncologist to discuss using Zometa. As I have mentioned before I have problems sleeping and wouldn’t you know  Sunday night was an awful one.  Why am I explaining this?  So that you will have pity during the rest of this post.

In my planner I had a 2:15 appointment.  At my office dealing with an issue it was 2:05, 2:06, and I excused myself from the conversation, called and was informed that the appointment wasn’t until 2:45, yippee!

So I waited in the waiting room for a little while reading that Clay Aiken is gay (no I swear, it’s true) and listening to the waterfall.  The soothing, calming, drowsiness inducing waterfall as I begin to feel sleepy…sleepy. I’m called back by my name being called.  I walk back, get up on the scale, and get blood drawn.

“Wait, I’m just here to talk to my doc, I don’t have treatment” too late, blood is drawn.  Back to the exam room, “Okay, just take off your top and the doctor will be in to see you soon”.  You know those exam tables can be pretty comfortable.

So Doc arrives and I explain why I’m here.  He agrees that Zometa looks very promising and they are excited about the results it shown in women with metastatic disease. There are a few negatives;

  1. Insurance will most likely not cover it as it is not indicated as standard treatment unless metastatic disease has started.
  2. We don’t know the long term issues that it could cause.  At this point they have only been giving it to women with metastatic disease and that hasn’t been five years yet.
  3. We don’t know how long we should give it to you.  With metastatic cancer they keep giving it to the patient for as long as it works.
  4. Apparently is you use this your bones, particularly your jaw, get so hard that if you have oral surgery it can shatter.

So here’s the plan.  My doctor is going to investigate the studies in more depth to see if he can find guidance. His nurse is going to contact their Zometa drug rep to see if they have any information about insurance coverage and if there are any clinical trials pending. I am supposed to contact my insurance company about getting a “case manager” back in place.

So there’s the plan.  Had I not been so sleepy I probably wouldn’t have had blood work although I would probably need some before making any change anyway.  In my opinion this is how my team is supposed to work, a doctor who listens, a conversation about the options and a follow up plan.  I can’t ask for much more than that.

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Know about the hospital you are using

The US Department for Health and Human Services (HHS) has a Hospital Compare website that is designed to make it easier for patients and their families to find out how conditions vary among hospitals.

In the area that I and I know many others live there is really only one hospital that is in a reasonable distance from their home or is covered by their insurance for day to day issues.  However, if you need significant treatment or surgery the drive may be worth it.  Hopefully this tool will help you make informed choices.

http://www.hospitalcompare.hhs.gov

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Femara samples

My doctor has given me some Femara “samples” the samples are regular one month bottles. I have great insurance and feel uncomfortable keeping these when I know there are cancer sisters without insurance who struggle to pay. I’m posting here to see if anyone who is struggling with paying for these can use them.  Contact me via comments if interested and please feel free to forward this.