Friday, December 21, 2007

American Cancer Society Report: People with Inadequate Health Insurance are More Likely to Die

An article on WebMD tells a not unexpected, but still deplorable, story:

Cancer patients without adequate health insurance tend to face grimmer odds than those with good health insurance, says an American Cancer Society report. The American Cancer Society based its report on information from the CDC and from the National Cancer Data Base.

The report shows that people with no health insurance or inadequate health insurance face four main challenges when it comes to cancer:

  • They're less likely to get screened for cancer.
  • They're less likely to get counseled about cancer prevention.
  • They're more likely to get diagnosed late, when their cancer is harder to treat.
  • They're more likely to die from cancer than people with adequate health insurance.
Health insurance isn't the only gap in cancer care. Racial and ethnic disparities also affect cancer outcomes.

Ever since I developed a chronic pain condition, and like too many other pain patients, wandered from specialist to specialist, from one health care system to another, from western to alternative treatments, I have been aware that my white, English speaking, educated, middle class, married, insured status served me well.

I was always taken seriously. No one ever intimated that my pain was not real, even though no cause was ever ascertained. With medium effort, I got referrals to specialists outside my provider network. My phone calls to my care team were returned.

My status ticket got me a seat on most every train I wanted to ride. Even though I knew the system was slanted in my favor and that others were disadvantaged, I took my advantage. I was sick, I was in wretched pain every day, and I was willing to do anything to make it stop. Even during my worst periods, I was aware of this unfairness -- and felt guilty and lucky.

Richard, my husband, also played the privilege card, many times - always for my benefit. And I counted on him to play it well, especially when I wanted insurance approval for seeing a pain specialist at Johns Hopkins or when our mail-order drug vendor was taking too long in delivering my medications.

We talked about everything else, but we never talked about this. I think we were both focused on survival and couldn't afford to let ethics dampen our efforts and our access to resources we both knew others weren't getting. Shame would come later - when I began to climb out of the pain pit.

Now I work with hospital systems that are trying to make a difference, trying to bring health care to all members of their community. Are my efforts helping to make things more equitable? Barely - one mini-micro drop of water on a parched landscape. I still feel guilty and lucky - but I have to do something.


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