"Too bad we can't afford to treat your leukemia"

[FourScore]

Daily Kos
"Too bad we can't afford to treat your leukemia"
by david78209
Sun Nov 14, 2010 at 12:05:54 PM PST

It's hard enough to tell a patient he or she has cancer. It's worse telling someone they have cancer that we can't cure. But telling someone she has a leukemia that responds well to treatment, but we may not be able to arrange for that treatment, is the hardest thing I ever remember having to tell a patient.

About six weeks ago a thirty-something mother of young children turned up with unsuspected leukemia. I work with a drug research institute, and we were screening her for a study of a new medicine's effect on back pain. Part of the screening of volunteers for the study is blood work, and this lady's blood count showed the leukemia. We repeated the lab test, just to be sure, and then I picked the mind of an oncologist friend who treats leukemia. He told me that what she has responds well to treatment, but the treatment is quite expensive.

When the confirming lab tests were back, I spoke to the lady. She doesn't have health insurance. We had already phoned around looking for a way to get her seen promptly either at the charity clinic at the medical school or by a private doctor who'd see her on Medicaid. When I spoke to her, all we could offer was a letter, copies of her lab tests, and an address where she could apply for Medicaid. A few days later, I thought we'd gotten things arranged well enough that a doctor would see her on a "Medicaid pending" basis.

Last week I learned that was wrong. In fact, when she went to apply she apparently was told by some clerk that she needed more papers of some sort. The clerk also apparently made some derisive reference to "the doctor who said you have leukemia." I suspect the clerk was looking for an excuse to ignore the letter and copies of lab work the lady had brought with her.

Friday I prepared a letter for the lady to send to a US Senator and her state Senator. I usually try to get a patient's Representative in the US House involved in such matters, but this lady's current representative just lost his re-election race so his office was unlikely to be doing much constituent service. (So did her state representative; fortunately her state Senator was re-elected.) I also wrote a letter to the state and US Senators to go with her letter. After introducing her, the text of my letters was:

(This lady) needs to get started on chemotherapy, SOON. Apparently she needs to qualify for Medicaid and Social Security disability before treatment can start.

It is no exaggeration to say that this is a matter of life and death for this young mother.

Had I failed to refer her to an oncologist promptly for these lab findings, I would very likely have committed malpractice. For her treatment to be further delayed by red tape would be just as reprehensible.

It's hard enough to tell a patient he or she has cancer. It's worse telling someone they have cancer that we can't cure. But telling Mrs. (---) she has a leukemia that responds well to treatment, but we may not be able to arrange for that treatment, is the hardest thing I ever remember having to tell a patient. If that happens again, I'll think hard about moving to someplace that has a more humane health care system.

It doesn't make me optimistic that Texas legislators are talking about having the state withdraw from the Medicaid program. Hell, our newly re-elected Governor talked about secession during the campaign. (I hope he wasn't serious; as I recall, the last attempt at secession led to the Civil War.) But it would be perfectly constitutional and legal for a state to withdraw from Medicaid.
http://www.nytimes.com/2010/11/07/us/politics/07ttmedicaid.html?_r=1

If anyone doubts that eliminating Medicaid would lead to unnecessary deaths, I now can give them the name of a young mother who would be an odds-on bet to suffer one of those preventable deaths.

http://www.dailykos.com/story/2010/11/14/920535/-Too-bad-we-cant-afford-to-treat-your-leukemia

[gateley]

1. God Bless America. nt

[GreenPartyVoter]

2. Damn. I hate the stupidity of this country so much sometimes. :^(

[alphafemale]

3. Sounds like a "death panel"

[JVS]

4. Obviously it is imperative to retain our unique American system.

[Greyhound]

27. +01

[Recursion]

5. It's harder and harder to find providers who take Medicaid

Even when it's not "pending".

Extending Medicaid (which is ultimately what any state-run public option without a dedicated revenue stream would become) would only make that worse.

Why is the treatment so expensive that doctors shy away from providing it without cash on the table? That's what I would be looking at...

[somone]

6. Pure evil

[Recursion]

7. On whose part?

That's the problem with broken systems; everybody on an individual level is behaving in a way that's hard to fault.

[RaleighNCDUer]

8. YOUR part, if you refuse to support single-payer.

If this country had a civilized system, this would NEVER happen.

Medicaid is what people turn to when the system fails. The question is, where do we turn when Medicaid fails? Collecting spare change at Quik Stops?

We are a fucking third world country.

[readmoreoften]

9. +1

[somone]

10. Yes. Single-payer is the way to go!

Even freakin' places like Taiwan have a universal single-payer system where every citizen can get medical care anywhere at minimal out-of-pocket costs.

[AlienGirl]

13. We are a third-wold country. We have to keep repeating that until we make it not true anymore. nt

[valerief]

25. We are the United States of Tijuana. Oh, wait. Doesn't Mexico have a better healthcare system than

us?

[Recursion]

30. Depends on what you mean by "better"

I'd rather have a stroke in the US; I'd rather have impetigo in Mexico. Well, really I'd rather have neither in either place, but you get my point.

Mexico actually provides less of its health care through public financing than even the US does, and there are some serious quality- and availability-of-service problems for the poor and those in rural areas.

Their delivery costs are very low compared to the US, though.

[Recursion]

15. Medicaid *is* single payer

You know that, right?

Medicaid is essentially the system Canada has, only it's open to everyone on a graduated-premium basis.

But here, it's driving doctors who take it into bankruptcy, which is why it's hard to find a doctor who will take it.

[RaleighNCDUer]

41. No, it isn't. It is a government run program with some aspects of single-payer,

but the simple fact is it exists within a much larger framework of a for-profit healthcare system.

If Medicare was all there was, THAT would be single-payer - a government run, tax supported healthcare delivery system accessible to all at minimum cost. Doctors would never have to worry about malpractice insurance, or malpractice suits, because any such suits would be suits against the government, not them. Their only worry would be if the suit ruled against them they'd have to actually leave the profession - unlike now, where they let the insurance pay off the victim and continue their malpractice. Any idea what doctors no longer paying malpractice insurance would save the patients? Any idea what eliminating incompetent doctors would save the patients? And that is just one small aspect of a single-payer system.

Single-payer is not one option of many available - either you have it, or you don't.

[Deep13]

35. +1

[SammyWinstonJack]

36. Probably would have access too treatment in a third world country

We're a cruel/self-absorbed country.

[area51]

11. +1

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, bankrupts and kills people.

Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"We will never have real reform until people's health stops being treated as a financial opportunity for corporations."

"Any proposal that sticks with our current dependence on for-profit private insurers ... will not be sustainable. And the new law will not get us to universal coverage ...." -- T.R. Reid, The Healing of America

[dkf]

12. The travesty is how expensive the chemo is.

Maybe the company can give a discount?

[Recursion]

16. +1

[grace0418]

21. Well, that's not the only problem when it comes to leukemia. When my mother-in-law

had it two years ago, her chemo wasn't the out-patient, two hours once a week that you see with other cancer treatments. She spent weeks at a time in the hospital, often in isolation. The first 5 days she was getting a constant dose of chemo. Not two hours, constant, for 5 days. Then she spent another week to two weeks recovering, sometimes delirious with fever, with nurses constantly caring for her. We had to wear gloves and masks to visit her.

She made a full and complete recovery, thank goodness, and thanks to excellent insurance she paid very little of the almost $500,000 in medical bills for the treatment. But the chemo drug alone was just a small fraction. Leukemia is very expensive to treat, even though it is often quite treatable. It makes me wonder how many of the deaths from leukemia are actually due to people not being able to afford treatment or putting off diagnosis because they can't afford the doctor visit.

[Mimosa]

29. 'not able to afford treatment,putting off diagnosis because they can't afford copays'

Sounds like me.

And yet we pay this ridiculous $900 a month to BC/BS which we can't afford because we're afraid not to. And we have nothing left for saving. Or even keeping up with taxes.

[KamaAina]

34. This woman wouldn't have been diagnosed had it not been for the study

which she likely signed up for in the first place because she needed the $$$.

Medicine has become like any other commodity: the good stuff is only for the rich. :(

[avaistheone1]

42. The travesty is that the docs who sell the chemo

make a pro$$$fit on it. I think their something very, very wrong with that.

[Recursion]

47. It's a huge and barely-spoken-of conflict of interest

The doctors buy the drugs themselves and then sell them to the patient at a markup.

[avaistheone1]

49. My understanding it is a pretty hefty markup too.

I was stunned to hear of this practice. I agree its a clear conflict of interest imo.

[Dyler Turden]

14. K&R

[Vinca]

17. Well, golly gee. I thought she could sign up for treatment under

the pre-existing condition pool . . . like the lymphoma patient in Keene, NH who was all over the White House front page. Oh . . . wait . . . I bet she can't afford it. Well, chin up young woman, "health care reform" has passed and it's just wonderful even though you're likely to die before 2014.:sarcasm:

[Bluenorthwest]

18. I'd just like to have the leadership stop saying they are Christians

They let young mothers die over money, bits of money. And then they turn on a dime and announce that some minority or another must go without equal rights to server their devout dogmas, which involve allowing the least among us to suffer and die, they make orphans, and call that a Sacrament of their so called faith.
God is in the mix, hallelujah! One man, one woman dead over dollars! Sacramental and Sacred!

[atreides1]

22. But they are Christian

The new age type, no use for tolerance, the poor, the elderly, and only concerned with themselves.

[SidDithers]

19. K&R...nt

Sid

[sarcasmo]

20. This country is NOT! the best country in the World,

[rasputin1952]

23. Sentenced to death, leaving children behind...

all for another dollar.

It goes back to the, "at least it's not me" syndrome that has come over the country.

This is really sad, and only one story of many...citizens sentenced to death when they very well could be saved...there is the real face of a "Death Panel"...:(

[NJCher]

28. no Purple Heart for her

It goes back to the, "at least it's not me" syndrome that has come over the country.

If a person is uninsured, they should train themselves to think of themselves as casualties on the battlefield. That's how "civil war" is fought in modern day America: you can live (without health insurance) as long as you're lucky. Otherwise you're out.

This young woman is no less a casualty of war than the soldiers in Afghanistan. It's just a different kind of war.

If you doubt me, see the case made here:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x9559837


Cher

[rasputin1952]

32. I remember "class warfare" was used ny Robert Novak all

of the time; whenever he was cornered, that would be his "war cry"...to which I would shout back at the TV, "you're damned right this is 'class warfare' you SOB! And we're gonna kick your ass!"

I have never had a problem calling it what it is, and I am proud to fight by the sides of my fellow citizens to stop the massive takeover that's going on. The problem is, I don't have a nationwide megaphone, and I'm certainly not backed by corporate masters and money...;)

[leahcim]

24. The nine most terrifying words in the English language are:

"I'm from the government and I'm here to help"

Somehow, "Too bad we can't afford to treat your leukemia" seems a tetch scarier to me, but RWers assure me that it's the other one.

[Greyhound]

26. She failed to heed the first rule so now she is left with "die quickly".

:cry::grr:

[Dappleganger]

31. Medicare for all...

there really is no better plan to get everyone in this country covered immediately.

[Ganja Ninja]

33. But at least we don't have socialism.

:banghead:

[Lucian]

37. That's a horrible story.

To refuse treatment to someone who has leukemia because of red tape is reprehensible.

This country really blows.

[marions ghost]

38. If it is CML Leukemia

the treatment Gleevec by Novartis is very effective but very expensive. The insurance companies got it classified as a prescription drug but it is truly chemo. You take a pill every day -- they cost $120 each, base price. You take it for the rest of your life, which can be quite long because the drug targets only the bad cells and eliminates them. Very good quality of life and few side effects. Gets white cell counts down rapidly.

I'd be curious to know if this is the drug that is being denied.

[obxhead]

39. I'm so proud that we could lock this broken system into place

with the HCR law.

[librechik]

40. OMG. Texas.

Go ahead. Ream me. But this woman could get treated on a sliding scale at the public hospital in my town.

[Boudica the Lyoness]

43. What if she had assets

Would she have to sell them first?

[librechik]

44. No--it's not like food stamps. She would be treated if she's a resident.

They look at income, but don't make demands like that.

And I think such requirements are a scandal and inhuman.

[Boudica the Lyoness]

46. Thanks for answering

It sounds like a good deal.

[Recursion]

48. Some FQHCs can do chemo services

But there may be too long of a waiting line.

[johnlucas]

45. Michael told you in 1995 "They Don't Care About Us"

I feel good knowing the doctor has compassion for his patient at the very least.

But this government doesn't care about its citizens & sees them as expendable.
They want you well enough to work in the modern-day gulags but if your body's too faulty they'll write you off & look for your replacement.

This is not what a society is supposed to be.
But this is what this society is (and many other societies around the world are).

The late great Michael Jackson broke it down in a song from 1995 HIStory album called "They Don't Care About Us".
They really don't care if you live or die.
So long as you continue making their lives more & more comfortable.
John Lucas