Donna Smith
Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation
My sleep was restless last night except for the snippets of scenes where I was being tended to by my cancer doctors from some time ago. In those dreams they cared for my body and comforted my fears as we worked together to overcome my illness. Of course time had changed things a bit and their offices were interwoven with the sweet things only dreams can infuse, but it sure was nice to revisit a time in my medical life when the system was even a little less broken than it is today. Don’t get me wrong, the bills were crushing then and some of the barriers daunting, but the slide to an even more difficult healthcare system for patients and our providers continues and deepens.
Then I woke up. My reality jolted me back. There were no doctors waiting to help me through the worry or read the newest tests that haven’t yet been done. I was supposed to have three CT scans yesterday. The prep I needed to drink was mixed, and the blood work completed to make sure that my kidneys were ready for the injected contrasts. The scans were scheduled days ago after my primary care doctor called to tell me that some markers for cancer were elevated in one of the earlier tests she ran. My symptoms match what the markers are showing, so I wasn’t exactly surprised when she called me. But it is always an emotional shock to hear that anything cancer-related might be brewing.
But in my real world, the hospital called me early yesterday to say that my insurance company had not yet issued the authorization for the scans. The insurance company wanted more time to talk to the doctors about the “clinicals.” So, the tests were cancelled until the insurance company says they approve. They were kind enough to tell the hospital that in 95 percent of the cases they will ultimately authorize the tests. I do not believe that statistic, but if I did believe it, now I was left to worry not only about whether or not cancer has returned to my life but also if I’ll be one of the “lucky” people the insurance company decides is deserving of further evaluation. I was not surprised, but I was sad. I already felt physically pretty awful, and now I would have to wait.
The recent cancer scare for me comes as some issues emerged following the major surgery I had just five weeks ago. I have been working hard to get better and stronger and get back to my work in helping advocate for a more sane healthcare system – one based on healthcare as a human right and one in which the care of my body is determined by me and my medical professionals and not the insurance company. The insurance company had already booted me out of the hospital in just under two days following the surgery. I had been stunned that the doctors seemed to want me to leave so soon until we arrived home that second day and the letter from the insurance giant was waiting to say the exact amount of time that had been approved for me. Then it all added up. No matter what shape I was in, the insurance company said I should go and few providers have the will to go toe-to-toe with the insurance companies they rely on for so much of their revenue. The bills are just now starting to march in, so that’s its own trauma, aside from the physical healing I have worked to maximize.
In my post-surgical period, I have been exercising and eating well and growing stronger every day, but nagging symptoms persisted that led my doctor to the first round of tests that found the elevated markers. It wasn’t the news I hoped for on the eve of my slated return to more work time. I wanted not only to know if I actually have a recurrence of cancer but I also tried hard to get the exams scheduled so they wouldn’t interfere with my return to work. Now, with another weekend looming, I get to worry longer about all of it. I will go back to work with a cloud hanging over my head -- all because the insurance company wants to second-guess my doctor’s orders and my body’s symptoms and markers.
It is such a travesty that so many people in this nation have to fight to get needed care. But another travesty is that we are led to believe that the healthcare reform passed in 2010 will fix the kinds of problems so many of us face with insurance companies like mine. It won’t. In fact, it is likely that as other kinds of controls are tightened on the insurance giants that the sorts of abuses I am feeling will grow more common. More care denials and delays. More patients waiting and worrying. More diseases advancing. Or in the alternate reality of those who believe that somehow a totally free-market system will solve the problems, I still say – dream on. If many folks honestly think giving total control over to the same people who delay and deny care now while under some minimal control will improve things, they are so very wrong. Those big, for-profit interests will not suddenly become kinder, gentler souls looking out for the health of each of their policy-holders.
Profit first is the wrong primary motivation for many things that make our lives better and our nation stronger. Healthcare is certainly one of those things. We have to work together to move the system beyond the policy of greed and protection of Wall Street’s healthcare corporate interests to one that advances human health and doesn’t drain personal wealth, not matter how modest. A single-payer model, with a progressively financed, single standard of high quality care for all is better for all of us – and I like a system that is better for all.
So, while I wait for the final word from the insurance company on whether or not I’ll be having my scans as ordered by my doctors and as I continue working to transform this system from one of cruel intentional infliction of emotional and physical distress, I may just try to nap some more where my doctors from days gone by worry about and care for me.
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