Blog Back: A Welcome Shift in Access to Healthcare Coverage

Welcome to October’s “Blog Back” column, a recent feature on the blog where the Living Beyond Breast Cancer staff write about their thoughts and experiences for you. This month’s columnist is Michelle Bielko, our Editor and Manager, Publications. In this “Blog Back” post, Michelle writes about her experience working on the Cancer Insurance Checklist, and what the shifting access in healthcare coverage means to her. 

As a volunteer emergency department liaison at a community hospital, too often I’ve overheard an individual in the throes of an emergent medical injury or illness exclaim with panic, “I don’t have health insurance. Will you still treat me?”, upon approaching the check-in desk. In those milliseconds before a patient registrar offers assurance that emergency care will be given regardless of insurance status, that individual often looks as if she or he fears hearing another set of words instead: “I’m sorry. In that case, we cannot treat you” — as if turning around and walking out the doors might be expected of her or him at a time of urgent medical need.

Then, there are those who do have health insurance. Many times I’ve watched as their fingers instinctively fumbled to retrieve their wallets from their pockets or purses before they spoke their names and relayed their symptoms. No matter the severity or extent of their suffering, before a verbal exchange takes place those fingers seem to almost always move in search of that 3 3/8 x 2 1/8 inch plastic card that has become the symbol of one’s “right” to healthcare.

These scenes that play out before me always leave me feeling deep pangs of remorse.  How could it be that when we find ourselves in that most vulnerable state of illness, our very first instinct is not to share what is ailing us, but to declare our insurance status? From my perspective, the structure of our health insurance system has historically emphasized in the national mindset payment above the human right to be healed — the latter of which I consider to be a sacred tenet central to the work of care providers, who practice out of a compassion for ending others’ suffering.

I feel deeply that a woman or man diagnosed with breast cancer — or any illness for that matter — should never be made to feel like a stock unworthy of being “invested in,” or offered coverage, on account of her or his illness(es). Regrettably, pre-existing condition exclusion policies have, for a long time, done just that. The implications of coverage denials have undeniably been grave. A decade ago in Denied: The Crisis of America’s UninsuredEd Kashi and Julie Winokur lamented: “Approximately 18,000 people die prematurely each year as a result of having no [health] insurance. That’s like having 6 September 11ths every year.”

For these reasons, I feel heartened by the paradigm shift in viewing healthcare coverage as a basic human right, accessible to all Americans.

One of the many things that make me proud to work for LBBC is the organization’s commitment to collaborating with other advocacy organizations across the nation on better ways to serve those affected by breast and other cancers. In support of this momentous governmental change in expanding accessibility to health insurance coverage to more Americans, I was privileged to represent LBBC as a member of a national Health Insurance Marketplace Work Group composed of representatives from 19 advocacy organizations. We came together to develop an online tool that helps those affected by breast or other cancers navigate the states’ Health Insurance Marketplaces/Exchanges to find the plan within their budget that best meets their healthcare coverage needs. The result of our collaboration — a four-page checklist tool, along with a glossary of terminology for understanding the vocabulary of the Marketplaces/Exchanges — can be accessed for free at CancerInsuranceChecklist.org. Check it out today!

What’s more? Knowing how important financing your care is following a diagnosis of breast cancer, LBBC updated our “Financial Concerns” online content this month to address questions you might have about health insurance and the Affordable Care Act, ways to effectively deal with claim denials, tips for offsetting the “hidden costs” of breast cancer, and much more! Visit LBBC’s website to learn more.

As I end this post, I want to share with all of you a quote I admire from physician and healthcare activist Donald Berwick, MD, MPP, exemplifying the sentiments that I hope will be deeply felt by us as healthcare consumers in this new era of greater accessibility to medical insurance coverage and care. Berwick writes, “I think health care is more about love than about most other things. If there isn’t at the core of this two human beings who have agreed to be in a relationship where one is trying to help relieve the suffering of another, which is love, you can’t get to the right answer here.” It is my hope that this new era reminds us that healthcare is rooted in love — that we are all worthy, in virtue of our humanity, of quality care that is affordable to us in our time of need.

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