Wednesday, August 09, 2006

Cancer and money

I am so incredibly lucky.

I am lucky that I live in the UK and that my National Insurance contributions mean that I don't have to pay anything for medical treatment, bar £6.50/$12 per prescription.

When I was diagnosed with cancer last year - no one was asking me how I was going to pay for:
  • 8 chemotherapy treatments and medication,
  • for a portocath insertion,
  • for emergency care when I got neutropaenia,
  • for a daily District Nurse to visit to do my injections,
  • for surgery,
  • for 25 radiotherapy treatments + planning and
  • more consultations that I can remember.

While I flailed around in confusion and fear - no one was asking me for my insurance details, demanding my credit card.

They simply treated me.

I never had to make decisions about whether I could afford the treatment I needed. I didn't have to put a price on my health - on my survival. I didn't have to delay treatment because I didn't have the cash. My doctors simply decided on the best treatment plan for me and
we did it.

And it's not that I have had all of this for free: I haven't - I've paid my National Insurance contributions for 6 years and I will continue to do so for the rest of my working life. And how much better than insurance is the UK system?? Fantastically better. Because the NI that I pay goes to the Health Service whether I am sick or not. The money I pay today doesn't treat me - it treats others and when I am sick then the money of others pays for me. It's a giant care package.

I am also incredibly lucky that when I was diagnosed with cancer I had a job - a good job with a good contract that gave me 5 months sick leave on full pay plus 5 months on half-pay. I worked while I was being treated so I never got into the half-pay scenario. But I am so grateful that I had a contract that protected me from discrimination, from being made redundant or losing pay - even my pension payments continued to be made.

Today I have read tiny excerpts from 2 blogs belonging to women in the United States - one is 20, the other 25.
  • One has been diagnosed with breast cancer and is bankrupting herself trying to pay for her treatment.
  • The other may have have breast cancer but her insurance company will not pay for her to see a surgeon to have it diagnosed because she is 'too young to have breast cancer'. She is going to have to pay herself to have the lump removed and hope that the diagnosis is good.
I am so lucky.

I wish I could give the treatment experience I had to these women who are even younger than I.

It is awful to have breast cancer.
It is awful to have breast cancer when you are only 20-odd.
It is truly awful to have it and not be able to be treated in the best possible way.

I had cancer and it was awful but at least I (and my family) could say that I was being treated by a fantastic consultant who was world-known in her field; that I was having all the treaments that were recommended, when they were recommended; that I was in an excellent teaching hospital. I didn't have to play a balancing act between staying alive and not being destitute.

I've never thought the US system was a good one: it didn't serve my grammy and grampy well but now I cannot believe that it's humanely right. To put people in these sorts of dilemmas. To have to die as a result of cancer because you couldn't afford the treatment at the right time.

I am appalled.
My thoughts are with people all over the world who cannot have what I have had.

And by-the-by: 'Thank you' National Health Service for the fantastic treatment, the fantastic people and for the timely manner in which I was seen. This is why I would never leave the UK.


abigail said...

amen to that.

I live in the US and am also appalled. I have BC, and, fortunately I have really good insurance through my job. If I hadn't....well, I just shudder thinking about it. We have a bad system here, when one's job status or bankroll determines one's medical care, especially for something as scary as cancer. Ridiculous.

lor (abigail)

Jeannette said...

I agree with you. Our health care system in the US has been in need of serious change for as long as I can remember. I too am lucky that my job provides good insurance benefits, but one of the most difficult things for me to see during treatment was people having to decide what type of chemo and when to have it based on how much they could afford and when they could afford it. One day, I sat in my reclining chair, cozy with a blanket, with the IV tube pumping chemo drugs into my system and the woman next to me could not get chemo due to low blood counts. The nurse told her a shot of Neulasta would help her rebound quicker after each treatment, but the woman could not afford it. I quietly got the nurse's attention and offered to buy the shots thinking, "how much could it cost?" Well, when I heard the price was $2600 for one tiny shot, I had to rescind my offer. Healthcare costs in the US are disgustingly ridiculous. In fact, they cost many people their lives.

I'm glad your system worked for you and that you are doing well.