Paying for Mastectomy/Reconstruction: Good Luck if You’re Uninsured

If I had a nickel for every time someone mentions health-care reform, I’d be doing better than Warren Buffett or Bill Gates. And nickels are what I’d like to focus on right now. Anyone who has been following this issue at all knows that people are being driven into bankruptcy if they develop medical conditions such as breast cancer and are unlucky enough not to have health insurance. I’d like to offer my two cents (I know, the money metaphors are just flowing today) on how that can happen by giving you a feel for what some of this costs.

My experience is limited to surgery since neither radiation nor chemotherapy was part of my treatment plan. I had a total of five surgical procedures for my ductal carcinoma in situ: two lumpectomies, one coupled with a wire localization procedure; a simple mastectomy combined with sentinel node biopsy and first-stage reconstruction, second-stage reconstruction coupled with augmenting and lifting the other breast to provide symmetry, and nipple reconstruction.

Grand total for these procedures, which does not include dozens of consultations, follow-up office visits and lab work not directly tied to each surgery, was just under $83,000 (in 2008).

I’m one of the lucky ones. Both my husband and I are employed and have health insurance. I met our family deductible quickly and it was smooth sailing from there. I hate to think of what would have happened if we did not have that access. We would have been taking out a second mortgage, which isn’t an option if you already have one, or don’t own a house.

I can’t help wondering what this cost scenario would look like if the health insurance landscape was different. What if health insurers could no longer cherry pick clients by denying people with pre-existing conditions? We know that hospitals have to factor the costs of treating uninsured and lower-compensation Medicare patients into what they charge the rest of us. What if there were fewer uninsured out there? What if doctors didn’t have to practice medicine with one eye on what insurance will accept and another on what they might get sued over? We keep talking about health-care reform and I would argue we need to be framing it in terms of insurance reform and tort reform. The health care I received was stellar and doesn’t need reform.

Surely someone has done or is doing studies on what these costs would look like if doctors and hospitals didn’t carry these burdens. The thing that has always resonated the most with me in this discussion was when President Obama said he remembers his mom fighting with insurance companies as she was dying of cancer. If only we could trust either political party to be looking at it from this angle instead of trying to score points at the other’s expense. Let’s just hope that whichever side “wins,” it’s not a Pyrrhic victory.

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