$626.43

[DFW]

29. Cancer spares no one, but hits the poor hardest

My wife's brother had it (stage 4 glioblastoma--100% death sentence), and despite fabulous treatment, and living 2 years longer than the doctors thought he would, he died at age 51. My wife had breast cancer, and though it spread due to her second class ("Kassenpatient&quot status in the German health insurance system, and her treatment was far more invasive that it would have been if she had been treated earlier, at least when it DID finally get treated, it cost her nothing. She had the whole gamut--two operations, the second of which was so invasive, they had to keep her in the hospital for a month. Then a round of chemo lasting almost 2 months. Then radiation lasting six weeks. Then a rehab spa, specifically designed for patients with breast and thyroid cancer, where all but two of the patients were women, predictably enough. Her employer was furious that he had to keep her on, being absent for about a year, but there was nothing he could do about it, and she ended up working 11 more years before retiring. So far, she is still with me. Imagine health spas for rehab, each one finely tuned to various kinds of cancer being treated, and available at no cost to all recovering cancer patients that want them. This is standard in Germany.

While my father was wasting away with terminal pancreatic cancer in 2000, there was a suggestion that Medicare reduce the amount of outpatient cancer care it covered from 95% to 85%. As one who knew only too well what that meant, my dad gathered up what energy he had left, arranged a conference call between him, Sen. Moynihan (D-NY for those who don't remember) and the Clinton White House. He told them (paraphrasing here), "you idiots, don't you realize that if you make it more expensive for outpatients, that patients will just get themselves checked in overnight to realize the better coverage? This would cost the Medicare system a fortune!" Even the thick-headed bureaucrats realized their mistake when they had it laid out for them in simple terms, and they withdrew the proposal. Not everyone has the White House or US Senators on speed dial, of course, but the more we flood our reps in Congress with stories and suggestions, the more they will be forced to realize that their action affect real people, not just numbers on a spreadsheet.

I don't see that anyone contends that Obamacare is the Omega of progress in our health care system. All have said it's a good start. As long as we have a solid Republican majority in one of our houses of Congress, I'd be amazed if we get anything better, and for too many of us, it's not adequate. If November leaves us with the same situation as now, all I can say is that anyone who refuses to vote for the Democratic candidate had better remain in excellent health, or else be financially well off. Why? If the Republicans keep both houses of Congress AND win the White House, the repeal will go through, probably with nothing to replace it for those who will lose coverage, and pre-existing conditions will immediately once again be legitimate grounds for cutting off or refusing coverage. A president can advocate single payer, but he (or she) cannot make it the law of the land with one wave of a magic wand. Executive orders can go only so far, but for broad initiatives, even the POTUS needs a little help from his friends.