Cancer Care, Employment, and Health Insurance

Consistent health insurance/coverage is vital for every person.  I think it is a shame that for so many people, myself included, health insurance is intricately linked to employment.  I have seen on far too many occasions the challenges that cancer patients face in getting care when they either do not have consistent health coverage or experience a lapse in that coverage.  This seems inappropriate in a country as developed and wealthy as ours.

Can you imagine being midway through cancer treatment and then losing your job because your cancer makes it impossible for you to work?  I recently saw this happen to one of my patients.  I imagined myself in his/her shoes.  It would be incredibly stressful to wonder if your next scan or treatment will be covered.  This is exactly the situation that can lead people to financial ruin.  It's an inappropriate stressor to place on someone who is already incredibly stressed.

In my ideal world, I would hope that all of Americans would have guaranteed health coverage of some form.  We already do this for people who are age 65 or older under Medicare.  Most Medicare recipients are quite satisfied with the access to care that they get.  Those people who desire additional coverage beyond what Medicare provides can purchase supplements.  This works well and assures that people at least have a minimum level of coverage.  If we were to extend this safety net to people who are younger than 65, it would make a world of difference.

Some people might argue that there is no problem with having health coverage linked to employment.  Others, might say that the government has no responsibility to provide minimal basic coverage to everyone.  I disagree.  Every time a person without insurance gets very sick, they inevitably present to an emergency department.  Emergency departments do not turn people away, appropriately so, and they provide life stabilizing care.  This cost is then passed along to taxpayers when bills cannot be paid.  Care provided through an emergency department can be incredibly expensive.  Discharging a patient who needs a primary care or specialty care follow-up without a plan for getting it because of coverage, almost assures that that patient will be back to the ED.  This perpetuates a vicious and expensive cycle.  I hope that during my career I can make strides toward breaking that cycle.