It All Comes Down to Money...........

How are you? is I believe a misused and abused social greeting. It’s something we’ve all been conditioned to say when we encounter someone else. I’ve found that the majority of the time when people ask how you are or how you are doing, the truth is, they really don’t want to know. It’s simply something people are used to saying. Have you ever answered that question truthfully and found that the person who asked suddenly stops calling? This is especially true when you’ve dealt with cancer.

I watched a TV show several weeks ago. It was a documentary involving three women in their early 20's all of whom had developed an addiction to prescription pain medication. Two of the women lived in California and their parents sent their daughters to a 90-day rehabilitation facility complete with all the bells and whistles necessary to help them overcome their addiction. It turns out that both young women went to the same facility even though their parents did not know each other.

The third young woman was from Staten Island NY. She had no insurance and her mother was not in a position to send her to the same type of facility. The first time she received any intervention was the first time she overdosed and then she received two days in detox. The second time she overdosed she received three days in detox and the third time she overdosed she received two weeks of "intensive therapy" before being sent home. Within a month, she was dead. The fact is that two days, three days and two weeks respectively are not enough to address the issue of addiction.

It all comes down to money! So many people think that it comes down to whether or not you have health insurance. This really isn't true. I have excellent health insurance coverage but am not in a position financially to handle to co-payments required for the visits themselves. In January, I had to cancel my follow-up visit with the doctor who handled my chemo because they would not waive the co-pay and I didn't have the $50.

Right now I am supposed to be going back up to Duke University Medical Center for surgery. I found a pea-sized nodule within the sphincter at approximately the same place I'd found the lesion two years ago which turned out to be invasive. The surgeon also wants to perform additional biopsies. This surgeon is one, who is willing to waive the co-payment but there are other issues which people don't realize.

There are a group of individuals who own their own planes and who volunteer to take cancer patients for treatment. The name of the group is Angel Flights. It costs the patient nothing to fly and they can even bring along a companion. So while I am able to get there and the doctor is willing to waive the co-pay why would it still be a problem. Because I need to stay somewhere for the three days that I will be up there and need to eat during that time too.

No hospital will release a patient following surgery unless they have someone to take them home, or in my case back to the hotel. I certainly won't be in any shape to fly immediately following the surgery and this will require another night at the hotel and another days meals for my daughter and myself. It comes to a little over $200 but it may as well be $2000 when you don't have it.

While there are groups out there that will assist cancer patients, paying for a hotel and food isn't something they cover. So, while I have great insurance coverage, I still wont' be able to have the surgery I need because as I've said, it all comes down to money or to put it another way, the haves and the have nots.

One piece of information which I hope will be helpful to anyone in a similar situation with co-pays, doctor's offices ARE allowed to waive the co-pays if they choose to. Many will tell you, and I have had my share of adamant Office Manager's tell me, that it is illegal. It is NOT illegal!! While it cannot be done across the board, it is within the doctor's discretion to waive the co-pay for patient's whose financial situation are dire and who simply would be unable to keep the appointment otherwise. So, if any Office Manager or other office employee and even the doctor tells you this is illegal to do, call and get the documentation from the contract which the doctor signed with that insurance carrier and prove them wrong. If they still refuse to waive the co-pay at least you can address the real issue which is that they are unwilling to take less money to see you. Let's call a spade a spade.