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Health Care Situations

July 26, 2009
by Kathleen Mears
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I have read the Obama administration's plan for healthcare reform and the resulting controversy. But I know many working poor and working class people do not have health insurance. A friend said she had no idea that one trip to the emergency room and the tests required would max out her $5,000 a year health insurance cost cap. She went to the ER with abdominal pain and a CAT scan was done. The CAT scan showed gallstones. When she saw her GP, he said a previous CAT scan of her kidneys showed gallstones. She had no idea that she had gallstones and said her doctor did not tell her. I told her the CAT scan could have been avoided, but she said she was so sick that she probably would have had it done anyway.

She was very angry because she could make no more health insurance claims for the rest of the year. But she was required to pay premiums to remain enrolled. To avoid the premiums she dropped her coverage. My friend signed up for the insurance plan without understanding there was a cost cap on her coverage.

I think we all have structured health insurance. Most health plans have exclusions. A few years ago a friend told me her insurance would no longer pay for biopsies of fiber cysts in her breasts. She had had many of these procedures. But rather than go without them, she wanted to pay for them herself. She did have the means, but it was still a scary situation. She has fibrocystic disease of the breast, but she can still get breast cancer. Now she has a yearly mammogram and a breast MRI every two years to diagnose any breast tumors.

These days, when a vital person breaks a bone, surgery is required to reinforce the break with pins or plates. That was not always the case. But it is not usually done when the patient is disabled or of advanced age. A female resident here broke her wrist a couple of weeks ago. It is her dominant arm and it is immobilized in a brace. Her daughter decided she did not want her 90-plus mother to go through surgery to put pins in it. The daughter has been assured that her mother's wrist will heal well. Since her mother uses a walker, I hope with therapy she can use her arm again.

A 61-year-old female resident no longer has mammograms. She does not want to go through them since she cannot stand very long on her own. Mammograms are quite difficult for those with functional limitations. Another alternative test for these women needs to be utilized. BreastCancer.org says women with disabilities receive less than optimal breast cancer treatment due to their functional limitations, lack of transportation, and family support.

I am having expensive chemo for breast cancer right now. Since both of my oncologists offered me different treatment options, I did my own research and decided to have four cycles of chemotherapy. I have not decided if I will opt to have Taxol treatments which could cause physical difficulties and are quite expensive. I will also have 35 radiation treatments and I will need ambulance transportation to them, an additional expense.

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Kathleen Mears

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Kathleen Mears has been a nursing home resident in Ohio for 20 years. She is an incomplete...