The realities of medical care and insurance collided in my life when my husband was diagnosed with cancer.
AT 4:29 p.m. on May 26 of last year, my husband’s doctor said to him, “I have bad news.” While I have delivered those words countless times to my patients, I now understand in a way I could not before how this news can turn one’s world on its axis.
As a doctor, I have seen the unprecedented uncertainty my patients and their loved ones face when I confirm a cancer diagnosis. Decisions have to be made — often quickly. What is the best treatment path? What will the next weeks and months look like? Will I be able to work? How will my family cope? My personal journey after my husband’s diagnosis made me more acutely aware that despite tremendous advances in detecting, diagnosing and treating cancer, uncertainty remains a potent side effect of the disease.
Now imagine adding on worry and confusion over what may happen next with the Affordable Care Act (ACA) repair or repeal, the fate of the faltering insurance exchanges, and how all these uncertainties may affect your ability to access care. Will you continue to have health coverage? Will you be able to afford the cost of your care? And if not, will you have to stop lifesaving treatment?
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Even as a health-care professional with a stable job and comfortable income, I feel the pressure of these concerns and the worry of what would happen to my husband’s care if I no longer had a job with insurance benefits. As policymakers continue to debate the future of the Affordable Care Act (ACA), cancer patients and survivors are coping with escalating fears about access to health-insurance coverage, worries that are significantly compounded for those without financial stability, as highlighted in a recent Washington Post article. As one cancer survivor interviewed for the article commented, “For cancer survivors, we literally live and die by insurance.”
Certain provisions of the ACA have offered critical protections for cancer patients that remove at least some uncertainties. Cancer patients no longer had to be concerned that a pre-existing condition would stand in the way of obtaining health-insurance coverage. Under the ACA, young adults up to age 26 could still be covered under their parents’ insurance. And cancer patients — already struggling with the financial impact of the disease — would not have to worry about lifetime or annual dollar limits on policies.
In my nearly 20 years as a practicing medical oncologist, I’ve had the privilege of caring for patients in rural communities, as well as in urban and academic settings. My experience as a physician, as immediate past president of the Association of Community Cancer Centers, and now as the spouse of a cancer patient, has driven home some certainties. I am certain that every day in cancer programs across the country multidisciplinary teams are delivering quality cancer care to patients in their home communities. I am certain that these patients are anxious for our health-care system to right itself. They need and want treatment now. I am certain that cancer patients do not need the added stress of worrying that critical protections and access to care afforded under the ACA will be stripped away — and neither do health-care providers on the front lines of cancer-care delivery.
As Congress and policymakers debate how best to reform the U.S. health-care system and deliberate next steps to fix, repair or replace the ACA, we should move forward by remembering exactly why we set out to tackle this in the first place — to improve the care provided to all Americans.
Congress has the power to put aside partisanship and build on the undisputed improvements made through the ACA. Congress has the power to provide clarity about how these improvements will affect our nation’s cancer-care patients and their health-care providers. Moreover, Congress has the power — and the responsibility — to ensure its constituents that critical patient-centered protections will remain and, as they take next steps in addressing changes to the ACA, that patients will have access to comprehensive, affordable health-insurance coverage, which will certainly alleviate some of the uncertainty.