The Haves and Have-Nots of Cancer Care

Mar 30, 2017 · 17 comments
Annete Paniagua (Los Angeles)
Cancer and its treatment is certainly difficult, but the patient's mood and mood has a lot to do, loving our loved ones every day, is the best support in the face of any difficulty. http://www.medicacenterfem.com/blog/cancer-cervicouterino/
hen3ry (New York)
Every one of us is going to need to visit a doctor at some point in our lives. We are all going to grow old and need assistance living alone or in a home. Some of us will contract illnesses requiring long term care or treatment if we are to be cured. Whether or not the treatment is successful we will need follow ups. Yet our for profit system of health care has priced most of us out of it. It's not a health care system. It's a wealth care system where, if you have the money you can get the care you need, when and where you need it. You can pick and choose your doctors, hospitals, and who will help you at home if necessary. You can even afford your medications. The rest of us have to jerry rig our care and pray that the doctors we are allowed to see have room for us, we'll be able to get back to work quickly, we'll be able to hire someone to fight with the hospital, the insurance company, the labs, etc. over the bills, and that our medications and treatment won't cost us our entire savings.

In America having insurance doesn't mean having access to health care. It means you have insurance. Our health care system doesn't care about patients. It cares about its bottom line which is to say our care and health doesn't concern it at all.
Lyn M. (Chicago)
First of all, I wish you continued good (for having advanced ovarian cancer) health. I hope that you are feeling well and that your treatment continues to keep your ovarian cancer at bay. You don't owe any of us an explanation, but I am curious as to your thought process about breast screening and treatment. It would seem that, at your age, and living with ovarian cancer, that screening for breast cancer wouldn't necessarily be recommended. In addition, DCIS is slow growing, and not invasive. Some providers are moving toward a "watchful waiting" approach with that, too. Would you mind telling your readers why you chose to have a mammogram and why you chose to get treated for it?
Susan (Eastern WA)
Care is a funny word. As a noun it refers to a service rendered, as in "health care," but as a verb it is something much more. It implies concern and interest and empathy in whatever, whomever, it is that is cared for.

The widespread indifference about whether people receive the care (n.) that they need makes clear that there is a pervasive lack of care (v.) in our government and perhaps in our society. I am saddened and discouraged that there is a rampant "I got me mine, to hell with you" kind of attitude and that it is so pervasive. We need to do better by out fellows.

Thanks so much for putting your personal spotlight on Planned Parenthood and all the care (both kinds) it offers so many of these fellows.
Dr Rick Boulay (Allentown, PA)
As a GYN Oncologist, I have the privilege of caring for women with cancer and precancers of the cervix.

In that capacity I have treated many women whose Pap smear screens, including those performed at Planned Parenthood, detected precancerous cells. For the vast majority of these women, a relatively simple operative procedure can cure her precancer while maintaining full functioning, including fertility.

Cervical cancer itself is a different beast. Its biggest risk: lack of pap smear screening. Its biggest prey: young women, especially those without the means or understanding to get screened. Its biggest victim: young families with children who lose a mother.

I commend your advocacy and support for the mission of Planned Parenthood especially in this polarized society. But I do ask you to reconsider your decision to offer financial support as a swap for your personal breast cancer screening. Screening recommendations are based on the general population. Your personal breast cancer risk may be higher than the standard population. And as the new biological treatments for ovarian cancer are indeed "new" it is difficult to predict their effect on life expectancy, perhaps another lagniappe. Please discuss with your doctor such an important decision.

We need your voice.
liz (Europe)
Yes, we most certainly do.
Casey Jonesed (Charlotte, NC)
GOP Plan... got enough money, then you can live.
Sorry everyone else.
ghumphrey (Lake City, SC)
Health and fitness of the public is treated as a commodity from which rich reap profits, regardless the consequences for the have-nots. Profit-driven free enterprise in the medical/health field is amoral at best; immoral, cruel, beyond the pale in reality.
Life is THE universal value...
"She or he cares for his life and the lives of loved ones as much as I do mine."
The elite and perennially out-of-touch, do not understand; or they do not care ...top priority: money and profits, NOT alleviating human suffering and preserving LIFE, FIRST, regardless the cost.
An investigative visit to emergency waiting rooms frequented by the have- nots in this country... will reveal the callous, inhumane, careless treatment of human beings in need of help, regardless the genuine efforts of hard working doctors and nurses on the job. A medical care model driven by a profit motive, BY DEFAULT, mistreats the have-nots and is disrespectful of human life.
More and more of us are forced into the have-not category by the U.S. Medical Monstrosity that some call "health care," more appropriately termed "health care-less."
Until leadership experiences the 'feel' of disrespect for life by the INDUSTRY that is foisted on those less fortunate, the profit mongers will drive this cruel health "care" system. Congresspersons should be forced to enter the health-care market like everyone else, THEN we'll see a humane system of health/fitness care for ALL.
Jean (NYC)
Honestly, I do not follow the world view underlying Congress' criterion for allowing states to block federal funding of PP services: provision of abortion services and/or affiliation with such a provider.

Where are all the U.S. women, finding themselves in a situation where an unplanned pregnancy has occurred, turning for pregnancy termination?

What sort of foolery is going on? Reporters, please explore and report on the fact that women get safe services beyond PP for ending a pregnancy. What sort of pariah status is Congress foisting on PP?!!

Only poor women need that service?! No, not true.

Bring this story from out of the dark and let people know that abortion services are, unfortunately, sometimes needed. It is needed by folks with gainful employment and private insurance and by folks who are young (and not so young) and poor and dependent on gov't. funding for health care and now PP who must rely on donations. This obfuscation is incredible!
CA (key west, Fla & wash twp, NJ)
Women are at least 50% of the population, why have we voted against our best interests but also our daughters and granddaughters.
Tanaka (SE PA)
It was a majority of only white uneducated women who voted against other women. Doesn't make it any more excusable, but a majority of black women and Hispanic women and Asian women and educated white women did not vote against other women -- and in the end against all children and men also.
emb (manhattan, ny)
I believe a large number of educated white women voted for Trump.
Frau Greta (Somewhere in New Jersey)
Perhaps Planned Parenthood suffers most from a naming problem. I believe the very concept of planning a pregnancy is an anathema to the old white men who make the laws regarding our bodies. It cedes too much control to women. Maybe it's time for a rebranding, using words that would clearly put those men into the realm of cruelty if it were defunded. Something that uses words like Family Initiative or Healthy Families.
B (Minneapolis)
By law federal funding and federally subsidized insurance, such as Obamacare, cannot be used to support abortion services. But people continued to donate or pay out of pocket for abortion services.

So, a month ago House Republicans and yesterday Senate Republicans resorted to blackmail and voted to allow states to block federal funding to any Planned Parent clinic that provides or is affiliated with a provider of abortion services. Two Republican Senators - Snow and Murkowski - voted against the bill so VP Pence stepped in to pass the measure. Obviously Trump will sign it.

As described in this article, the funds denied by this disgraceful political act would not have paid for abortion services. They would have provided tens of thousands of preventive exams for breast cancer, cervical cancer, etc. Thousands of women will undoubtedly die as a result, children and families will be bereft, health costs will be higher.
em (ny)
I understand the donations but what does it have to do with screening or not screening?
Lance Brofman (New York)
In the USA we have attempted to deal with the combination of inelastic demand and unregulated medical care prices in various ways. One method of keeping medical care expense as a percent of GDP to "only" double that of other developed countries was to have a significant portion of the population uninsured and denied medical care in some circumstances. The existence of large numbers of uninsured (conscripts in the war against rising medical costs) did moderate the growth in health care costs.

HMO's were once thought to be a way of dealing with the inexorable price increases. The problem is that HMOs have to compete against each other for services of doctors and hospitals. As long as medical prices are set by market forces, the inelasticity of demand will force market prices inexorably higher. In a "mixed system" with both free-market and controlled health care prices like the USA, prices inexorably are driven upwards to the market level as long as demand is inelastic. Prices such as payments from Medicare that are "controlled" have to be increased continuously with legislation such as the "doctor-fix" to stay competitive with market prices. Medical prices can only be effectively controlled either by direct price controls as in Japan or with systems where everyone gets care for "free" from the government (Canada, UK, France). In those countries only the extremely wealthy can chose not to use the government paid health services th...."
http://seekingalpha.com/article/1647632
Sarah O'Leary (Dallas, Texas)
Thank you so very much for sharing your personal story, and for your shero-ism. Courage is simply not a big enough word. It doesn't even come close.

Like all who support the efforts of Planned Parenthood, your contributions will help save women's lives. It is completely unacceptable that white male politicians have laid claim to our bodies and vilified our dear friend -- Planned Parenthood.

I believe in human miracles. Your courage, tenacity and selflessness is proof positive of one. Here's hoping 10+ more years of having you here with us on earth.