A front page story in today's Wall Street Journal, by reporter John Carreyrou (john.carreyrou@wsj.com), profiles an uninsured breast cancer patient named Shirley Loewe and her four-year ordeal with the U.S. health care system. Shirley, who had inflammatory breast cancer, a rare, aggressive form, was not diagnosed until she walked into a Texas emergency room with a tumor nearly four inches in diameter. It was June 2003. Shirley's tumor was the size of a softball.
Carreyrou delivers the profile in a sensitive, straightforward manner; it's worth reading as an example of how horribly the "patchwork" of laws and regulations governing the health care system can fail individuals in need. Shirley's story, and the laws and loopholes it highlights, is relevant to those trying to get a grasp of health care as a political issue, one emerging as a defining issue in the upcoming Presidential elections. But, as a general breast cancer story -- one meant to educate the public or increase awareness of the disease -- it is not one that I would pass along without caveats.
If you are actively in treatment or worrying about how to make sense of your cancer prognosis, I would not recommend reading this article, as it seems (I would truly, truly hope) to be one of those worst-case scenario breast cancer stories. It's one that leaves a mark. For me, I feel it as a void in my chest.
Carreyrou describes Shirley's breast cancer odyssey as one "that would take her to five hospitals, two clinics, two charitable organizations and two nursing homes in two states. She was denied assistance or care at least six times along the way, for reasons that ranged from not being poor enough to not being sick enough."
Read the full article: "Legal Loophole Ensnares Breast Cancer Patients."
The article discusses the Breast Cancer and Cervical Cancer Prevention and Treatment Act and a common loophole that snags thousands of women, like Shirley, each year. Passed by Congress in 2000, the law allows uninsured women under the age of 65 who are diagnosed with breast or cervical cancer to have their treatment covered by Medicaid, even if they fail to meet the usual eligibility criteria for the government-funded program.
According to Carreyrou's article, states can choose to cover only those who are diagnosed at clinics with federally-funded cancer detection programs. Texas, where Shirley was diagnosed, was one of the states that denied uninsured women with breast or cervical cancer Medicaid coverage if they weren't diagnosed at the right clinic. The state removed its coverage restrictions on September 1, but 21 other states still restrict coverage.
These states include (Source: Susan G. Komen for the Cure):
Alabama
Arizona
Colorado
Connecticut
Florida
Hawaii
Idaho
Indiana
Kansas
Minnesota
Missouri
Montana
Nevada
New Mexico
North Dakota
Ohio
Oregon
Pennsylvania
South Dakota
Virginia
Wyoming
