Thursday, January 19, 2012

This F*cking Cancer Has Wrecked My Life and It’s Not Even Cancer

Sorry this is now the blog that swears all the time.

I woke up anxious this morning and then got to thinking about the wisdom of posting one’s health information online. I do believe everything we put on the Internet—every post to a forum, every blog comment, every email—is aggregated somewhere and I wouldn’t be a bit surprised if insurance companies have ways to find our files and make use of them, or will in time.

On the other hand, your health history is your health history, and if you have diabetes or heart disease, that’s in your record whether you mention it online or not. It seems to me it would only be a problem if it was something you intended to conceal from a prospective insurer (probably not such a great idea).

From there it was a short hop to wondering if I’m going to have problems getting insurance because of having had cancer. The day I found out I was losing my job, a woman from HR reminded me about COBRA, under which your health insurance continues for 18 months after your job ends, but she said people often find it cheaper to buy their own coverage. Currently, I pay X amount for my health insurance and my employer picks up the rest; under COBRA, I’d pay the entire monthly premium, plus a two percent surcharge, or about four times what I currently pay.

I’d been starting to think, with anticipation, of putting together a life made up of bits of this and bits of that: teaching, writing, a part-time job as necessary, paying for my own health insurance, as many do, but today it was off to the insurance website to read their treatise on pre-existing conditions, and the answer is yes: a cancer diagnosis will make it impossible to purchase your own coverage.

But surely not if it’s Stage 0 cancer, considered by many to be pre-cancer? I called my surgeon and my ob/gyn and both offices confirmed that, in the eyes of insurance companies, I’m out of luck, which simultaneously plunged me into despair and opened up a whole new area of research. So many things to learn lately!

After several hours on breastcancer.org and various other websites, I’ve concluded that the crucial thing is to avoid having a break in one’s health coverage, and I’ve realized that what I’m going to need is a job that offers insurance via a group policy, almost certainly a good old full-time job. The group policy works because the members all pay premiums in an amount presumably calculated to account for the fact that some will need more services and some will need less. If we’re part of a larger whole, it works out financially if I have cancer and you never get anything worse than the sniffles, or vice versa. This is why President Obama wants to require all of us to have insurance, so that we form one giant group and pre-existing conditions don’t matter.

So never mind the bits of this and bits of that. I’m disappointed, but must take into account the facts that have emerged and amend my plans accordingly. There will probably be many course corrections as the days unfold and new things are learned: it’s a process.

But not a very fun one today, though it’s not one hundred percent gloom. Once the HR lady mentioned individual insurance generally being cheaper than COBRA, I’d assumed I would go with the individual insurance, but my surgeon’s assistant reminded about COBRA today. It will be there if necessary, at least for a time.

I also called the nurse educator at SFMC to see what happens if someday I have cancer again but no insurance, and there are options.

By the way, I finally figured out that doctors A. and P. probably both recommended radiation oncologist Dr. L. because, as the chair of the department of radiation oncology at SFMC, he might be the only person at SFMC who does intraoperative radiation. 

I sent Emily at work a note assuring her I’m not mad at her because she remains employed while I soon won’t be, and then we spoke on the phone and I found out that, far from having casual feelings about what has happened to me, my co-workers are perturbed. Right after my manager gave me the news, he met briefly with my immediate group to let them know, and Emily reported that one of my peers was so upset, he announced he was taking the rest of the day off.

So I give them As for empathy, after all, though they’d have gotten better marks for bedside manner if they’d called me up in tears. Of course, maybe they were just upset because what happened to me made them afraid their own displacements are coming soon, in which case, Fs all around.
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