It’s not just a phrase it’s a means to an end. I have a very simple, straight- forward message today that can actually mean the difference between (not to overstate) devastation and healing.
The nurse is amazed that three new consults in a row on Friday all hail from the same Midwest state. A common regional trait is candor. Unfortunately the heat and humidity of Florida must have influenced the chemistry of this “natural state”. Known to be straight shooters I was surprised how circumspect each of them were. Xavier, Marsha and Terry push back on the offer for therapy. It is highly recommended and standard of care for their three types of cancer to be controlled. All sorts of ‘reasoning’ is in evidence: fear, friend told me radiation burns and will make me sick, don’t have time, it’s inconvenient (not like cancer is)! I am patient and in each encounter, after all the information is shared, I ask the same question: “What is the real issue”? They each seem to visibly breathe a sigh of relief. Their real desire is to be honest. They are stopped however, by embarrassment. They don’t want to bring money into the equation however, it is central to each issue.
Xavier has no insurance so has to pay out of pocket for extremely expensive care while not even working. Terry admits the gas to travel a distance is an issue and the 20% she will owe, not having a Medicare supplement, is prohibitive and Marsha works 12 hour days for the minimal insurance she has and will have to shorten hours and still have co pays.
Once I get to the bottom of this, for each one, we can set up financial counseling and even assistance. I can work around their schedules for timing and even limit the number of visits to cut cost.
Will other offices do this for you if you don’t speak up? No. Economics are everyone’s concern , but your health and well being is ours. Allow your docs and their practices to help when and however they can. Last week a friend’s daughter called. She has been turned down by hospitals and other offices because of her “poor” insurance. At least she has some. Her family intervened to get care but only after she has suffered and gone to the ER several times. The mental anguish is worse then the physical now. Hospitals receive substantial government subsidies and should accept all comers as we do in private practice. It is so difficult to hear, “No we don’t take your insurance!” Since I cannot change that dynamic I can at least provide guidance and support when possible.
Please be brave when faced with your own need for help. Be assured that you can receive the care and treatment you need, but it will take patience and effort. Be sure someone is on your team to help you navigate- they can work to set up the right appointments, sit on long insufferable holds and also demand help or at least the first available appointment. You need a champion or even a few.
What a tough time it is. You will soon be asked to consider your health insurance during enrollment period. I have written about this before. It is great that preexisting conditions cannot limit your choices, now as it did in the past. (If you have cancer you can still change insurers). We do not need free lunches. We need expensive chemo, surgery, radiation, scans and even hospitalization. That is what insurance is for. It’s not for the fender bender. It is the devastating crash and that is what cancer is. Get the best policy you can because the restraints are getting tighter and FOMO is real, even in cancer care.
Honesty requires the best policy for you to enjoy the benefits others are receiving. It is not for the rich it is for the wise, so don’t take this part of your budget for granted. You will be rewarded with calm assurance that you made good decisions for yourself and your family – even if they need to assist you with the cost. I tell you they would rather be part of your decisions then find you adrift and everyone heart sick due to poor coverage. Always be honest with those trying to help you. It is the best way to be armed for battle. It will in turn be a gift to your whole family that they can rest assured you did all that you could.