|
Breast
cancer: treatable, but no one can afford to pay It's unforgivable that we can prevent breast cancer, yet women die every day from it. How many? About 43,000 this year, according to The Breast Cancer Site on the Internet. Of course, this just a statistic until the "statistic" is you, your wife, mother, sister, or best friend. How many women in Nevada County should be concerned? The 1990 US Census showed we had 50.8% women, and 19,403 of them were over 40 years of age. The 2000 census shows our population increased by 17.2%, so now there are about 22,740 women who are candidates for breast cancer. I estimate that less than half the women do the essential early detection procedures, based on informal talks with my doctor's office and public information officers from two large local facilities. Why not? High costs and too little information. Here's the medical side (and please check with your doctor for the details). Give yourself a breast self-examination once a month, and act on any suspicious lump. You can learn the technique from your doctor, and there are even plastic instruction cards you can hang in your shower. Somewhere between age 35 and 40, get your first mammogram as a "baseline." Then, your doctor will probably recommend mammograms every other year until you're 50, when they should be annual. Other factors may cause your doctor to recommend annual or semi-annual mammograms right from the start. In prevention and detection, how does Nevada County stack up? The technology is excellent. The people are caring. However, public education could be far better, and the costs to the patient are an abomination. Technology Sierra Nevada Memorial Hospital has a new Breast Imaging Center. It's in a new building, has the latest equipment, and is staffed by very nice, caring and helpful people. Unfortunately, a mammogram is going to set you back $125.00! They're also booked ahead 10 weeks! Costs At least a breast self-examination is free, and you can learn how to do it through the Internet, videos, and private counseling. I spoke with eight women about mammograms and every one objects to the cost. If you don't have insurance or don't get financial help from a program, you're paying the full $125.00. You pay $85.00 for the equipment and building. I asked Siemens, the manufacturer, about the cost of their Mammostat 3000 or 3500 machines. They refused to answer. Also, you pay $40.00 of that $125.00 for the radiologist to read the mammogram. What about insurance? Surely, you jest. Two of my friends have excellent corporate jobs, and they both have to meet $1000 deductibles before insurance pays dollar one on a mammogram. And one of them is unsure if the insurance will pay for her doctor-ordered second mammogram per year. The same is true of Health Net, my suck-eggs insurance company. You pay $20.00, but only after you meet a $1,000, $2,000, or $5,000 deductible. If you're over 65, you have Medicare, but that doesn't help the working woman at age 40. If you're not insured or are under-insured, California's Breast Cancer Early Detection Program (funded by cigarette taxes and tobacco settlement money) may help you get a low-cost mammogram. You've got to be poor (income less than 200% of the poverty line). Or you can lie. As I understand it, the SNMH Foundation and the Barbara Schmidt Millar Triathlon may be sources for financial help. Last resort: stand in line in front of a trailer at a women's health fair for a free one. Education For those with access to the Internet, go to www.nationalbreastcancer.org or www.thebreastcancersite.com. Locally, it's appalling that the SNMH website is only a "we're swell" brochure for the hospital. The Breast Imaging Center gets a paragraph and a phone number. Shameful! Important and useful material could be there, and at no significant cost! What's needed? This isn't tough, folks. A women just goes to an imaging center and says, "Please give me a mammogram." The receptionist says, "Fine. Have a seat. There's no charge." And that's all there is to it. If you who have a problem with that model, you're probably equally baffled by the concept of "free" public education, or that part of the Constitution that says one purpose of our government is to "promote the general Welfare." Barry Schoenborn is a technical writer, and a 13-year resident of Nevada County. His column appears the second Saturday of the month. barry@wvswrite.com is his e-mail address. The opinions of columnists are not necessarily those of The Union. |