I have two friends (I actually have more than two, but this story only involves two of them).
They're both roughly the same age. They're both married. They both have children. 'A' has one child. 'B' has two. B has a college degree, A does not. A relies on some public assistance to help her and her family make it through each month - not a whole lot, but some.
They both work for the same company, and have the same medical insurance through that company. The similarities, however, end there.
A decided that she wanted more children. When she had difficult conceiving, she had IVF - a procedure covered by her insurance. It worked, and she got pregnant with triplets. TRIPLETS.
A's babies were born at 25 weeks, which meant that they required lots and lots of supportive care in the NICU. One died after 10 days. The other two are still there. A got the hospital bill for the one who died and realized that, despite her insurance company covering 80% of the cost, she was going to have to file for medical bankruptcy because she can't pay it - and that's just for 10 days of care for ONE child. She hasn't seen bills for the two that are still in the NICU yet, but if she can't pay her portion for one there's no way she's going to be able to pay for the other two.
That's A's story. Now let's talk about B...
When B was 15, her mother died from breast cancer. She also lost a maternal aunt to the disease. Current research suggests that that increases 'B''s breast cancer risk by upwards of 60%. 'B' worries about developing the disease that killed her mother and aunt and wants to be tested (BRCA test) to see if she carries the mutated gene that causes the cancer. 'B' has decided that if she DOES in fact test positive, she's going to have a bilateral mastectomy so she can, as she puts it 'get on with my life without that shadow hanging over me all the time'.
Sounds like a good plan, right? The insurance company doesn't think so. They won't cover the cost of the BRCA test - $3500 - and 'B' can't afford to pay for it herself.
This insurance company will fork out literally millions on IVF treatments and neo-natal intensive care for premature babies for a couple who already have a child, but it won't cover a $3,500 genetic test for a woman whos family history puts her in a high-risk category for developing a potentially fatal disease.
What the fuck, America? Is it just me, or does this seem unfair and fiscally irresponsible?
Tuesday, June 8, 2010
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