Friday, July 24, 2015

If you get cancer, you should quit your job and go on Medicaid

Duh duh duh...

A POLITICAL POST!


For the most part, I've kept this blog pretty apolitical. After all, cancer doesn't care if you're a Democrat, Republican, or an Independent. However, by nature I am a political gal, and now that I'm out of the trenches of treatment, I thought it would be good to share my feelings and experiences with the U.S. healthcare system, and what cancer patients can do to help ensure that they will get through their treatment without crushing medical debt.

So, before I get into the thick of things, let me disclose something: I am a loud and proud liberal Democrat. FDR is my favorite U.S. president, and I think President Barack Obama will go down as one of the best presidents in modern American History. It's not just the whole healthcare reform thing -- which was, in the words of Vice-President Joe Biden "a big fucking deal" at the time it was signed into law in 2010 (after all, most U.S. presidents since Theodore Roosevelt have tried to pass some sort of healthcare reform legislation), and which has been even more successful than even its strongest proponents calculated. President Obama has taken this country from the depths of a recession into a period of (relative) economic stability, been the first president in U.S. History to support same-sex marriage (which then set the stage for SCOTUS to make that the law of the land), and has been an overall champion of a strong, resilient middle class for the 21st century.

So, that's where I stand on the political spectrum. To my Republican friends out there -- please keep reading and keep an open mind. While the issue of healthcare is highly politicized in our country, what I'm going to say in the next few paragraphs really has nothing to do with politics and everything to do with saving lives -- literally, emotionally, and financially.

You may have gathered from my headline that I recommend that if you get cancer, you should quit your job and go on Medicaid. Of course, for most people it is not that simple, but if you happen to find yourself in a similar place as I did -- getting cancer at age 26 or older (when you're no longer eligible to be on your parents' plan), not married, and making a modest salary (I worked in education, which I loved, but let's be real...it doesn't pay the bills like being a Wall Street investment banker would!) -- I'd highly recommend that you at least consider resigning from your job and enrolling in Medicaid. After all, jobs will come and go -- the average American worker now stays at one job for just 4.4 years, according to the Bureau of Labor Statistics -- but medical debt can, unfortunately, last forever.

My situation was perhaps a little different from most. I had been living and working in NYC at the time of my diagnosis. Before I even knew Medicaid was an option, I wanted to move back to MN, where I'm from and where my family lives, for treatment. Since I was not eligible for FLMA at my old job, my only option was to resign. After I made my decision, my parents and I looked at what my options would be on the MN healthcare exchange website (https://www.mnsure.org/). We figured I would be eligible for some sort of Obamacare plan. However, given that I no longer had an income, I was eligible for Medical Assistance, the Minnesota term for Medicaid.

At first, I felt a little guilty going on this. Even though, as I mentioned above, I am a liberal Democrat, I felt there was a stigma attached to Medicaid, and that I was somehow "cheating the system". After all, I was a college-educated "white collar" professional. I was upwardly mobile! I had a 401K (not that there's much in it, but still)! Medicaid was for "poor people" who were too lazy to get a "real job" (for the record, I never personally thought this, but unfortunately I think this is how our society views those on Medicaid, which made me feel uncomfortable going on it). However, when you have a life-threatening disease, you don't really have time to think about politics, so I took the leap and quit my job, moved back home, and enrolled in Medicaid.

Thankfully, Minnesota has one of the most generous healthcare systems in the country, and I was able to get treatment at the University of Minnesota, which is top-notch when it comes to oncology. I was never treated as a second-class citizen, or a leech on society, or any of the other awful things people on Medicaid or any other sort of public-assistance program are often thought of, at any point in my treatment. And for that, I feel extremely lucky. I feel even more lucky that, aside from co-pays (which were pretty minimal), my treatment was 100% covered -- this includes visits, medications and scans.

To be honest, I have no idea of the total cost of my treatment. But just to give you some perspective of how expensive saving yourself from cancer can be, let me share one medication I do know the cost of: Neulasta. You'll remember that I had to get an injection of Neulasta following each treatment of chemotherapy because of my severely low white blood cell count. Oh, it's just a quick injection, how much can that cost? Well, it came with a very hefty price tag: FIVE THOUSAND DOLLARS. I kid you not. The first time the nurse brought it out she breathed a sigh of relief, as oftentimes many private insurance plans do not cover it. I did this injection 11 out of 12 treatments, so if I would have been uninsured, or had insurance that didn't cover it, I'd be in the hole $55,000 -- on top of what the other medications and scans would cost. I am honestly nauseated at the thought of what my medical debt could have been.

Now, there is a reason why healthcare is so expensive in this country. It's a private market, and medicines that work are worth a lot. Profit is what drives these ground-breaking, life-saving medical innovations. And for the most part, this is a good thing. However, I don't know about you, but that figure seems absolutely insane. Like, unfathomable. And unfortunately, for many people this is the reality of what it costs to save their lives.

This is why I encourage anyone who is recently diagnosed to at least consider this option. While I know this isn't an option for many people -- maybe you cannot afford to not be working (thankfully, I was able to move back in with my parents, who kindly took me back into the nest), or you live in a state with a really crappy Medicaid system, or you are working your dream job and don't want to leave it -- if you're somewhere in between, it might be worth putting your professional life on hold to focus on getting healthy in a reasonably affordable way, especially if you have additional debt from student loans or a mortgage or whatever.

Without Medicaid, I would never have been able to return to my life in NYC. Without Medicaid, I would never be able to go to graduate school, which I am starting in the fall (and am super stoked for!). Without Medicaid, I would never be able to have my positive outlook on life and what I can do in my life, because I'd be too busy worrying about how I would dig myself out of an impossibly deep hole.

So there you have it. Medicaid saved me -- literally, emotionally, and financially. It's allowed me to resume my life and become a productive member of society again. And, most of all, it's allowed me to continue to follow my dreams and not let my life get bogged down by shitty circumstances beyond my control. And for that I am beyond thankful.

Wherever you fall on the political spectrum, I urge you to keep an open mind about government programs. Sure, many of them don't work as well as they should. In fact, many of them don't work at all. But there are many that do, and rather than vilifying them, we need to realize that these programs benefit real people. And in my case -- and many others -- they even save lives.

We live in the 21st century, in the richest country in the history of the world. We've made incredible gains in science. Diseases like Hodgkin's lymphoma, which used to be a death sentence, are now just a shitty bump in the road for most people. If we as a society can do that, certainly we can figure out a way to make quality healthcare affordable. But until that day truly comes, I am thankful that I was able to rely on Medicaid, and I encourage anyone else who is unfortunate enough to find themselves in Cancer Club to at least consider it as an option.

Thanks, LBJ!

LBJ, accompanied by President Truman, signs Medicare and Medicaid into law on July 30, 1965

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