Maria’s Story: Why we need healthcare reform

In honor of National Breast Cancer Awareness Month, Women at Forty is asking readers to submit their true stories of challenge and triumph.  In today’s feature, guest blogger Rachel Dachel tells the touching story of a wife, mother and friend who fought cancer and her insurance company, and won.

breast cancer awareness Healthcare Reform is a national hot button topic; it has been for more than 15 years, as First Lady Hillary Rodham Clinton made universal healthcare her priority and signature platform. Unfortunately, neither reform nor universal care materialized, so healthcare in America has continued on “as is.” Insanity can be defined as “continuing to do the same thing while expecting a different outcome.” It sounds as though America fits the description—at least as far as healthcare in this country is concerned.

For too many people, healthcare is more than just something being debated in town hall meetings and on cable news shows; it hits close to home. Not just acquiring coverage, but also having medical coverage and actually obtaining treatment and having it paid for in as timely and stress-free a manner as possible. Illness threatens the lives of millions of Americans and sadly, uncaring bureaucrats and greedy insurance corporations have threatened their sanity, faith and financial future while deciding if the cost of saving a life fits into the profit margin. Such was the case with my best friend, Maria.

Maria and I met at work in the late 90s. We worked for a company that was known for providing excellent benefits to its employees and their families. Insurance had covered the birth of her three children as well as the nicks, scrapes and broken bones that came along with rambunctious boys. Her healthcare coverage was part of why Maria remained with the company and always lauded it. Well, until she really needed it.

In her early 30s, Maria noticed lumps in one of her breasts. Frightened, she sought medical attention immediately and after examinations, tests and biopsies, was relieved when told “it’s not cancerous.” Although the lumps seemed to multiply, she didn’t worry because the doctor continued to say “it’s not cancerous.” Over a few years, she developed lumps in the other breast as well and upon her next round of tests was told, “It’s not cancerous…YET.” One simple little word—three little letters—changed everything.

An Ounce of Prevention

After getting additional opinions, examining her family history and a great deal of soul searching, Maria and her doctors determined that a radical double mastectomy would be her best option. She was not yet 35-years-old and had three boys under ten-years-old. Maria opted to have her breasts removed in the hopes of preventing a battle with breast cancer and living to see her precious children grow to maturity.

Maria was a trooper about it. She was the epitome of grace under pressure and most of our other friends and co-workers had no idea what she was experiencing. She continued to be the busy working-mother for all outward appearances, and to think ahead to when the physical discomfort and tear-filled nights would be long behind her and life would return to something closer to normal.

After months of preparation and prayer, it was time for the final consultation with the surgeon who would remove her breasts and the threat that they posed to her life, her family. Maria called me. Her voice was weak and I could hear it crack, just as I could hear tears rolling down her cheeks. While finishing up the surgical consultation, a representative from the insurance company had called to advise her that her mastectomy would not be covered and she would be responsible for all costs associated with the surgery and her recovery. Since the lumps were pre-cancerous, the insurance company had decided that she was choosing to remove her breasts at this time. The representative reassured her though, that when the condition became cancerous, it would be a coverable procedure—and then had the nerve to thank her for choosing XYZ insurance and wish her a good day.

Difficult Decisions You Shouldn’t Have to Ponder

Next were frantic calls back to the insurance company, then to Maria’s attorney. After months of coming to terms with losing her breasts and preparing for a recovery period of several months, my friend’s world was rocked, literally. Maria and her husband began debating her health versus their family’s financial ruin. Maria’s health insurance was also needed for her diabetic son. If she went ahead with the surgery without the insurance company’s approval, not only would she have to pay the medical expenses, but she would face an unpaid recovery period and possible job loss. The latter would compound the family tragedy even further, as losing her job would mean having to find other insurance, and her son’s diabetes could be seen as a pre-existing condition and thus he could be denied coverage.

Thankfully, the attorney made light work of the insurance bureaucrats. Maria was able to keep her original date for the surgery, and I am proud and blessed to report that the surgery went well. I still remember the wave of relief I felt as I watched her sleep in the hospital after the surgery. Despite the wires, monitors and the look of exhaustion, she never looked more beautiful to me. My friend, my sister—Superwoman had survived the battle and was on her way back to being all things to all people: wife, mother, aunt, sister, daughter, friend, co-worker, maid, chef, teacher, personal shopper, late-night phone buddy and radical double mastectomy survivor.

Adding Insult to Injury

Months passed as Maria recuperated and anticipated her next milestone, reconstructive surgery. The process for that involved pain—not discomfort. A band was placed beneath the skin where her breasts once were, then inflated over several weeks to stretch her skin and eventually accommodate the breast implants that would help restore her body image and her feminine figure. There were days when no amount of medication could assuage her pain, but she soldiered on, because that is simply what Maria does.

Ironically, as her final surgery approached, some sort of idiot alert sounded at the insurance company and Maria was told that reconstruction was elective and the procedure would not be covered. This time, we were all a bit wiser and better prepared and at least we knew that Maria’s life was not in any immediate danger. The attorney was dispatched, the insurance company relented and Maria got her new breasts. Nipples, however, were deemed purely cosmetic, so those had to be paid for out-of-pocket.

Those of us who know and love Maria are blessed to have her in our lives and cannot imagine things any other way. But there are too many Marias in America whose stories have very different endings. No life should be lost and no family should go bankrupt because of the callous greed of an insurance company. President Obama saw his own mother suffer with cancer at the hands of insurance companies and he wants to change the way they do things. He wants to adopt a different practice, one with common sense and dignity where you actually get the coverage you’ve paid for. He wants to stop the insanity.

Rachel Dachel is a freelance writer and editor, and the creator and author of the blog Rachel-y Motivated Incidents.

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