Insurance woes

Last week after I posted about Kris Carr's book, Crazy Sexy Cancer Tips, in which I said, "There are downright practical tips (learn what your insurance coverage includes before beginning treatment...," a reader emailed and asked, "What do people without health insurance (and there are millions of us) do when they get cancer? Do they just have to shrug and say, "Well, it was a good life even if it ended a bit earlier than I expected," or is there some agency out there that loans hundreds of thousands of dollars to people with marginal income and spotty credit?"

Like the reader (and 46.6-million other Americans in 2005 according to the Census Bureau), I am without health insurance, and have been since the mid-1990s. At that time, Ken and I were farming in Minnesota. We had been carrying the insurance ourselves for several years, but every six months the bill would come, and it would have jumped by leaps and bounds from the previous six months. We would increase the deductible by leaps and bounds to exert some control over the run-away cost of our insurance, only to have the next bill come and be higher still. When the bill hit $600 a month for the two of us, with a $10,000 deductible for each of us and 20% cost share on the covered costs (prescriptions, for example, weren't covered) we finally decided we couldn't do it anymore.

We had lenghthy discussions before we let it go: obviously, this kind of coverage was definitely limited to catastrophic problems, cancer being the most likely. We decided that if we did get cancer, or any other major health problem, we didn't necessarily want to go through a some of the things that modern medicine puts you through. At the same time, this policy wouldn't cover any type of alternative practitioners, people we were starting to feel might be more appealing to us for some types of problems (we both swear by our chiropractor). We also decided that we would prefer to spend our money on eating very well and avoiding toxins, because by that point we were already starting to think those things were more closely linked to health than we had previously believed.

I don't regret our decision, even though it's probable that one day each of us will be diagnosed with something terrible. At that point, I don't expect to live quite as long as someone who has the full-meal deal. But really, who does, anymore, and even if they do, a 2005 study by some Harvard medical school researchers showed that over half of personal bankruptcies are illness-related, but most of those filing bankruptcy for illness had health insurance! Particularly interesting findings of their study:

"Three-fourths (75.7 percent) of these debtors were insured at the onset of the bankrupting illness. Three-fifths (60.1 percent) initially had private coverage, but one-third of them lost coverage during the course of their illness [canceled by the insurance company when they cost too much]. Of debtors, 5.7 percent had Medicare, 8.4 percent Medicaid, and 1.6 percent veterans/military coverage. Those covered under government programs were less likely than others to have experienced coverage interruptions."

What to do when you are sick and uninsured

Kris Carr's suggestion in her book is to immediately talk to the social service worker at the hospital. These employees are usually familiar with what support is available in your state from federal and state sources (such as medicaid).

The Foundation for Health Care Coverage has an excellent website (or 800 number at 800.234.1317) with information to assist uninsured people find out what kind of assistance is out there and how to go about obtaining it.

Something I have done in the ensuing years when I have had to use medical doctors (such as when I crushed my hand building a fence, or had a ruptured cyst) is tell the doctor as soon as they walk in the room, "I am uninsured. I'll pay your bill, but since I'm cash and carry can you work with me to keep it controlled--for example, can we order tests one or two at a time, and really use a process of elimination?" Doctors have been great when I say this right up front. The orthopedic doc for my hand, for instance, always charged me for "minimal visits" even when he was with me a long time. When the cast finally came off, he showed me all the exercises to do and made a number a suggestions, rather than send me off to physical therapy.

Particularly if you have kids, do consider getting a basic term life insurance policy. (Don't get suckered by cash-value life insurance or any of the other fancy policies.) It may seem morbid, but this investment will help protect your family against bankruptcy when you die (whatever the cause), and it isn't as outrageously expensive as health insurance. For a young adult, the cost should be less than a couple hundred dollars per year.

And, finally, follow the advice that Kris Carr's physician gave her (because her cancer is so rare, there was no good treatment regime): "Focus on building your immune system through diet and lifestyle."

Crazy Sexy Cancer Tips by Kris Carr

I attended the Mountains and Plains Booksellers' Association fall meeting last weekend in Denver (ostensibly to sign copies of my Pocketful of Poultry book and to meet with my editor from Storey Publishing), but while there, I had to take advantage of the situation! I spent a few hours cruising the trade show floor, looking at this season's new releases from dozens of publishers. For a book junkie, what could be more fun? I found a number of books there that looked appropriate for book reviews here, and will cover them over the coming weeks...

The first one: Crazy Sexy Cancer Tips. This part-memoir/part-prescriptive book, is by Kris Carr, an actress and photographer diagnosed at 31 with epithelioid hemangioendothelioma, a cancer of the blood vessels in the liver and lungs. It has a foreword by Sheryl Crow. Carr also did a movie by the same name, which aired in August on the TLC channel.

I haven't seen the movie, but I will say, this book is absolutely exceptional. Funny, scary, heart-breaking, and inspiring, all rolled into one, the book offers not only Carr's tips, but also those of dozens of other young women who have heard the words, you have cancer. There are downright practical tips (learn what your insurance coverage includes before beginning treatment, or drink plenty of clean water and eat organic) and whimsical ones, too (have a shaving party and don a pink wig when it's time to let your hair go). Though the focus is on young adults with cancer (including a chapter on dating, sex, marriage, and babies), this book can easily cross generations, empowering women who hear the big-C diagnosis to live fully and purposefully. For this, Carr deserves a Pulitzer, a National Book Award, and an Oscar.