The Mammogram Maze

This is not to express favor or disfavor over "Obama Care," nor to have this be construed as a political statement. I understand that for every pro, there is a con, and for every opinion, there is at least one equally valid contrary opinion. This is only my experience.

While sitting in a political science class last year desperately trying not to yawn, the instructor began to talk about “Obama Care.”  I felt the heat rise quickly in the room.  The class of at least 100 students was divided straight down the middle politically.

I don’t need to tell you that I am a professed tree-hugger, a save the world, one person at a time type of girl. This is not because I understand all the layers of politics, I don’t. I simply wear rose colored glasses where in my perfect world, the hungry would be fed, the cold would be warmed and those of us with lousy medical coverage or none at all would have options.

The instructor asked, “If I turn the heat up to 80, how many of you would be uncomfortable?” A few raised their hands.  “If I turn the heat up to 90, how many would be uncomfortable?”  More raised their hands.  “If I turn the heat up to 150, how many of you would beg me to turn it down?”  Everyone in the room raised their hands.

“Politics is about how our own lives are affected at any given time. If you have great health coverage, you are comfortable.  If you don’t and you need it, you are uncomfortable. We assess our own needs and make determinations primarily on how comfortable or uncomfortable we are.”

Thinking about my own life, I had to agree, I was not comfortable. Having been self-employed most of my life, I always paid for my own health insurance.  I had the best plan available.  I was young, the premiums were low.

And then I got old… or in the world of health care, I became a liability instead of an asset. My premiums gradually rose from $250 to $460 per month. I looked elsewhere, but because of earlier health problems, I became uninsurable. Even Kaiser wouldn't touch me. In the world of cherry picking, I was no longer a cherry.

I looked at the situation logically, but saw none. I have never had cancer. I had a hysterectomy leaving me with less susceptibility to cancer than most women, and then was classified as “high” risk.

I was billed $6,000 in co-pays and deductibles. Lucky for me, I got out of the hospital in record speed because I knew for each day I would have to pay an additional $500.

“I’m letting you out a day early because you seem to be doing so well! Record speed!” my OBGYN exclaimed in awe of my superwoman recovery. Did I mention that I am a good actress? By my standards, I got paid $500 for that performance.

Shortly thereafter I realized I had to change my health plan. I could no longer afford the surgery payments and the $460 premiums each month. I eliminated every perk and reduced my plan to a $225 bare bones plan (i.e. no doctor visits, no mammogram, no anything unless I am hospitalized); which means, I won’t lose my house if I am staring at serious illness or facing death.

Then came time for my yearly mammogram.  I cannot even begin to count the friends and family members that have gone through the hell of breast cancer; some of whom have died and many who have suffered single or double mastectomies, chemotherapy, radiation and emotional and physical scars from this disease.

Under the circumstances, one would think that getting a mammogram would be as easy as a flu-shot, but it didn’t work that way, not for me anyway.

I called my OBGYN for a referral; the one that was paid a lot of money to take out my uterus.  She wouldn’t give me a referral without a doctor’s appointment, costing approximately $100.

Remember now that my new plan doesn’t cover doctor visits.  I thought the need for a referral, a piece of paper seemed ridiculous.

Luckily, after hours of research and “sorry you’re too young for a free one, sorry you aren’t on welfare, sorry….” I found out that Alta Bates gave free mammograms, so I made an appointment.  Once I got there, I found the mammogram was free, but they did need a referral first. 

I called my doctor's office from the waiting room.  "You have to come in for a referral maaaam.” There was no empathy. I called again, humiliated.  “I can’t afford to go in…isn’t there any way…” she cut me off at the pass. “No, you must come in.”

Wait a minute, this is my doctor. The doctor who I have intimately trusted over the years with my… parts and she was denying me something as basic as a mammogram referral? Maybe I was unreasonable, maybe I don’t understand the rules of medical ethics and policies, but I was upset.

This is what people go through every single day for something as basic as preventative health care. And so I pulled a typical me under duress. I cried, I tried to intimidate, I pleaded, I tried to guilt; I was shameless…to no avail.

"Sorry maam, I can't help you."  I sat in the lobby with head in hands and sobbed like a 2-year-old, snot and all.  In my world of fairness, life, liberty, and the pursuit of happiness, this was neither of the above. I simply didn’t have an extra hundred dollars for a mammogram.

I then did what I always do when I’m having a meltdown. I called my cousin. My cousin can fix anything. She is like the miracle worker.

Once I got past the point of nonsensical babbling and could actually form comprehensible words, she responded with the usual…. “Oh! I can fix that!”

And so she proceeded to call one of her dear friends who just happens to be a surgeon.  I won’t mention his name just in case there is some ethical “bad” thing about giving someone a referral for a mammogram without seeing and charging them, so I’ll just call him “John.”  Well “John” couldn’t fax the referral fast enough.  Within 10 minutes I was having my boobies smashed and flattened into the machine with a smile on my face. 

A year has passed since then and it’s time for yet another mammogram.  There is one difference, however. A few months back I called Anthem to change my plan.

“You can’t” they said, “You have the cheapest plan available to any living human or animal on the planet." And so I said all smarty pants, “Well….what happened to the Obama Care plan?”  “Oh, you don’t want that plan” the salesman replied.

Not easily appeased I responded with “Well, my plan really isn’t doing me any good. Tell me the difference in plans.”

You know when commercials try to sell you something and then at the end the volume falls a few decibels and they speak Martian-like while disclosing the potential problems? ”Side effects may include nausea, vomiting, headaches, blindness, earaches, runny nose, a desire to cook, seizures, and even death.”  Well that’s basically what I got.

“The plan would cost you $25.00 less per month and offer 50 preventative care visits at no charge, including but not limited to colonoscopies, mammograms, and two doctor visits per year at $40…”  Did he just say “Mammograms? Doctor visits?  $25 less per month?” Why wouldn’t I want that plan?  And so, I took the plan.  I bit the apple.

I recently went to Alta Bates for my yearly mammogram, no charge, no prescription needed, and since I just turned 50, it is time for a colonoscopy; which is also covered.  All I needed was to have the heat turned down.

But I urge you, if you haven’t gotten your mammogram, for all of those who have lived, died, suffered, walked the miles, raised awareness and money for research…please let it not be in vain.

They paved the road for the rest of us, it's up to us to take the next step; that's the least we can do.  Make that appointment and get your mammogram.

If you can’t get a referral, just call my cousin. She can work miracles.