Amen, Leroy.

I have been dealing for two weeks with a billing problem during which my account was erroneously sent by my provider to a collection agency. Now I don't have just Stage IV breast cancer to worry about; I also have to worry about underserved potential damage to our credit rating.

This problem pales in comparison to the one I heard about last week from my oncology nurse. One of her patients was referred to a nephrologist because her kidneys are failing. During the last two months, she has been admitted three times to the hospital for treatment. She is very ill, and she has no one but herself and an adult, mentally impaired daughter. She fell behind on her payments and the nephrologist's office called and cancelled her appointment. Now she is in renal failure, but cannot get treatment until she makes payment. But she is too sick to have the energy to pay those bills. How's that for a catch 22?

In this country, the most affluent in the world, not all of us even have, or can afford, health care coverage. If you think it is equally available to everyone, then you just haven't been a part of it yet.

Ignorance is bliss until you are hit with a catastrophic illness and live in fear that you will not be able to work and will lose your health care coverage.
Or maybe you work, say, as a preschool teacher, or a nurse's aide, or whatever for about $25,000 per year. On that salary, you can't afford a health insurance premium and still pay for groceries and rent. Yet, you make too much to qualify for our government assistance programs. There are so many ways to fall between the cracks.

We should be ashamed, indeed.

Sent by Sandra Shuler | 7:27 AM ET | 05-30-2007

Every so often in the BCO.org chat room, a woman will come in who has been diagnosed w/ breast cancer, and who has no health insurance. It's an unimaginable position to be in. Sometimes they live in other countries, but not in Australia or Canada, where they have universal coverage, not in Great Britain, for the same reason. Often as not, they're from the richest country in the world, the US. You're right about the shame Leroy. How is it that we allow others among us to suffer and die unaided, or let millions go into financial ruin trying to keep up with co-pays, deductables, and non-covered parts of their treatment. Will it take most of the members of Congress having personal experience of someone they care about in this position?

Sent by Nancy K. Clark | 8:23 AM ET | 05-30-2007

I know i am lucky to have help with my cancer treatments, or else i'd be on my own planning my funeral. National Insurance is good but not as great as you'd think, i have a friend from the UK and he says that , yes, people have the help they need but usually have to wait months for it and not the best quality, so lots of people end up paying for private insurance to get better service and options, not to mention being able to see a doctor in a reasonable amount of time. there are problems in every country it seems, but ours is despicable
and we definitely should be ashamed that we cant even take care of our own citizens. Hopefully in 2008, things will shift in another direction where our country will care about its people.

Sent by Jenn | 8:24 AM ET | 05-30-2007

Amen. When I was dealing with cancer, I felt so grateful that I not only had very good health insurance but also a disability policy through work that paid about 60% of my salary while I could not work from the nasty chemo effects. It was sobering to realize that without the policies, especially the health insurance, I could have been rendered bankrupt, homeless, or in debt the rest of my life - all through the luck of the draw.

Very well said, Leroy. It is shameful.

Sent by Art Ritter | 8:26 AM ET | 05-30-2007

This is something that I often struggle with... how much is my life worth? I'm very fortunate to be extremely well insured and a stay-at-home mom so work and continued coverage is not an issue. I receive itemized bills from my world-class cancer center and a recent bill for a single day of chemo was $22,000! Arenesp (red blood cell booster: $5000, Irinotecan (chemo): $11,000 etc. I'm only responsible for a $15.00 copay but someone is paying the cost.

I have a rare and uncurable cancer that should have killed me about a year ago. I've estimated that my, ultimately futile, treatment has cost close to a million dollars thus far. Can we as a society afford that kind of money to prolong a single life? How much basic care would that buy for the uninsured? Where is the money going? Drug companies? It seems that way since out of the $22K only $109 was billed for 45 minutes of my oncologists time. None of my treatments/medications are cutting edge so how can these costs be justified? R&D should have been recouped long ago.

Obviously for my 3 young children and myself, any cost is worth it. Would I feel the same way if by choosing treatment I was to impoverish my family? Do people (with my kind of diagnosis/prognosis) in countries with some sort of government sponsored health sytem have access this kind of care? I don't think so. A European friend has a brother with a similar diagnosis/prognosis, similar demographics (40's young kids) and he was only offered basic palliative care. Is treatment for a few priveleged morally right when the masses go without? Or is it better to limit (based on age, prognosis, societal worth etc.)available care so that everyone has basic health coverage? Who makes the choice?

On a separate note; HMO's often get a bad reputation. My large northeastern HMO has not questioned a single charge from chemo, to prescription drugs to monthly scans to visits to countless specialists. They pay everything in a timely fashion. I've even been assigned a case manager whose job is to mahke sure that I receive all available services.

I spend alot of time thinking about this. Some sort of survivor (although I'm a long way from that) guilt?

Sent by holly | 8:36 AM ET | 05-30-2007

Add to your equation employers who bear down on caregivers because the one they care-take has not died in a timely manner.

I agree - we, as a country, should be very ashamed. The fact that 'we' aren't fills me with.... well, how do you define the undefinable? Let me just say that we, as humans, should know better.

Sent by Connie Jaeger | 9:21 AM ET | 05-30-2007

Dear Leroy,
I've been reading your blog since the broadcast and have been touched by your thoughts, even though I hadn't emailed you. I wanted you to know that it made me glad to be a small part of a healthcare community that makes some small difference.
Oddly enough, as I was driving to work this morning, this very topic was going through my mind.
It's something that is never very far from my mind, to be honest. I work for a large private oncology practice in South Carolina. Part of my job is to assist the patient with identifying and obtaining benefits that they may be eligible for. Primarily those are policies that they may have purchased to help in emergencies, like disability, cancer policies,mortgage insurance,etc.
But as you've said, this disease is devastating. Not just physically, but financially.
I'm proud that we are one of the only private practices I know that have someone in my position that advocates for the patient. The funds that I help them receive go to THEM to assist with their everday expenses. We also have 3 social workers that help identify grants, loans, and other emergency funds.
But most importantly, in the over 20 years that this practice has been here, the physicians have made it their mission that no patient is every turned away for their inability to pay. They are some of the most dedicated, caring individuals I've ever had the privilege to work with.
I've seen members of our staff (there are over 200 of us now), reach into their pockets to assist patients-monetarily, or by giving them a ride to and from treatment, maybe by buying them lunch, whatever it takes.
I sit on a board for this facility that concerns itself with ways to assist those that are under-funded or without insurance. We are constantly striving to come up with ways to raise money to assist these patients and families.
It's a drop in the bucket, of course, but until there's another alternative, it's the only way we know to address this.
Thank you for giving insight on people whose lives have been impacted by this disease, and giving the patients and family a voice.
Bless you.

Sent by Norma Fisher-Mixon | 9:34 AM ET | 05-30-2007

I have worked in human services for 30 years. One of the first things that shocked me was watching cancer patients stand in line for food stamps. When my well insured friend was diagnosed with pancreatic cancer, eventually passing away, her share of the costs caused her husband to lose their home soon after she was gone. You are so right I have waited 30 years to see us, as a society, do better. I hope we can, soon.

Sent by Dianna Austin | 9:46 AM ET | 05-30-2007

My solution - tax non-commercial fuel use to fund a universal coverage plans. Kill to birds... conserve energy and create the needed safety net. SOMETHING will happen eventually, but I'd rather prepare than react.
I know... it's not popular, but it's reality.

Sent by Tim | 9:56 AM ET | 05-30-2007

Madeline- thanks for the comment on how to look at the fairness. It made me smile. And also, I dont think God chooses who is going to survive and who doesn't. I know he is rooting for everyone. But I'll always remember your comment. Thanks!

Sent by DiAnn | 9:58 AM ET | 05-30-2007

"Adding insult to injury", you could not have said it better Leroy. My husband has been taking chemotherapy by infusion every three weeks for the past six months. Now his oncologist has added oral chemotherapy taken on a daily basis, seven days a week. I was informed by my insurance company that they did not cover this drug. A social worker at the chemo center said she would help me get on a patient assistance program. Need I tell you the end result? Our annual income is too high, my husband does not qualify. The pills cost 20 dollars per pill.......my husband has to take six pills per day, three in the morning and three in the evening. I am fortunate to have some savings that I thought would be our fun money for our "Golden Years" but, this will be exhausted. At the end of the month it is like paying a second mortgage. Then I wonder what will happen when our funds are depleted..........what happens next? Will I be eligible for the drug then or do they force you to liquidate your other assets; do I have to sell my home? These are not things that we should have to worry about at this point in time when a loved one is so ill. This can also put an emotional guilt trip on you (worrying about the financial end of things) I would give up everything just to have my husband well. Shameful!

Sent by sasha | 10:19 AM ET | 05-30-2007

I just got the EOB for my husband's last set of scans - the insurance's negotiated rate was 15% of the $15K that was billed. If we didn't have insurance, then the hospital would have expected us to pay the full $15K, but because we have insurance, they are ok with getting only a fraction of that. It doesn't make sense.

Another point to add to your commentary is that people without insurance are more likely to be diagnosed at Stage 4. How many lives and dollars would be saved if the recommended annual screenings were the norm for everyone?

Sent by Erica | 10:21 AM ET | 05-30-2007

Oh Leroy, you hit home again. This is my life. 2 weeks before I was diagnosed my Cobra ran out from my old job and my new health insurance started. I am a self employed artist who left a nice paying job to start her own business 2 years ago and was doing very well until this hit. I was very proud that I was a "working artist" and could afford health insurance. Well, as it turns out there are limits to this health insurance that I worked so hard to pay for. Without me creating art the business went to the dogs but that isn't the worst of it.

I have hit the limit for diagnostic care and chemo and radiation. I have paid nearly $10,000 in medical bills (my savings) and will have about $50,000 more to pay by the end of the year IF there is no recurrence. I am out of money and am trying desperately to hold onto my little 2 bedroom house that I worked so hard to buy. I probably will have to go back to the corporate world if I can find an employer that will be sympathetic enough to hire someone that has at least 5 doctor appointments a month and who is very fatigued at best (I just finished 8 months of treatment).

I get calls everyday from the hospital about my bills that I try very hard to sort out but don't understand. I was well cared for by the doctors and don't want to cheat anyone but beyond my house I have nothing else to give. So, if I give up the house...what have I fought so hard to survive for? I'm single and only have a dog to answer to. Life is more important than a house but I don't have the energy to rebuild a life. What am I left with? I have to tell the docs to take it easy on the scans because I must pay for every one. They want to scan me every 6-8 weeks. I can't afford it. Yet, this is a critcal time for me and this cancer and I'm still waiting on word of remission or stem cell transplant. I fight so hard to remain strong, positive and smiling but this financial thing is sucking away the life that I did not give to the cancer. I'm crying my eyes out as I type. I am lucky that people are trying to help and that so many love me but I just can't help but wonder when the insult to injury will stop.

I'm sorry to be such a downer but I'm overwhelmed. I want my life back that I loved so much. I am a painter and was told I brought so much to the world with my art. Now what?

I know I'm not alone. I send my love to all of you and especially those in the same shoes. It isn't easy for any of us, let alone when the cost of care or the inablilty to get it steps in.

I say a prayer for all of us.

Sent by Lori Levin | 10:21 AM ET | 05-30-2007

Having cancer and not having insurance must be a special kind of hell. Getting social security disability is 6 months at least and then an almost automatic denial, resulting in a couple of years' worth of wrangling with lawyers. I can't imagine not having insurance. In that at least I was fortunate.

I remember having to really do my homework before the infusion team would give me Emend and Zofran for nausea. The first time they sent me home with just compazine. I was out of commission for a whole week. Thank God for www.bclist.org, and the many women and men there who have had treatment for breast cancer. They told me what I needed and sent me links. Even with insurance, they were trying to cut the cost of treatment. I am sure the infusion room nurses were under a gag order to not "offer" information about possible additional (very, very expensive) drugs. Emend was about $400.00 out of pocket. I paid it at one point because I would not have been able to get it the next day, when I needed it. The insurance company refused to pay because it was a day early.

Sent by Alycia Keating | 10:22 AM ET | 05-30-2007

Thank you Leroy for talking about this subject which is very dear to my heart and life. I was diagnosed with Non Hodgkins Lymphoma stage IV on 12/24/04. I began chemo and other appts using FMLA and Disability coverage. I worked for the largest telecommunication company in the US. They brag on how well they treat their employees but when I began to miss work because of my cancer I was threatened with job loss. I returned to work during chemo, and followed to the bathroom and asked how long I would be while I was throwing up.
I was then terminated after the protection FMLA was used up. I was lucky to have paid for long term disability insurance so my health coverage continues and half of what I was making is given to me monthly. The toll on my family to be making half of my income and fighting every 3 months with the Long term Insurance company that I am disabled is exhausting. I recieve care from an HMO which at first told me, they would not treat my cancer. I had to go outside the HMO and pay a doctor outside of the HMO to give me a second opinion on the type of care I needed. Then I went back and demanded that my HMO treat me. At times my battle with the HMO, LTD, and cancer feels hopeless. Yet no one cares...Lately there were whales in the river near my home. The state and federal government spent millions to get them help and back to the pacific ocean, yet no ones advocates for those of us with cancer who not only are fighting for our lives but for basic care.

Sent by Miriam | 10:48 AM ET | 05-30-2007

Today's column about the cost of cancer really struck a nerve. My wife of now two weeks was diagnosed with stage 4 Bronchio-alveolar cancer on February 21st, 2007. She is a self-employed real estate broker and the only insurance coverage she could afford prior to our marriage covered only in-patient hospital stays and little or nothing else. She is holding her own and even gaining against the monster and, blessedly, we are not without resources and the grace and generosity of friends. Debbie is fortunate that her cancer, at this point at least, can be treated by a new generation targeted drug called Tarciva. It is the cost of this drug that is outrageous, however, even more than the 80 dollars per pill you noted in your article. Debbie has no medication coverage to speak of so the first month of Tarciva cost us 3570 dollars at our local Walgreens pharmacy for 30 pills. We knew at the time that we could purchase the same drug in Canada over the internet for 2500 dollars per month but needed her first month's dosage quickly. We have been buying the drug through Canada since and now I see rumblings in the Senate that this ability is being challenged by who else, the powerful and rich pharmaceutical lobby. Debbie and I recently learned some fantastic news however. The insurance that I have from my work, I work for a large county in Texas, will cover Debbie, pre-existing condition and all, now that we are married. And the price we will now pay for the same drug, Tarciva, has gone from $3570 per month to $60.00 per month through my plan with Aetna. Though we are happy about the much reduced financial burden we now have, it is a crying shame that we can now get the same drug for $3510.00 less per month with the insurance we now are blessed to have. What in hell do people do without insurance, seems to me they probably die before they can raise much of a fuss. How can a pill that an insurance company can sell for 60 dollars with coverage be worth 3570 dollars without coverage?

Sent by Tim Broussard | 10:50 AM ET | 05-30-2007

This issue I addressed a few blogs ago, related to that "only given the burdens we can bear" jargon... lots of people get cancer without stable/high paying jobs and without insurance or "good" insurance. The truth is, one can make all the glib statements in the world, it does cover the reality. It ends up just keeps coming down to the same message being sent out to me, there is no value to life if there's no money attached to you. What, you can't pay? Well, then die, and oh yeah, you get to suffer needlessly and so does your family, before you do. What, you can't get to your job? Well, you're fired! Forget about trying to accommodate you, we want only healthy people! Doesn't that sound scary? It is. And you should be scared, because if none of this has happened to you, then you are just LUCKY and fortunate, and it could change. All the fluffy statements will do no one any good, only a support system that values, respects, and honors each life instead of the $$. Of course, this is an old story, constantly being retold. It really makes me sad.

And while I appreciate those people in the basement who created the treatment I am on, if I did not keep dragging myself to work because I am frightened of what will happen if I don't, I sure would not be able to afford the approximately 5-6 thousand dollars per month for this cancer drug. If I don't take this drug for my leukemia, I will die, no maybes about it. Yes, I know we all die, but jeez it would nice to be a golden 50, aww, heck, it would be nice to be a plain 46! However, I am more afraid of the potential for ruin, for my spouse and I, and a disastrous quality of life for us, then I am of my own cancerous blood. I am trying hard to keep it going, and stay positive, but I DO get overwhelmed with the tenuousness of it all at times. "Stressful" doesn't cover how illness affects people's lives. It is so much, much larger than that. Yes, it is a shame, shamefull, indeed, that these weights are placed on people when they already have cancer on their plate.

It is odd that my health insurance company can "provide" this drug to me at SIGNIFICANT cost reduction, but the price can't be lowered all across the board for those who need it without insurance. I just don't understand it.

I could blather on about the subject of the imbalance of the haves and have nots, but I'll stop -there will be others to take up the conversation, that's certain.

Sent by Pika | 11:01 AM ET | 05-30-2007

This is the struggle that my family is facing, and has made me open my eyes. My mom was diagnosed with stage IIIC ovarian cancer in October after emergency surgery for a bowel perforation.

My parents luckily had successful careers and were able to develop a nice retirement nest egg. Money has never been an issue with my family, my sister and I have always been provided for. With my parents retirement and with several other reasons, my parents dropped their insurance plan. They both had been relatively healthy and felt it better use of their money to pay for the sporadic doctor's visits than to maintain insurance coverage.

From the time my mom had emergency surgery to now has not been covered by any form of insurance. She does not qualify for Medicare or Medicaid, and no insurance company would approve her application. So needless to say, my family is left with ALL expenses. I won't go into details, but I can tell you I have personally written a check for a little over $1500 for a single prescription at Eckerds.

I know the available monies in the healthcare industry, I am a master's nursing student. I see everyday individual's benefiting from a system which aids those below the poverty line. Why can't we have a level field, where the system helps everyone equally? Is it right that my parents simply based upon their success must severely deplete their assests and receive no help?

Thank-you for this blog, I read it daily, and am so motivated by your words and others. I cannot wait to become a pain/palliative care nurse and help.

Sent by Lauren | 11:12 AM ET | 05-30-2007

Hi Leroy,

Back in November 2005, I found out my sister did not have health insurance and had limited funds. It was apparent, the cause of her hoarseness was more than allergies. I would call make the appointments and have to self pay, my next questions was what will it cost. The hospital at the time of presurgical testing asked for money upfront. The day of the biopsy, in 2 hours the bill had become $20,000. We spent Thanksgiving that year, putting together financial information for public assistance. You have to plan her funeral, not what I wanted to here, how much can you pay right now. I know everyone wants their money, but? Now she needs chemo, and the first oncologist said you have to go to County. I cringed. She did go to a county facility. Bad, well all I can say is she received GREAT CARE.

Working through the financial aspects, bills pouring in... questions, did you know about limit of liability? NO, what is that... $10,000 in bills became $30. WHEW, what about public assistance. Hoops, hurdles, and stumbles. Letters from Public aid, more documentation, dropped off signed in... "We didn't receive it, you have until noon to get the papers here."

Limited coverage through Public assistance, and collection too, and finally things (treatments and follow-up) slows down. Public assistance gets cancelled, NOW you have to do it all over, except this time I/we have experience. What questions to ask, personally deliver and hand the paperwork to the requestor. Get the names, phone number, fax numbers, and always say...."Thank you very much, I appreciate all your help."

Insurance or public assistance, everyone faced with the diagnosis of cancer is facing potential finacial crisis. Being sick isn't easy and being the family of someone with cancer isn't easy.

Thanks. :)

Sent by Susan Chap | 11:13 AM ET | 05-30-2007

Well said, Holly! The questions you pose would make good fodder for a semester course on ethical issues in health care.

Who is at fault? Doctors? Hospitals? Insurance companies? Lawyers? I think the answer to that question is, "Yes." And we ALL share the guilt. Each of us is a part of this system, after all. I don't pretend to have the solution to our problems, but certainly it is one that needs much, much work.

I've asked myself often (at least every time I get a statement reflecting the cost of my chemotherapy treatment!) the same question you have: am I really worth all this expense????? It takes the breath away. Thanks for sharing your thoughts. Sandra

Sent by Sandra Shuler | 11:16 AM ET | 05-30-2007

I was speaking to my General Practitioner to see if I could get something for a fungal infection on my toenail. He told me the drug will get rid of the fungus, but only for a while. As a metaphor, he said that cancer treatment was better than fungal treatment. I said, ???There is a fungal treatment that will leave entire families destitute????
For a long time, I have seen the devolution of medical care into a profit making enterprise. Fast food restaurants could take lessons from Physicians on how to move patrons quickly. Even insurance errors and the long delay to resolve anything is seen as a profit source. It has become painfully apparent that medicine is not compatible with capitalism. I have tried very hard to come up with another way to deliver health care, but I do not see anything viable. Certainly, the government is far too inept to be involved in health care. The government can???t win the war on drugs even though their opposition is a bunch of stoned addicts.
I would prefer to offer a solution rather than just complain. Perhaps framing the issue as a capitalist failure will allow someone more intelligent than me to find a solution.

Gary

Sent by Gary Miller | 11:22 AM ET | 05-30-2007

We retired three years ago with hopes of spending what we had saved and invested in things retired people do. Last year the bad news came and that money is starting to slowly seep away. I am at stage IV and I have often thought at what point do I stop. I do not want to leave my husband with nothing. I am looking forward to Michael Moore's "Sicko". I think it will shed some light on why we are in this pickle.

Sent by Cherie Cuneo | 11:27 AM ET | 05-30-2007

My husband, an American, was diagnosed and died from cancer here in Germany. I felt a little envious of the people in the German system. They show their health card and get services. In Germany, things are not as good as they used to be, sometimes they must pay for things out of pocket, but they are not as bad as our American system. The worry just isn't as great. My German doctor said Great Brittain has about 12000 German trained doctors working there right now. The money is why they go. The system in Great Brittain is not as good for the patients. I understand there are long waits for services and sometimes services are denied because of age, etc.

There just needs to be a cap on greed.

The forms - who needs all this paperwork, that needs to go too.

Sent by Irene | 12:07 PM ET | 05-30-2007

Thank you for reminding me of a blessing I have today; health insurance.
When my mom got sick with lung cancer, luckily she had worked at the phone company for 27 years and was able to retire with full medical benefits and a pension. So she is fortunate in that regard. If she were to have gotten sick last year before she turned 50, she would not have been eligable for a pension and would have lost her medical benefits. Life would have been extremely hard since she is a single mother of two, me and my 13-yr-old sis.
Someday I want to start a fund for those who need treatment but cannot afford it, particularly for women with ovarian cancer. And the fund could be for women here in this country or in other parts of the world. Anyway, off to work I go so I can pay my medical bill next month:)

Sent by Lisa | 12:07 PM ET | 05-30-2007

For Lou Mayers:
Thank you for comment about your buddy who is melanoma survivor. I also am fortunate to have friends who have supported me. Typically, I deal with adversity on my own, but cancer brought me to my knees and had me scurrying for all the help I could get. I'm wondering if your friend received a specific treatment that put him in remission or was it spontaneous?

Now it's your turn to seek and receive help; your buddy will be there for you, and I will keep you in my thoughts.

Sent by Bob A. | 12:16 PM ET | 05-30-2007

LeRoy
Top of the morning to you. I must agree with you but I am one of the fortunate ones. I have three insurances. I have my employer, my wife's employer which is the school district and Tri West. Most of my doctors are in my list of providers. So I haven't had to pay much for my years worth of treatment. The one thing that is kind of bad is the order in which they all charged. Triwest is my insurance from the military. They don't pay for anything.The only thing they will pitch a fit about is the order. A nice way for the government to take care of the retired military.
Every time I get a benefit statement, it always states due to the agreement and the amount the provider gets is substantial less than the total. For that I am very greatful. I do feel sorry for those who have to make a decision that could determine whether or not they live or die. I talk to my case manager from my employment every time after a major procedure.
I consider my self very lucky with all the coverages I have as it has taken alot of the stress off of my wife and I.

Very good topic LeRoy. Keep them coming.

Sent by Clark | 12:36 PM ET | 05-30-2007

After reading all these comments I feel really lucky and grateful for living in Spain, I think the quality of our National Insurance for patiens who are going through "this experience" is pretty good, I know this is not applicable for other problems, waiting lists are long. Well, this has been my experience so far.

Sent by Angela | 12:38 PM ET | 05-30-2007

Thank you Leroy for discussing this topic today. When my son was in treatment, a few of the mothers at the clinic became friends. Two of the very young children was unable to eat and had feeding tubes in their stomachs. I remember one of the children did not tolerate a brand of the liquid diet very well. The mother finally found a liquid diet that she tolerated but discovered that her insurance would not pay for it. The next day, one of the other mothers brought in a case of the liquid diet and said her insurance paid for it, so she shared. It is devastating to watch your own child suffer and it is infuriating when you know you could help but the system won't let you. I had to fight the insurance for 8 months to pay a second assistant surgeon for my son's initial liver surgery. How dare the insurance think they know better than doctors as to whether a second surgeon was necessary. I don't think healthcare insurance should ever be a for-profit company because the companies are loyal to their investors, not the patients. Do I really want to be treated by a system that do not have my interest as a priority?

I understand that many countries who have universal healthcare do not have a perfect system. However, they at least have a basic safety net. I think some basic safety net is better than nothing. And hopefully, in those systems, the patients' interests are priority over the net income.

Sent by grace | 12:45 PM ET | 05-30-2007

We are very blessed with great insurance that is assisting us in our son's care -- although we had to COBRA it when my wife lost her job. She spent 8 hours with them on the phone last week, however, after discovering months of bills that were paid inconsistenly -- so now our whole account is under review. Did they overpay or underpay? We're hoping underpay, otherwise we're about to be slapped with expenses we thought were covered but aren't.

As if we, or anyone else fighting this disease, don't have other issues to worry about.

Sent by Vampdaddy | 1:03 PM ET | 05-30-2007

Like Leroy, I was "lucky" when I was sick. I had pretty good insurance. Beyond that, my employer was very supportive both financially and professionally. But I have seen with my own eyes the difference in how people are treated who have less insurance coverage or, worse yet, none. There is a disaprity in the quality of care. There were tests and procedures that I got done that my floor mates in the hospital didn't get. I remember one elderly, poor woman who had cancer. She had a giant tumor on her chest. She worked two jobs as a janitor. She was sweet as could be. The hospital sent her home (to die in my opinion). She had no insurance. Her care was absolutely not on a par with mine.

Why can we spend billions upon billions of dollars on fighting a war of questionble purpose, but not provide even basic health care to our own people? Why do we have money to kill, but not money to save lives? Is it me?

I am a pretty politically conservative person. I am probably a Libertarian more than a Republican. I swear that I would be happily pay more in tax dollars if we could just provide healthcare to people. I must admit though that putting the government in charge of anything almost always seems to lead to inefficiency and some level of bureacuracy.

Who should have to chose between feeding their kids or having a medical treatment that could save their life?

Maybe I'm too idealistic, but I have seen what happens to the disenfranchised who have the misfortune to become critically ill. It seems unfair and unnecessary in a country with the wealth and resources that we have.

Sent by Dave U. | 1:14 PM ET | 05-30-2007

Leroy this is one of my favorite topics with all this fun! (enter sarcasim) I have Brain cancer so I do have to say I use it to my advantage sometime. Depending on the person I am talking to. Sometimes I have to pull what I like to call the cancer card. Is it the right thing to do? The nice thing to do? Maybe not always but sometimes I just find it needed. This topic also fits in well with social security disability. I always figured by the time I become old enough social security it wouldn't be there. So hey I guess I was wrong! I remember the conversation very well with the gal at ssd. I remember her asking what kind of cancer. I said Glioblastoma brain cancer. And then the next question really got me. Well how long do you expect to collect it? So I said I suppose until I drop dead. Let's just say it got a little quiet. Was it the right thing to say? Maybe not but sometimes you just have enough. Here I am with a hole in my head and have to deal with some of the most ridiculous questions. And as for insurance I have learnedd to play their game. Especially with the pills. I will give an example since it may help someone else. With my chemo(temador) They would charge me $100.00 for 1 pill or 34 pills. It took me about 45 minutes on the phone with the insurance lady to get this info from her since she would not just give me the info upfront. My onclogist always laughed at me when I had him write my script. Like you said Leroy not bad enough we have to deal with cancer itself then you have to learn the other games that come along wih it.
Leroy. I have only heard of you through these brief writings that I check into everyday. I enjoy them greatly and can only imagine what a wonderful person you are. I have never even met you and you have added to my life. So for the peole who have been blessed to have you in their life as a friend or family member. I am sure theey coud list a lot more wonderful things about you than one program and this lousy hand you have been dealt...
God Bless you Leroy

Sent by Christine VanHoose | 1:22 PM ET | 05-30-2007

Leroy, When I heard the news my cancer was back, I was told there are only two choices. One that kills 10% to 15% of people given the infusion, right there on the table. The other costs about $7500 a month. Initially, I was told my insurance would not cover the treatment. So I argued, kicked, and screamed until, after two days of calls, I finally got to a person who knew what they were doing. In the end, it costs me about $7500 for the year, but that is still a large amount of money. What is the choice, you have to fight the disease, but at the same time you don't want to bankrupt your family while doing it. I am in a better situation than many, but for a time, at the beginning, I thought I was just going to die. Insurance Companies as a whole are in it to make money, and the apathy that exists is staggering. If you are not a fighter, the insurance companies don't offer solutions on their own, there is something very wrong with that. Stan

Sent by Stan Wozniak | 1:43 PM ET | 05-30-2007

Leroy,
I couldn't agree more. The emotional toll of dealing with cancer when you have insurance is grueling. I can't imagine the toll if insurance was out of the picture. Thanks for your thought provoking blog today.

Sent by Melanie McClanahan | 1:48 PM ET | 05-30-2007

Leroy,
I???m positive that there are millions of us out there who are saying a big AMEN to your post. I wish I knew how to fix the health care system, or which ???solution??? to even advocate for ??? but it???s such a huge monster I don???t have a clue where to start.

While I don???t have cancer, my genetic disorder (HPS) causes a bleeding disorder, legal blindness, a Crohn???s like colitis and pulmonary fibrosis. Currently I???m on 11 medications with a co-pay of $25 to $35 each. Then there???s ostomy supplies and CPAP supplies. And then there???s doctor???s appointments at $20 each (I have three scheduled for June so far). And since I don???t drive, if I can???t find a ride, or don???t want to sacrifice an entire work day to bus connections, I pay $30 each way in cab fare. And this is provided that NOTHING GOES WRONG! But hey, I???ve got a chronic illness. Stuff goes wrong.

I participate in a clinical trial at NIH. Thankfully, most of my travel costs are paid for that, but I still have to get to the airport etc. More dollars added.

I am a complete slave to my health insurance. I work in the print media, but to be honest, I feel like I???ve been robbed of my ambition, of my dreams. As a legally blind person, I fought like hell even to go to journalism school, let alone start a career. Now, I feel cheated of what I worked so hard to create. As you well know, growing a media career often involves taking risks (or changing careers for that matter.) I don???t dare. My condition is progressive and there will likely be more medications, more drug trials, and someday possibly a lung transplant in my future. I???m single. My life revolves around my insurance. There is no one to help me.

But I???m lucky.

As director of outreach for our patient advocacy group (an all volunteer operation) I deal with families all the time who are either completely uninsured, or who rely on public assistance programs for their insurance. Try getting a complex, progressive genetic disorder that no doctor has ever heard of treated at a free clinic where you see a different doctor at each visit.

I don???t know if I???ll ever own a house, buy nice furniture, etc. My parents and peer group can???t understand why I constantly am pinching pennies and don???t own anything. It???s hard to build wealth if you???ve got chronic illness from your teens onward. But, that doesn???t mean I don???t constantly feel frustrated and inadequate about my finances.

Everyone acts like I can???t budget ??? but I???m working a full time job, freelancing on the side, and helping to run this non-profit for our disorder. Give me a break folks! I???m doing the best I can!

I used to be very into financial planning programs, reading up on how to invest etc. I can???t even stand to sit through our company???s 401K talk anymore. I can???t help but wonder that if one day treatments and a cure are found and I beat this thing after decades of fighting it, will I have anything left for old age?

If this is where I???m at now, what???s going to happen when I get really sick?

Heather in Kansas
www.heatherkirkwood.blogspot.com

Sent by Heather Kirkwood | 1:50 PM ET | 05-30-2007

Thank you for talking about this so clearly. We absolutely should be ashamed of this as a country. I am fortunate to have had insurance (and a company I have not had to fight with a lot of get the care I need--they've been good) and a very supportive employer and a husband that helped to keep track of the bills when I was too sick from the treatments to care. I know lots of us fighting this battle are not nearly so lucky.

Sent by N.R. | 1:58 PM ET | 05-30-2007

Leroy - my wife and I had transfered to Sacramento, Ca from San Luis Obispo, Ca 8 months before I was diagnosed with cancer. In San Luis Obispo I had a PPO and it cost me almost $5,000 for my share when I had a Basel Cell removed from my ear. Here in Sacramento I have Kaiser. The total cost to me for surgery, 6 months of chemo and all of my medication for the colon cancer came out to $432.00. I shudder to think what debt we would have been in if we were still in San Luis Obispo.

Sent by Richard Welch | 2:33 PM ET | 05-30-2007

Leroy,
You are so right about the unfairness of the medical system in this country. I thought about the uninsured people dealing with cancer every time I was at the hospital. For them, cancer is probably a death sentence in the immediate future. Cancer is heartbreaking enough without that pressure.
I was lucky to have good insurance (which has since been terminated), because I got very good care which cost, for surgery and chemo, just under $300,000. My white-blood-cell-booster shots cost $8,500 each and I had to get one after each chemo treatment. The hospital still charges me $4,900 for a blood draw and for the lab work related to that. My insurance disallowed $4,400 of that so I paid about $500 for that procedure every three months. For someone without insurance? They don???t even get the disallowance from their provider so they have to worry about the inflated charges on top of everything else.
Our healthcare system needs a major overhaul. Why is it tied into a particular job? And available to those who have money? And why does health care service cost so darn much? This system is not just or humane and it???s not getting any better.

Sent by Maggie | 2:41 PM ET | 05-30-2007

When I was diagnosed with stage 3c ovarian cancer in Dec. 2002 I thought I had insurance. I had even been paying for a "cancer rider". You can imagine my surprise and dismay when someone from the billing office of the hospital came to my room shortly after surgery to tell me that my insurance was basically "no good"! The room was $1280 per day and the insurance was only going to pay $200. Fortunately, they assured me that I would get the same treatment with or without insurance. They also advised me to get a different insurance as soon as I could since I would be having more surgery in a few months. (They couldn't remove the cancer during the 1st procedure and were planning 4 rounds of chemo hoping that it would help reduce the cancer into a mass that could be removed.) The four rounds of chemo cost between $7,000 to $13,000 each and the insurance only paid $1,,000 per treatment. I was left owing more than $50,000 for the first surgery and 4 rounds of chemo.

I was lucky that in Massachusetts if you have insurance (good or not) and apply to another company they have to take you without pre-existing conditions. So I was able to change to a very good HMO (to the tune of over $700 a month) and had the second surgery and 4 more rounds of chemo and only had to pay $500.00 for all of it. I am still paying off the $50,000 owed from the first half of treatment. I hope I live long enough to complete the task!

It is truly unfortunate that our country can't seem to figure out how to provide universal care to us the way Canada does for the citizens there.

Sondra Scott

Sent by Sondra Scott | 2:43 PM ET | 05-30-2007

Boy did you say a mouthful. My 6 cycles of Chemo cost $15,000 followed by a $5,000 Neulasta injection. That is a $120,000 cost mostly for drugs.

I saw the Neulasta advertised many times on TV. Why? What is the target audience?

A report just recently aired saying Americans pay 60% more for prescription medication that the rest of the world.

The rational of the drug companies is the high cost of research to develop new drugs. The truth is, the spend more on advertising than they do on research. I always wondered why no one asked them why American's should have to pay the brunt of the research bill, but since they are not dealing honestly, there is no reason to ask the question.

Our Legislators have lead us to the wolves of drug companies and oil companies. Our Democratic principles and capitalism in this country has been sold to these lobbiests whose greed, the lobbiest and the polititians, that may well be the end to democracy.

I find it sadly ironic that we are at war trying to show the rest of the world the joys of democracy and antitrust principles.

I just hope the public starts to become angry and let their "representatives" know how they feel. And then back it up with the only currancy we have, our vote!

Norma

Sent by Norma Greer | 3:09 PM ET | 05-30-2007

Dear Leroy,

Medical costs and lack of insurance for many in this country are travesties. I had always been a little blissfully unaware, or perhaps more like the ostrich with its head in the sand, about the true costs of medical care without insurance. Sure, you hear the stories, but until you are aware of what these costs are, until you see them in black and white on paper, does it really hit home.

I am one of the fortunate ones, blessed with my and my husband's ability, through our respective jobs, to be financially unscathed by the cost of my breast cancer treatment. But I will never forget the day when I received a breakdown of the bill from the oncologist to the insurance company for costs related to my chemotherapy. One shot, that I received every three weeks, was over $5,000. The cost of one chemo session, in the thousands. It finally made me raise my head from the sand and start thinking about all those who don't have insurance. And now, I guess it is time to do more than be aware of this injustice. I just don't know what it will take to start to rectify this situation.

Thank you, as always, for laying it out in black and white.

Best,
Mo

Sent by Mo Spikes | 3:21 PM ET | 05-30-2007

Leroy,

I have watched people go broke trying to stay alive and it is repulsive to me. I have found myself thinking that if I ever got into that situation, I'd just hang it up so my family could have something left - which is a very horrible thing even to contemplate.

There isn't any reason why health care is so costly in this country except greed and bureaucracy. Other nations - England and France come to mind - manage much better than we do to provide care for all. I'm voting for the candidate with the best health care reform plan in the next election. The one we have now is a disgrace for sure.

Sent by Diana Kitch | 3:40 PM ET | 05-30-2007

I have health insurance. Thank goodness!! But the fact remains that with co-pays, deductibles, out-of-network costs and other expenses not covered, we are under a mountain of debt even though we have insurance.

I don't know if I'm going to survive the cancer, but I do know one thing for sure -- my credit will never recover.

Sent by jane | 3:51 PM ET | 05-30-2007

Try living with a chronic disease like hemophilia. $800,000+ in the last 3 years alone. I own nothing. Without insurance, without a job, I???d be so far in debt I could never get out.

Just dealing with the inevitable mistakes (and there are many) such as miscoding but the doctors, incorrect items charged to my account, haggling between what the insurance will and will not cover is headache enough.

First question is ???What insurance do you have???? And I am always advised (by signing a form) that I am responsible for all the charges that insurance doesn???t cover. I always write on the form, if it isn???t covered by insurance, I don???t want it.

One thing I have noticed, however, is that there are ALWAYS doctors visits from doctors I have never heard of on the bill. Because I usually go to a ???teaching??? hospital, it is not unusual for a doctor that I have never seen or will ever see again to walk into my room, look at the chart, sign it, smile and leave. However, they apparently don???t have access to my insurance card, because their charges ???bounce back.??? Since the amount of my visits are always astronomical, I???d be interested in how many of those doctors collect a quick $250 just by walking into my room. How many other ???consultations??? on ???monster??? cases would a physician be able to get away with at $250 a pop? Beats a day on the golf course, I bet.

Sent by Bob | 3:51 PM ET | 05-30-2007

Hello everyone,

This country should definitely be ashamed. When I was growing up we said the pledge of allegiance every morning before we began our morning studies. I always liked the end as a child, specifically the statement "with liberty and justice for all." We were taught that the US was a great country to live in and you could go as far as your dreams carried you. How untrue I have found this to be.

Your post this morning brought my own situation to the forefront. My son has a seizure disorder. An MRI this year turned up a "dot" on his brain. He has trouble with motor skills, paying attention for long periods and the bones in his feet are not developing properly. In early March, I asked my employer for an unpaid leave of absence for 30 days because I wanted to get some second and third opinions. My employer denied the request and I was promptly fired. So the last few months I have been pretty diligent about looking for work and trying to manage his seizures. It's been pretty stressful - - to say the least. Because I get child support in the amount of $550 per month I am not eligible for emergency food stamps or any of the social programs that would aid us in our time of need.

I was, however, referred by my landlord to an agency in Illinois that assisted people who fall behind in their rent. I explained my situation to the caseworker. She asked me what was my income. I said beside child support $0. She told me I was ineligible for the program because I needed income. I replied that if I had income I wouldn't be in this situation right now. She said that is how the funding for this program works. They will only help you if you have income.

Naturally, I didn't understand. You will help me if I can help myself but if I cannot help myself, you won't help either?

Needless to say my son's medical care is being put on hold until I have some income to pay the co-pays. You know it's sad that I can't fill prescriptions because doing so would mean we can't eat. But I have to pray that he doesn't seize because I'd be in trouble this way as well.

How did this country get like this?

Sent by Gloria Lovett | 4:29 PM ET | 05-30-2007

I do have a question for those of you out there that have used FMLA leave. So far this year, I have already taken 10 weeks of my FMLA leave. Part of that was for having my precious Sophia and I also opted to have my second thyroid surgery during the same 10 week period. I am now looking at atleast one month off for treatment. I have been reassured by HR that I'm okay on time, but I know that I'll have to have another month off in 6 months. I just want to make sure I have my bases covered. Does FMLA leave vary from state to state...any help is appreciated!

Leroy, what an amazing writer you are! Your ability to put into words what we are all thinking astounds me! You ALL are in my prayers and thoughts!

Sent by Tess from KY | 5:00 PM ET | 05-30-2007

Dear Leroy, Well said again. My husband drives 4 hours every day so I will have health care. He lives in fear of us losing our home but I am finally able to work again. I lost my job and was unable to get long term disability that I paid for. You have to be dying to get social security assistance and the middle class person is left to spend their savings and more to just survive. My daughter has become an advocate for me and looks for financial assistance. I wrote to you, I wrote to Oprah. It needs to be shouted from the rooftops that "cancer patients need financial help". It makes me upset sometimes to see movie stars saying how they survived cancer. Well of course they did, they had the money to pay for the best care and could focus on getting well because they didn't have to work!!!!!!! PLEASE continue to address this issue because you have a voice that will be heard. Speak up for us in the cancer community you have formed. Thank you.

Sent by Vicki (FL) | 6:56 PM ET | 05-30-2007

It costs my family thousands of dollars to cover co-pays and costs that standard insurance didn't. I am blessed we were able to survive. I grieve for those who treatments devastate the family income and savings.

My biggest fear is to re-occur and lose my income. My family would be better off financially if I die. What is wrong with this picture?

Thanks for bringing this subject up.

Sent by Janis | 7:00 PM ET | 05-30-2007

The decision when I have to stop work will be easier for me. I have to work until the doctor tells me there is no more hope. I know I have no chance of remission or cure. I won't put us into financial ruin. I will just give in to the disease and live it out as best I can. I want to live to 60, but I probably won't. Money and insurance are constantly going through my mind. How much can we make in profit on the house when I give in to move to a condo? Will it be enough to put me back on my husband's old coverage, for how long? The insurance I have through my work is excellent. I've had to pay $10 co-pay twice to my internist then my oncologist. In the two years I've been on chemo for up to $60,000 a month the only bill I've gotten aside from presciptions was for a $13 flu shot. Prescriptions are a breeze. Never more than $6. I cry myself to work every day because I don't know how I am going to do it. I have a cry part of the way home because I don't know how I did it. I've been teacher of the year because of cancer. Colleagues have donated over 35 personal leave days to help me survive chemo. Summer vacation is 12 school days away. And a picture that never leaves my mind is the day before Thanksgiving 2006 of the elderly man sitting very close next to me waiting for chemo - he had 4 shopping bags of bills he was sorting through with the social worker. They kept falling all over the floor and he was in tears. I can see how easily that financial ruin can happen to any of us cancer patients .

Sent by Cheryl McDowell | 7:39 PM ET | 05-30-2007

YIKES! I wrote a long post this a.m. and lost it, but no matter: Everyone else more than said it. Insurance is just a start. The high cost of "chronic" cancer lies with many things the IRS won't allow, even when you have the upfront to pay it. We barely do. The last 2-1/2 years have taken every stitch of savings, all available credit on our credit cards, all home equity and much of our sanity. Caregiving has threatened my job, certainly affected the lack of discipline/supervision of our 13 year old. The costs are HUGE.

I think its great that we are all talking about this. Most of us suffer in one-off silence. None of the groups/associations etc. really deal well withis topic. We'd practically need a political party with a cancer plank to really gets some attention.

So glad to see everyone post about the high cost of cancer. Makes me feel a lot better, and not so lonely.

Sent by Teri | 8:27 PM ET | 05-30-2007

Bob A.
I guess there were things I didn't even know about my friends cancer. I wrote his wife for answers to your questions. Here is what she wrote back. I thought it should be shared with everyone. It's quite a story. Bonita is stage4 breast cancer.

"Ross's big bout with cancer was not melanoma...it was "head and neck"
cancer, although he had several bouts of skin cancer before his head &
neck cancer started.

There are 3 kinds of skin cancer...Basal cell, squamous cell, and
malignant melanoma, which is considered the worse & deadliest. Ross
has had all 3 types from time to time and several surgeries to remove
cancerous skin tumors, including a melanoma...the first was on his lip
many years ago. All of his skin cancers were removed by a plastic
surgeon, and they always took enough to get to clean margins.

When his head & neck cancer started it started in the area where the ear
touches the side of the face. At first we thought it was another bout
with skin cancer but it grew very large very quickly. He had surgery,
then he had radiation & we breathed a sigh of relief. A year later it
came back and quickly became huge...they could not radiate the area
again nor could they do more surgery. This is when the dr said he had
maybe 6 months. There was nothing left to try except chemo, so they
put in the port and said they were starting him on the highest dose of
chemo they had ever used....he went in 5 days a week for 3 weeks each
month (3 weeks on, 1 off) for 6 months. Each day's drip lasted
approximately 7 hours...it was a combination cocktail, can't remember
what was in it. That was a trying time....he was so weak for so
long...some days he was so weak that just walking to the bathroom or out
back to sit in the arbor was a major effort. Some days he would be
bored and ask that I drive him to the shopping center just to
browse...we would get there and he would be too sick to get out of the
car & we would turn around and come back home & he'd go back to bed.
That was at the end of 1999. Today he is home remodeling our master
bedroom and bath. The cancer has not returned yet, and it probably
knocked out a lot of his skin cancer as well. He still goes every 6
months to his dermatologist and every inch of his body is checked for
early signs of skin cancer, and they are either taken off with "freezer
burn" or removed by in-office surgery. We are not giving the new skin
cancers any fair chances. He also has periodic CT scans to watch for
any recurring problems, especially with the head & neck cancer. Now he
is strong and holding me together while I do my battle with metastatic
bc. May marked one year for me.

One thing I have learned through all of this....when there is a choice,
choose the most aggressive treatment while you can & as soon as you can.
Each day choose to live happy for that day, keep your mind and body as
strong as possible, find things to make you laugh, and reach out to all
of your family and friends. It makes them feel needed & useful to be
able to help or even just to listen, and it makes a HUGE difference in
how well you get through all the challenges you face. My friends send
me jokes, recommend good books & funny movies, do tons of internet
research & send articles my way, spend "normal" times with me even when
I'm trembling inside, and hold me during those times when the tears
come. Cancer is affecting far too many good people and it is a
formidable opponent. I plan to fight like hell for as long as I can.

Cancer is not a private affair....we all need each other if we are to
win the battle. You may share any part of our stories with whomever you
feel may helped or inspired by them.

Hugs to you, dear friend...

Bonita"

Sent by Lou Mayers | 8:40 PM ET | 05-30-2007

Leroy- I have noticed that NPR has moved your blog to the botttom of their contents page. Do they think your blog is not a feature item now that you're enjoying NED ? Does this strike you as odd- I guess you can look upon it as good news.

Sent by Linda H. | 9:27 PM ET | 05-30-2007

Don't you sometimes wonder, when you hear of a cancer patient who decides to forego yet another round of treatment and just let nature take its course, whether it is not the rigors of the cancer treatment that they want to avoid, but the rigors of dealing with the medical and insurance complex?

Sent by tex | 9:32 PM ET | 05-30-2007

Tess from KY:
Info on the FMLA is available on the US Department of Labor website. http://www.dol.gov/esa/whd/fmla/
I don't know whether there is also a KY statute.

Sent by tex | 9:40 PM ET | 05-30-2007

Dear Leroy,

I wrote for the first time two days ago for the first time, when I finally got enough courage to actually send my post instead of deleting it after writing, for fear of sounding negative.

Because I have been misdiagnosed, and being a complicated patient to begin with, and dealing with many other health problems in the past, my first question, when I began to have problems getting answers regarding the status of my cancer - does my insurance coverage have anything to do with the quality of care I have (not) been receiving? Questions such as, which of the three lab reports reporting the number of lymph nodes removed you received after my mastectomy is actually accurate? I promise, I am not embellishing when I say there were different numbers, and the surgeon was unable to enlighten me how many she actually removed, because she does so many surgeries, I was only one of many. How could she be expected to remember one patient's labs? One report said 3, another 14, another 30. I have never been able to determine which is accurate. One problem, many labs were filed in another patient's chart! Her only response, and I was not alone in the room when she said this was, "Oops, I think I might have made a mistake and did not get all your cancer"!
I do not know why I am continuing to have such difficulty, but I have been assured it is not my insurance coverage. I have been disabled from a prior neck injury which resulted in a broken neck and was only repaired after five more surgeries (including living for one year in a "halo", only to have it collapse again 24 hours after removing this apparatus. This misery continued over 5 years (due to a misdiagnosis by a physician who thought he was infallable, and a mistake could not have been made during his surgical procedure, dismissing me as a hysterical female.)

I am left to believe it is only because I am too difficult to deal with, so they just do not. It is too much work and I do not fit into the boiler plate diagnosis, which would require some thought on the part of the physician and staff, so I have been left behind.
No one physician, and there have been many since my Breast Cancer diagnosis in February 2006, has been able to tell me why I am so ill, only their unanswered questions and hypothises regarding where the cancer has spread,
leaving me to wonder between test after test if I am every going to feel well enough to consider myself a valuable human being. At this point,I feel pretty useless, not able to do the most nominal functions such as cook a meal and clean house, take care of the normal daily occurances without becoming exhausted after only a few minutes of trying my best.

Hopefully, soon I will get some good direction as to where to turn next to find out the real problem, and try to get my difficulties corected. My fear is that the clock is ticking, and we all know how loudly it ticks, sometimes. But, with all your help, I wil be able to maintain some hope, and I will continue to come here to read your thoughtful posts, and grab on to your words of encouragement and of hope and keep the belief your strength will rub off. Then I will go on the the next day.

Love,
Briana

Sent by briana | 9:53 PM ET | 05-30-2007

Hi Leroy and all,

Leroy ??? thanks for taking several people???s requests and raising the topic of cancer costs. The comments have been very revealing and deepened my anger and sadness at what the insurance-pharmaceutical-hospital complex is doing to all of us in a profit maximizing medical system. I???m very lucky. My cancer costs a good deal, but the insurance and deductibles are affordable - and not based on my working. Obviously, from the other comments, many are not so fortunate. The retail billing would be ten times as much. I cannot even imagine what circumstances we would be facing if we had to choose between paying this and my death. Without treatment this would have occurred around six month ago, rather than in the next few months, or, at best, years. I hope I???m using the time well.

What you are hearing from your other correspondents is only the tip of the iceberg ??? those who blog.. What is the situation of cancer patients who are not computer oriented ??? people who, I suspect, are worse off and more poorly insured than we are.

We are in a Catch-22 situation in several ways. We???re dependent for the extension and, in many cases, preservation, of our lives on the very enterprises that are impoverishing and denying coverage to many of us. Our treatments costs huge amounts of money that could save many more lives if invested in disease prevention. Both could be dealt with if our political leadership chose to invest in health, education and social infrastructure rather than war.

Cancer, indeed, suck - but not because of the disease alone.

The costs do not just add insult to injury ??? they pile injury upon injury.

Thanks for reading

John Shippee
Atlanta, Georgia

Sent by John Shippee | 11:22 PM ET | 05-30-2007

Hey Leroy,
Heather in Kansas again - you know, you should print off all of these comments and make copies for every member of Congress.

Sent by Heather Kirkwood | 11:54 PM ET | 05-30-2007

Wow .. great subject. I am a Brit living in the USA and recently diagnosed with colon cancer, stage III. If I hadn???t been covered with insurance I dread to think what I would have done. In fact we have said that more than likely I would have flown home to Britain and got the treatment, cos we couldn???t have afforded to pay for it here in the USA if my husband wasn???t earning good money and covered by insurance.

It???s correct that there are delays in the British health system but that???s for example for something like a knee surgery. I have just had an auntie who died from cancer just before Christmas and my uncle unfortunately is suffering from lung cancer, both got the same treatment I have had here, as far as quality, drugs etc. The difference is they are not out of pocket $10,000 and that???s with insurance. My uncle has the Macmillan nurse visiting him, he doesn???t have to drag himself out to the clinic if he feels ill, they still do home visits ??? all is paid for via the National Health service.

I love the USA and living here, but it???s because I have a comfortable life style, I would hate living in this country if I was not comfortable enough to for example go to a doctor.

Now the weather on the other hand.. you can keep the UK rain, I love Colorado :}

Sent by Jill | 12:56 AM ET | 05-31-2007

When my husband discovered 7 years ago that he had brain cancer melanoma he was so lucky that he was being treated through the Veteran Administration. The way our finances all he has to pay for is whatever presciptions they give him. They started out at $2.00 a prescription now they are $7.00. I hear some of the veterans complain. I tell them they have no idea what the real world cost is. I had one prescription for 8 pills that was over $l00.00. My husband has had a lot of colonstormies and endoscopes last year trying to find out why he was so sick. They even did MRI's and Cat Scans. They finally decided that it was all in mind. The end of August we were back in the E. R. of the V. A. and his hemoglobin was down to 6.8. The E. R. doctor said "Well, we are going to have to go in and explore to see what is wrong." dLuckily, the oncology surgeon, whom happens to be a very good diagonistiON, too the PET SCAN and the Cat Scan back to where he teachs. And there it was. A mushroom shape tumor on the outside of the intestion very close to the stomach opening. The last day of August they did surgery and the prognosis was not good. The lymph nodes around that whole area lookes really bad. The family told hubby about the tumor but not the lymph nodes until 9-11. They were clear. The doctor told us that they are going to have to be more agressive checking him out. The only complaint I have with the V. A. doctors is that they don't communicate very good with each other. Hubby does get mad at me about being as verbal with the doctors. If I had not with that O R doctor the results might have not been what they were.

Sent by Jill Tanking | 7:55 AM ET | 05-31-2007

We all need to be advocates for these issues, take action, become involved, sometimes all you need to do is write an email to your Senator or Representative, let them know how you feel, why you are frustrated and how it affects your life, we elected them therefor they need to make the changes, there are 54 posts here right now, thats 54 emails or letters, you relatives and friends can also write as caregivers and supporters. Lets take it a step further and let them take a peak at the suffering, the pain we all suffer living with cancer. Go to your newspapers and tell them your stories of struggle and coureage, to have to go to work sick, to be terminated from your job for being sick, losing your homes, its amazing. I am there like many of you and I feel for all of us, poor or rich, it doesn't matter we are all fighting the same battle, when we are supposed to keep our energie to heal.

Sent by M. Sardinha | 8:10 AM ET | 05-31-2007

So true.
We spend our lives working to have the coverage and then when we are down and out we lose it.
I was 49 when dx'd with stage IIIC ovarian cancer. I was an RN and had worked at the same hospital for 28 years. During treatment my docs did not want me working. ICU is too germy.
After missing 4 months the hospital relieved me of my position. I was truly shocked and felt kicked in the gut. Talk about pain.
Thankfully I was married and hubby was insured. What if I was a single mom with two sons. How in the world could I have afforded cobra payments????
Something is drastically wrong with this system.
It is like you have to stay well to be insured for God's sake.

Sent by karen mason | 8:31 AM ET | 05-31-2007

Too many people put off screenings for colorectal cancer because they are afraid they couldn't pay for treatment if cancer were found. Of course, this just makes things worse when symptoms finally make going to the doctor unavoidable -- and the cancer is found at an advanced and very, very expensive stage. Good news is that there is a bill in Congress now that would make colorectal cancer screening available to all Americans without insurance and would pay for treatment discovered during that screening.

Sent by Kate Murphy | 9:21 AM ET | 05-31-2007

I just reached my out of pocket maximum for the year. I celebrated that as much as I'm going to celebrate my last chemo treatment in 13 days. And I have to mention that I am able to use vacation for all my treatments. Overall, I'm a very lucky person. This has been expensive and time consuming but thank goodness I have the resources. I think about those people that don't have the resources and already targeted all my donations to those organizations.

Sent by Lisa | 9:53 AM ET | 05-31-2007

I read your blog on May 31st. I was diagnosed with lung cancer last Sept. went through 33 radiation treatments, and 6 chemo treatments, the tumor had shrunk by Feb., but in May it had grown again, so my oncologiet prescribed Tarceva A fairly new cancer drug. Cost is $150.00 per tab. take one A day. I could not afford this, so my nurse looked into getting help. She contacted SPOC, A Co. in Ca. that helps with payment for drugs. They got me in touch with the Crinic Dease fund in Texas, whoare going to pay for this drug along with my insurance co. for the rest of the year. The first 30 tabs. would have cost me $2200.00. I started them on the 25th of May. So there is help out there if you have someone to help you find it.

Sent by Richard Peck | 11:20 AM ET | 05-31-2007

I have suffered from severe IBS for many years and (ironically, I guess) it became so bad several years ago that it actually qualified me for Social Security Disability, which includes a _very_ small monthly monetary payment. The most important part of qualifying for the disability, for me, has been that I now have Medicare coverage, parts A (which is free), B & D (for which S.S. Admin. takes a small amount out of my benefit each month). I also pay about $165/mo for a supplemental policy which picks up whatever Medicare doesn't cover. I am very grateful that I have this coverage, because without it my husband and I would be up the "creek without a paddle".
I was diagnosed with Ovarian Cancer stage 3c in Jan. '06. I have had cutting edge treatment at the Seattle Cancer Care Alliance and University of Washington Medical Center. So far, we have only had to pay about $4000 out of pocket for the treatments. But we live on an island 100 miles north of Seattle and a 2 hour ferry ride from the mainland before we can even begin the drive down. Monthly trips to the mainland are expensive, and no coverage helps us with the travel expenses, and nothing can alleviate the stress of those long, long trips when Cancer is the motivator. Then we often have to stay in Seattle for a week or so at a time; the costs add up exponentially.
My husband essentially let his new business go to become my primary caregiver for a year, so we had no income. We have a sizable mortgage on our home. If my husband had not reached full retirement age a couple of years ago, we would have had nothing but his IRA to live on, and as it is, we have whittled that down to almost nothing. We are currently involved in several "creative financing" efforts, including moving out of our beloved home into a tiny building and trailer on our property so that we can rent the house and generate some income that way. We are staring down the barrel of a financial gun that could go off at any minute and blow us away, and _we_ are some of the _lucky ones_!
It _is_ shameful, what people have to pay in this country, just for _basic_ health care, let alone catastrophic, cataclismic events like cancer. Priorities in this country seem to have been turned upside down, and though there is a lot of talk about "reforming" our health care system, I see no real progress, only more moral and ethical confusion.
After my diagnosis, people in this community were incredibly supportive of my husband and me, and 2 charitable accounts were set up in our name to help cover what medical expenses would not be covered by insurance. We were stunned by people's generosity; money poured in to those accounts. We were also blessed to have an organization here that provided free flights to the mainland for people with cancer who simply could not take the ferry, and, for people like us, free ferry tickets and even shuttle service to and from hospitals. _We are lucky_. Even so, the money from those accounts is long gone; we cannot accept free ferry tickets or shuttle service now, during regular follow up trips to the SCCA. And we wonder all the time, how do people who _don't_ have any kind of coverage, who have no savings, who live on the edge, or below, of poverty level, even cope with such a thing as a cancer diagnosis and treatment. Are they just expected to give up and let it kill them without a fight?
Is there something that we can do to motivate the current administration to institute some form of assistance for people in these situations? I would love to help, if there is.

Sent by Katherine from San Juan Island | 12:05 PM ET | 05-31-2007

I agree with you! The stress involved is terrible!!

When I was 1st diagnosed, I could not work. I had no choice but to rely on welfare. I dreaded going there. They make you feel like a worthless low life, begging for help even though I have worked most of my life and paid my taxes for programs like that, they still make you feel like half of a person. I live in New York State and who ever adjusts the average cost of living for the standards on what they allow to help you, really needs to come to the 21st century. No wonder people are homeless, and just give up, for what they deiced to give me to help me. I am currently living on $29.00/month food stamps and my basic diet consists of romaine noodles. (Not a very healthy food but it is substance). They helped me with half my rent: less than 300/mo. I don't know if they've checked housing costs in this century, but it cost more than $600. /month for an apartment.... Then they stopped after 6months. I was lucky enough to have an understanding landlord. He let me stay for free until I was approved for Social Security.

I had to apply for Social Security Disability because I could not work. Even though all of my doctors gave them reports (with x-rays, CT-scans and phlebotomy reports) they still made me see their doctors (as though they did not believe my doctors and we were trying to put one over on them). And after jumping through all their hoops.... Alas, Social Security denied my claim. I heard rumor that it is their common practice to deny 90% of claims no matter what. I had to get a lawyer. I was lucky enough to find a free lawyer who cared enough to help me. (Not many people continue to fight and unfortunately give up on everything... I've seen it happen). It's bad enough to have cancer and all the turmoil that goes along with it, but to also have your own country treat you like a beggar. The stress for all the bull (excuse my language) is enough to make you just quit and die.

After a year or so, I was finally approved. Welfare took what ever Social Security to "pay them back" and I was left with a measly amount to pay off what ever bills I could. Yes!!! It is very very hard! The co-pays are piling up, I have to scrounge for gas to go for treatments and I live like a hermit, because I cannot afford to do anything, but the key note here is I live... I still have hope... I have too... I'm just not ready to give up yet.

Sent by Shirley | 12:21 PM ET | 05-31-2007

Leroy,

One of the things I have been saying from the beginning of this cancer gig, what to do people without insurance do? I supposedly have decent insurance and yet many things were/are still a battle, like getting the anti-nausea drugs I needed for chemo... my insurance company covered an oral course of drugs before they would allow the intravenous drugs, but the hospital protocol was intravenous only...the hospital followed their protocol and now we are fighting with the insurance company..luckily!, I got so sick even with the intravenous anti-nausea meds, that I qualified the second round... But still, the chemo made me so sick that I was eventually on every anti-nausea pill they could prescribe-five...and adding the newest ones were a battle.. one of them cost over a 100 dollars a pill...but I paid out pocket for them initially because I would do anything to feel better..and I had the money to do so...

Thankfully, for me, I have a friend who took on dealing with the insurance company for me, so that I didn't have to and one of the staff at the doctor's office has been working closely with my friend to get stuff covered. Without those two people, I wouldn't have bothered because I was too sick from chemo..

something needs to change in this country.. people should just have to worry about getting well... as if getting cancer is not enough...

Sent by Yvette | 1:10 PM ET | 05-31-2007

Leroy,
I've been reading this blog for a few months, but this is the first time I've posted.
My mom has stage IV breast cancer, but worse, VA insurance(Veterans Insurance). Her care is limited by funds and staff that primarily treat men. Whatever care she receives has to stay within what they are "willing" to give.
She has been receiving chemo and the mets to her lungs, bones and liver have completely disappeared. However, she has been having pain in her remaining breast and asked for a mamogram. She was told "why bother?" She asked for a lumpectomy to help with the pain and was told, "I don't operate on stage IV cancer patients, it's a waist of time."
After all she has been through; this is the ultimate slap in the face. She is willing to fight, so they should too.
Unfortunately, that was the only breast surgeon available to her at the VA.
Bad doctor? Bad health system? Bad attitude? It doesn't matter because the result is still the same...my mom will endure uneccesary pain and suffering because of her health insurance and its inadequacies.

Sent by Wende | 2:00 PM ET | 05-31-2007

Every citizen of the US should have equal and unfettered access to healthcare in the same way as we have police or fire protection. I am a physician and high utilizer of services for my advanced cancer. I was recently in French Polynesia and those folks (French) have full access to doctors and hosptials with a co-pay for meds and visits and are happy. I am not a socialist but we must as a society provide a system of access and payment as we do to other services. Hopefully, statesmen in Washington will help solve this instead of continuing to acting as politicians dancing with Drug Companies, Insurance Companies, etc.

Sent by dr bill | 2:14 PM ET | 05-31-2007

I saw a pickup truck with a sign that said "I voted for Bush. Please forgive me!" I certainly felt that way after I saw President Bush on TV talking about how the people will just have to start paying more of the costs of their health care. I wonder how much he pays for his...my guess is nothing.
My co-pays for chemo this last year were almost $1,000 per month. A friend said thank God you have the money to pay for it. I replied thank God I have credit cards with high limits.
I had surgery on 6/22/06 and I have yet to get the hospital bill. I keep watching the mailbox waiting for the anvil to fall!
In spite of this, I feel fortunate to have coverage through a Medicare HMO. It is not perfect but so far they have not denied any treatment and did send me to a university hospital for surgery.
The thing that scares me most about the healthcare we get now is the long delays in getting treatment and getting into surgery. My first indication that I had cancer again was a biopsy done on 4/1/06. I had authorization to see a surgeon at the university on 4/25/06 which I felt was pretty good service from my HMO since I had some tests and had seen a local surgeon during these three weeks. It took me a full month to see the surgeon at the university and another full month to get into surgery. I have Stage 3 small bowel cancer. The first time I had cancer in 1961 (back in the dark ages), I had symptoms on Friday, saw a doctor on Saturday, was hospitalized on Sunday and had surgery before the week was out. The result was Stage 1 Colon Cancer. I was cancer free for the next 25 years. My doctors blamed my HMO for the delays, but I credit over 50% of the problem with the medical establishment and their policies and lack of urgency.

Sent by Charlotte Kewish | 3:18 PM ET | 05-31-2007

Dear Norma Fisher-Mixon,
I am very confused. I have always been told by every piece of literature I have read and by all the cancer advocacy groups, the place you should turn for help is your oncologists office, and being in a very tentative situation, I did exactly that. I have Breast Cancer which was misdiagnosed, then over the past 16 months, because of many many abnormal tests and other opinions, I have been told I have bone cancer/ Myeloma, kidney involvement, breast cancer that has gone to the bone, which is different than bone cancer and will not show on a normal biopsy, live in a constant state of stress because of an abusive and emotionally cruel relationship and have been abandoned by family and friends. I know this sounds harsh, but it is the truth, and when I turned to him to ask for counseling to help me get through this maze, try to make some sense of it, he told me his practice didn't handle things like that and did not have counselors available, did not have a referral list of social workers or therapists and did not know of a good primary care physicians for me to go to to help me sort this out before I go absolutely crazy with fear.
This, plus my appointment, lasted a whole 11 minutes before he turned and left the room, only to leave me crying out of frustration because last my best source for some kind of relief would not even look me in the eye when he told me I was very ill but he did not know the source, but to try to find another doctor, and epidemiologist, and did not give me a name, to help me manage this. I was completely blown off.
I read your blog about people like you who help those who are in my position and at the end of their rope, literally, and having a hard time hanging on. I know I need an advocate, because of the illness and the side effects of the cancer medications have left me so drained I can hardly function, much less advocate for myself any longer. What do people like me do in a situation like this? Who do we turn to when the people we are told will help us just turn and walk away, leaving us crying in the exam room and then never even turn around to ask if you are alright? I am desperate for a clue, some direction if someone could just point me where I need to go and what to do. I am not unintelligent, and I did have skills before the cancer meds took my memory and organizational skills, but if I do nothing, I will not be able to go on much longer, because I fear I will give in to the strong feeling that no one cares anyway, so I might as well just give in to it and let go, and go on my way. My sister has promised when I am buried she will make certain it is in a plastic bag in Potters Field. That is my family support and what I would have to look forward to if I did not take care of myself several years ago and have the presence of mind to make certain I had a burial policy. My health insurance is not the issue, it is good, so I am at a loss. I have come here before, and tried to be less aggressive and more lady-like, but I need help, soon, or I fear.......
I hate to sound so desperate, I have tried to temper things on this blog and not sound so needy and desperate, but I can no longer hide the fear that I cannot do this any longer. Do you know where I can turn to talk with some one? If you have any suggestions, I am willing to listen and try to do anything I physically am able to do.
I thank you for your kind thought and any clue you might give me what direction to turn next.

briana

Sent by briana | 5:00 PM ET | 05-31-2007

I could not agree more with Mr. Sievers about health insurance. It's a really sad irony that we are spending so very much to "fight terrorism" (what a joke: our continued presence and actions in Iraq have only vastly increased terrorism) and incur so much unnecessary death as we do so, while a huge number of people in this country are not insured.

I have spoken to many people from Canada and England too in our shop over the years re their health insurance, most of whom cite problems with it, and most of whom as well thank God they HAVE it !

Of course there will be problems, glitches, etc. - I feel the bigger problem would be having cancer and not getting treatment, or getting inadequate treatment, or being financially ruined.

Thanks for the opportunity to have a voice on this critical issue.

Sent by Nancy Oliveri | 5:34 PM ET | 05-31-2007

Ugh. Insurance. What a sore subject. I couldn't agree more with your sentiments here.

I am lucky that I have insurance (that I pay for out of my own pocket) and that my family helps me, but it is a never-ending battle. I met my $750 deductible on Jan. 3 this year. And I'll probably exhaust my $2,000 annual prescription drug coverage by the end of June.

I'm currently awaiting their decision whether or not to cover my surgeon's bill for my surgery this month. (They're trying to say it's covered under the hospital bill.) *sigh*

But I'm actually grateful because I'm one of the fortunate ones! I'm still haunted by an article I read a couple of months ago about the causes of deaths among homeless people in Seattle/King County last year. Among homicide, suicide, drug overdose and alcohol poisoning, there was CANCER. Can you imagine being HOMELESS and dying from cancer? I'm still just sick to my stomach when I think of it.

I look at this assortment of prescription drugs on my table, the computer in front of me, all the books that surround me and, my God, I am thankful.

Thank you for posting about this, Leroy. I hope you and everyone else here are having a good day.

Sent by Lisa Lindstrom | 7:06 PM ET | 05-31-2007

I could not agree more! I am a patient navigator in an urban core hospital in the midwest. When many of the surrounding metro hospitals went to "private funding", or for profit status the flood gates opened and along with inhumane medicaid cuts in Missouri we have had a terrible time caring for people. Cancer is like a tornado, or wrecking ball that hits your life. Nothing is left standing. The ability to work, think, pay bills are taken away and replaced with worry, nausea and pain. That along with wrestling with the reality of mortality in a way not experienced before. My heart breaks daily. I am humbled by the courage that my patients have. I am grateful to them for showing me what inner strength and love look like. I am embarrassed that as a country we let our citizens suffer when billions that could go to health care are given to the wealthy in tax breaks. I love what I do, but there are days that it's very hard to say good bye. It is especially hard when I know that things could be so different for so many. I could write a book, but will say that we need to put a face on what it is like for the medically underserved populations. I speak with them every day and they are truly the forgotten people in our country.

Sent by Elizabeth Gore | 7:44 PM ET | 05-31-2007

I am a single mom with very poor insurance coverage. I am going thru treatment for a bilateral mastectomy. I am fortunate that I work in the health care industry, a small hospital where everyone knows everyone. My surgeon and oncologist have graciously accepted what my insurance pays them and no more. However, I still had to refinance my home because I have to try to work in between chemo treatments in order to keep my
insurance. Family leave act was used for surgeries, and all my vacation time is gone.Without the refinance, I would have lost the house too. The frightening part is ...if I live thru this cancer, I will be paying a house note well into my 80's. Is this the American dream we try to sell to the rest of the world?

Sent by Liz Zimmerman | 12:02 AM ET | 06-01-2007

Ditto to everything said here, about the incredibly frustrating insurance situation in our country. One thing that hasn't been said is that part of the reason for high medical costs is because the multi-payer insurance system is so incredibly inefficient. I read an article about a doctor who employs 4 people in his office just to process insurance claims, due to the complex regulations and procedures connected with dozens of different companies. If he only had to deal with a single payer (such as Medicare), he estimates that he would only have to employ one person to process claims. The cost of all those paper-shuffling bureaucrats, not only in doctor's offices, but also deep in the bowels of the insurance companies' posh skyscrapers, are being passed on to patients.

There's another cost, though - the fact that patients themselves have to spend obscene amounts of time keeping track of their own insurance paperwork. Their time is worth something, too - but, even more than their time, there's the psychic energy needed to deal with the stress. I'm thinking of the story quoted upstream, about the old guy in the chemo suite who as crying because he had 4 bags full of medical bills. It's absolutely inhumane to expect patients to take up the slack of a seriously dysfunctional health-care funding system.

"A Pastor's Cancer Diary"
http://www.cewilton.blogspot.com

Sent by Carl Wilton | 12:57 AM ET | 06-01-2007

Hah, health insurance...

Sent by FEG | 2:00 AM ET | 06-01-2007

As a Canadian working in the US, I wish to share my experience of the Quebec medical system.
I was diagnosed with testicular cancer on Thursday, paid $250 for an immediate ultrasound, (instead of waiting 2 weeks for free hospital results). Saw the oncology specialist Friday AM, got an IMMEDIATE apppointment with the Surgeon, and was sceduled for his next opening, Tuesday AM.
If ANYBODY spreads rumors of inferior health care in Canada, sock 'em!
My radiation was scheduled quickly, and ALL the follow up and appointments and staff worked like a well oiled machine. And all this in a big city hospital. Total cost to me? $600 for immediate imaging, but free if I could wait.
As well, my late father was ill for several years, same GREAT care.
And a dear uncle of mine just passed away, he was blessed with government paid health care.
The Canadian/Quebec health care system ROCKS!
Andrew

Sent by Andrew Golt | 2:12 AM ET | 06-01-2007

After having two strokes, two brain surgeries, and uterine cancer with hysterectomy in a ten year period I am of course broke and long past bankruptcy. I take anti-seizure meds, migraine meds, chronic pain meds, and I can't even remember what else. If I didn't work three jobs I couldn't make it. I have four kids, ages 22-16. We choose between food, clothes, meds, lunch money, etc. My kids are great. I'm exhausted all the time. Too healthy to be disabled, which I don't want to be, too sick to make it to work sometimes. I'm killing myself to stay alive. What happens to us? Health care gets better every day and saves lives that maybe it shouldn't, like me. Now companies are getting tougher about rules missing work and what happens to us? My medicines are an entire paycheck from one job. AND I WORK IN THE HEALTHCARE INDUSTRY!!

I write my congressment, local, state and federal, with inside stories every week. Never have I gotten a response. When their grandmothers come to my hospital with a stroke and I'm the one who takes care of them, you can bet they'll be grateful, but do our well paid, well insured for life congressman care about that? Not on our lives they don't. My tax money pays for Medicaid Junkie Crackheads to get free health care. I know, I work on them at midnight in the ER, but I'd lose my jobs if I did drugs. Why can't they take a drug test before they get that monthly card? My insurance didn't get betterjust because I had another kid. I have cocaine addicts having seizures trying to bite me and hit me while I wipe feces off of them and I'm paying for their care. While I work three jobs to pay for their care and my care. I'm not supposed to be working this hard because after brain surgery that caused seizures I need rest, but one of my medicines costs 145.00 a month and that's just one. A junkie crackhead can take the same medicine for $3.00. I pay the rest. It makes me want to move to Canada. I'm beginning to not believe all that propaganda about America the Great. It's beautiful, but have you ever seen Australia, New Zealand, Austria......

Sent by Doaty Flanigan | 3:48 PM ET | 06-07-2007

NPR Blog Editors:

I am a cancer patient who follow's Leroy's column, especially the one about health insurance posted on 5-30-07. I tried to post comment that included mention of Michael Moore's recent film, Sicko. Now, I can't find that commentary. Did you not post it?

Sent by Christopher Barry | 3:09 PM ET | 06-11-2007

You couldn't of said it better about the Sopranos. I wanted to tell you that I read your blog everyday and you have been in my thoughts and prayers daily. Keep up the strength and the courage. Best regards, Sarah

Sent by sarah crutchfield | 11:38 AM ET | 06-12-2007

Leroy... I've followed your blogs since your segment on Discovery. YOU are me in all your thoughts and feelings. Drung the program, I felt that you were speaking from deep within me. I was diagnosed on 8/1, 4 days short of my 50th birthday, with Extensive Small Cell Lung Cancer Stage IV, spreading to my liver, bones & lymph nodes. I,too, was "free" for 4 months before yet another dreaded negative scan result. My life seems to be spinning uncontrollably before my eyes. Yes... those 3 words "You have cancer!" changes your life forever!!! I was told 3-9 months and I've just made it to 10 months. I always wondered if I'd want to know???... I still wonder :-( Many family and friends can't understand why I'm planning for the worse. They believe that I'm being negative. They just don't understand. I'm not negative, only positive, but I must also live within reality. I am so confused, scared and lost. What next? You, and all the many cancer "survivors," will continue to be in my thoughts and prayers! Prayers are powerful... and continue to keep me positive. God Bless... Vicki

Sent by Vicki Jones | 11:11 PM ET | 06-12-2007