Originally written in 2009, prior to all the ACA hullabaloo. Seems a fitting repost now. A reminder to all the naysayers about what it's really like to be uninsured and what a toll it takes - especially on single women raising families alone.
I have a friend. She used to be married to a successful computer scientist. She and her husband, their three children and two dogs lived happily in a beautiful custom home on a mountainside among the towering pines.
They had an optimum health care plan which paid for almost everything. It covered his prostate cancer surgery and aftercare. His melanoma. His injuries after a bicycle crash.
It took care of almost every dollar of her enormous tab for spinal surgery after she was rear-ended by a landscaping truck. She went all the way to San Fransisco for that and was operated on by the same surgeon who did Joe Montana's back! She took a $5,000 ambulance ride home from the city because she was in such a delicate condition. It even paid for that.
Dental, vision, kids check-ups, the occasional broken bone, no worries there. Even though they could have afforded to cover almost anything at all because of his generous salary, they didn't have to. Life was good.
Then she got divorced.
He kept the house and the insurance.
Because she had undergone spinal surgery, and had a bad pap smear the year before, Blue Cross didn't want to cover her. Nobody did.
The only coverage she could get was a lame catastrophic policy for 500 bucks a month. It didn't pay for anything in terms of day to day health care or maintenance. If she got a terminal illness or was mangled in a crash, it would have helped a little.
She went along with that program as long as she could, but eventually it became too expensive. She was having trouble finding a full time job with benefits - she had been a full time Mom for too long apparently. She had been elected to a prominent position as a leader of her town, but there weren't any benefits that came with that either. Just more headaches and stress.
She became one of the millions of uninsured in America and she, like all the others, simply began crossing her fingers and hoping for the best.
She was supposed to go back for another pap smear, but was too scared now that another year had gone by. What if there was something really wrong? How would she pay for a colposcopy? What if she had full blown cancer by now? Even a standard annual exam at her gynecologist without any complications was out of her reach now. $400 dollars for a simple breast exam and giant Q-tip up her vagina.
Every time she saw one of those cervical cancer vaccine ads on TV she quickly flipped the switch and got a wierd feeling in the pit of her stomach.
Another year went by. She was growing increasingly nervous. She didn't tell anybody about her plight. She was really good at keeping it all inside. She was ashamed.
But this spring she found a free yoga channel on the internet and she found her practice was helping her build up her courage.
In April, she called Planned Parenthood in a nearby city and scheduled an appointment for an annual exam. They informed her that she could pay on a sliding scale based on her income and she could come in the very next day. All this time waiting and it was that simple. She gulped and made the appointment. Better to know than not to know. Better to get it over with and stop worrying about what might happen and just begin dealing with whatever the results were.
The next morning she sat nervously in the simple waiting room in a ramshackle building in a questionable part of town. The clinic was sandwiched between a convenience store and a thrift shop. It all seemed fitting. How far she'd come from that custom home on a hillside and unlimited, state of the art care in pleasing offices with color coordinated carpet and paint. Here she sat amid the drone of loud mufflers and raucous conversation just outside the open door, her heart palpitating, as she awaited her fate. But at least nobody knew her here. It was better that way and she was good at being alone.
When she was called into the office, a nice woman took her blood pressure, remarking how low it was. "Wow, those numbers are great!" she said, smiling with encouragement.
The nurse asked a few simple questions about her past health history. My friend felt compelled to tell her that it had been quite a while since her last exam. The nurse attempted to ease my friend's mind, told her about the process of getting results back and and also asked her if she had ever had a mammogram. She said there was a program under a grant from the Susan G. Komen Foundation and she could set up a free one for my friend. My friend wondered if she was ready for all of this at once, but realized what a great opporutunity it was and said yes, she'd like to take advantage of the free mammogram. The nurse handed her a coupon to redeem at one of several diagnostic centers in town within two weeks.
Then she was ushered into the exam room where she stripped down to nothing, put on a flimsy paper robe which openend in the front and got up on the table and waited. There was a gap in the ceiling tiles and she focused her gaze there. She wondered if someone was looking down at her. She felt as is everyone was looking down at her. She was frightened and cold, but noticed she was sweating just the same.
After what seemed like at least 20 minutes, the Doctor knocked and asked for permission to enter.
The woman was quite young with soft features, a beautiful complexion and an extremely gentle demeanor. They began to talk and she felt immediately at ease. As she discussed her situation with the Doctor, she could feel the floodgates beginnning to open. She spilled. And the Doctor listened. Understanding. She had been to private care doctors her whole life, the best of the best, but never had she felt so comfortable with a gynecologist before. This woman was obviously working here because she cared about women and their care. No matter that most of them couldn't pay. She had completed the breast exam before my friend even realized it was over. The Doctor commented that everything seemed absolutely perfect there. Time to move on down to the real source of concern.
Sometimes a pap smear can be uncomfortable, but this time it was a breeze. In and out in seconds, no pinching, no pulling and then it was done. That was it. She told my friend that, while a visual is not the best indication of cervical healthiness, hers looked just as it should. No appearance that would cause concern. So at least, while waiting for results, she should bear that in mind and be optimistic. If things came back badly, they would deal with it then, but for now, feel good about coming in and taking this step.
If there was anything wrong a letter would arrive within a few weeks. No news equals good news.
Nothing came. She called in a few weeks just to be sure, and they said everything was fine. And she went to have her free mammogram the next week. With a clean bill of health for now, at least regarding some of the major things that could potentially kill a woman of her age, she moves on.