Uninsured cancer patient gives human face to health care debate

The Sacramento Bee has a three-part profile of an uninsured cancer patient, which is tracked alongside the progressing health care reform debate.

Tony Andrade, 47, of Sacramento, Calif., "is the Everyman of President Barack Obama's push for overhauling the country's health care system: working, but for low wages, without health benefits - in the company of 37 million employed Americans who are uninsured."

In part one of the series, Andrade finds out he has bladder cancer, but surgery to remove his tumor is cancelled when Kaiser Permanente learns he is no longer a member. He tries to apply for coverage through Medi-Cal, California's Medicaid program, but his $11.50-an-hour job makes him too wealthy to qualify. "But Sacramento County, like all California counties, has a special program to provide for some of those not eligible for Medi-Cal: CMISP, the County Medically Indigent Services Program. … The confluence of events is unfortunate, with the county tightening its rules to admit fewer people - 40,000 instead of 50,000 - just as more need the services," but Andrade is able to get help. "The county will pay Andrade's future medical bills. It will give him access to doctors who can help him control his diabetes, obesity and other health problems. And it will refer him to the specialists he needs to deal with his cancer." After the surgery, however, he learns that the cancer has spread into surrounding tissue, and he will require more treatment" (Calvan, 11/29).

In part two, Andrade faces another surgery under his uncertain county health program. "Andrade knows enough about cancer - people in his life have died from the disease - to realize his situation is grave: A tumor was removed from his bladder, but more cancer was found. Now he has to figure out whether, without private health insurance, he can get the additional surgery he needs. That unknown seems far more daunting than the larger question, as it does for many of the 46 million uninsured in America today. As a debate over health insurance raged in public throughout the summer, Andrade dealt with his own private crisis" (Calvan, 11/30).

In part three, "[h]uge bills begin arriving in the mail, a frightening déjà vu for Tony Andrade. The shoe box in his bedroom already is stacked with overdue notices from hospitals and doctors." The surgery was successful, but a new statement from Kaiser Permanente gives him "two weeks to pay $11,309.10, most of it for" his initial ER visit "where the cancerous growth in his bladder was discovered. The body scans alone cost $7,600." Other bills mount that he thought would go directly to Sacramento County. "It would seem a cruel twist that those with the least have to pay the most for medical care. But lacking health insurance means forgoing the bargaining power of insurance companies. Andrade's bills likely are thousands of dollars higher than they would be if he were insured" (Calvan, 12/1).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.