(Forgive me if this was diaried already but I searched for one, really I did!)
Nick Colombo won another chance on life yesterday. The CyberKnife might not be a guaranteed cure for his advanced bone cancer, but at least the doctors will get a crack at using it in hopes it does some good. Even if the results are only palliative...that is, if they only reduce his pain and make whatever time he has more bearable...it's a good thing.
However, not every Nick Colombo of the world has a family savvy enough to go to the media to shame their insurance company into paying for a procedure they would rather not pay for to endanger their bottom line. And not every Nick Colombo of the world even has insurance, and that makes their chances even worse. Follow me over the flip, for I would like you to posthumously meet someone who was very near and dear to me, who was murdered by lack of access to health care.
Richie Hass was always a very healthy guy. He used to smoke a long time ago, but one of the first things he did when he started dating me was to give up smoking completely. He did it without the modern aid we have now: no Chantix, no patch, no gum, no BuSpar, nothing but his own will. He slipped a couple of times and bummed a single cigarette when facing major stress. But I could count those incidents on one hand.
Around October of 2006, he began feeling really, really crappy. We figured it was some sort of flu bug. But the malaise never went away. Richie was always kind of wiry but he was losing weight at an alarming rate, and started looking like an extra from Schindler's List. By mid-December, things were looking really bad. Then he had an incident where he found himself bleeding out his rectum when he visited the bathroom. That was it: time to go to the ER.
Rather than chance the horrors of LA County's Olive View Medical Center in Sylmar, we went to our local hospital ER. After they drew blood, they realized Richie was in bad shape. He had raging anemia, and high elevation of calcium in his blood. The hospital had no choice but to admit, and figure out what to do about securing funding for him after the fact.
On the day after Christmas, 2006, Richie was diagnosed with multiple myeloma, a blood cancer related to but not identical to the leukemias and the lymphomas. When myeloma is caught before it becomes symptomatic, when it is monoclonal gammopathy of unknown significance or smoldering myeloma, it can be dealt with more reliably and there is little change to quality of life. By the time it becomes symptomatic, it is already in the third and final stage. How can a person without insurance and without a "medical home" detect myeloma in those early stages? You can't. And often even people with insurance don't get caught in those early stages because the blood tests that are used for early detection are not commonly given except in "Executive Physicals" done for obtaining "key person insurance" in corporations.
We lucked out in that Richie got treated at the City of Hope, a National Cancer Research Institute in Duarte, California. This is a facility that, since 1913, has helped people with life-threatening diseases regardless of ability to pay. Unfortunately this is not the case for most people. If Richie had not been admitted to their outpatient cancer care program, it is likely I would have been dealing with final care issues in February or March 2007 rather than now. And therein lies the important thing I wish to talk about here.
It might seem obvious, but some people need to be swatted with a clue-by-four regarding this fact of life: when people are uninsured or underinsured they get diagnosed later and have worse outcomes than people with good health insurance. If Richie had been given a test measuring gamma globulin levels in the blood perhaps he could have been helped earlier. But that's just not something you can get when you go to a health fair or something. And even if you are insured that's a blood test you aren't likely to get for general screening. It should be a part of the standard panel, but bean counters might not think it prudent. [/snark]
I wish Nick Colombo well. I couldn't get out to the OC to march yesterday: I had an appointment with the Neptune Society to finalize arrangements for Richie's cremation. But I would have if I could, and if Richie had been healthy he would be right there in the crowd making sure Pacificare didn't murder Nick by spreadsheet. Richie's story is yet another reason why we need HEALTH CARE FOR ALL. NOW.