Mrs. Wilson and her husband were worried, as they came to my office. It’s not really surprising for people to be worried when they see an oncologist; not surprising that breast cancer or other new cancer diagnoses causes those fears. They had come sixty miles to Ft Worth to see me, from Wise County to the northwest. That part of west Texas didn’t have an oncologist or county hospital.
“Just how big is six centimeters?” she asked, and Mr. Wilson watched intently, hands in his quilted coat, green and worn, but still on the job.
“Big.” I said. “Stage III.”
“How much will all this cost?” she asked. His eyes shifted to the floor, but his ears weren’t missing a thing. I guessed she did the accounting on their place, where cattle prices really meant more than hamburger prices.
“A lot,” I said. Mrs. Wilson was in a bad spot, since she was sixty years old, and didn’t have any health insurance. I didn’t ask, but I guessed she had ignored the breast lump for a while just because of the cost fear. Medicare wouldn’t help out for five years. They told me later, months later, that they spent that night deciding what their land and cattle would bring at sale. Mr. Wilson had inherited it from his father twenty two years ago, and they were literally thinking of selling the farm. But they didn’t know for sure that it would cover enough of her expenses, and they didn’t know where he might get a job in Wise County. Times always seemed to be tough in farming and ranching communities.
That afternoon, I made rounds at one of the local hospitals. In bed, and shackled to the bed was a woman with breast cancer. We never asked, but someone had told me she was a drug runner. She was incarcerated at the Federal Medical Center at what used to be Carswell Air Force Base, a federal prison facility now. She was getting the same therapy I hoped to give Mrs. Wilson, but the prisoner was getting it free. It didn’t seem right, but I quite trying to figure out health care payment a long time ago. Perhaps this is what Mrs. Wilson needed. Federal payment of her breast cancer treatment. I doubted that she could find a drug gang to get involved with, but maybe she could threaten the President or something. She could get convicted, sent to the FMC for cancer treatment, and I could see her again in about six or eight weeks with full coverage. A recent Justice Department study reported by the Associated Press (1-22-07) said inmates live longer than age adjusted peer groups, so the care must be adequate.
I mentioned this plan to one of my partners and she said everyone should get coverage like Congress does. There was bitterness in her voice as she told me, but I didn’t agree. Congressmen and women are accomplished, successful individuals. They probably get health care like a General Motors vice-president. All I wanted was for my patient to get health care equal to a convicted felon, the dregs of our society. I don’t know what all a felon could get in terms of health care, but whatever it is I believe that level of care should be offered to any citizen of the United States. A jury of their peers has determined that these people are the worst in our society, but then we give them full health insurance coverage with no co-payments, no limitations or life time maximums, no mental health exclusions, no pre-existing illness exclusions. That’s better than what I get in terms of my policy, if anyone is interested.
So that’s what I believe, that all citizens of the United States should get health care equal to a convicted felon. If we as a nation offer it to our worst members how can we withhold it from the ones who work everyday and follow the laws? The Mrs. Wilsons of America are waiting.
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