What's the Story in Florida?

OK, I hate to think that after all these years I'm still a bit naive, but I have never personally known anyone who has been refused cancer treatment because they couldn't pay for it or didn't have insurance.

I have heard stories--mostly passed on by nurses, not patients--of oncologists in private practice refusing to take Medicare patients (more shame on them) so that these patients have to get their care at public facilities, like the University of Washington Medical Center.

But flat refused to treat someone who didn't have enough insurance ... I have never met anyone in that situation.

So then comes the following comment, posted to my blog: "Where can I get help for my cancer bills? I have done the same as you, but my bills sre getting worse and in this state they refuse you if you can't pay."

Of course, I e-mailed her to find out where she lives, and she said FLORIDA.

I don't know what kind of cancer she was treated for, but she says, "My fear is also that my insurance will get cancelled because I will not be able to pay for it if I get laid off and things are looking bad at work due to the housing slump and rise in gas prices."

If you are laid off, you will be able to continue your health insurance for 18 months through COBRA, so if this happens, be sure to ask at work about COBRA. It will be more expensive, because you will have to pay the entire premium yourself (including the part that your employer was paying).

"The doctor that refused me was Dr. Kamal in Ocala, Florida. Then I cried and had them recheck and they said that they did not realize that my insurance was paying 100% and I could go ahead and receive treatment."

No comment on that one. Dr. Kamal? Want to defend yourself?

"At the end of my treatment we went in to get hopefully good news and all they could talk about was a $10,000 bill that I owed them and lead me to believe that I could not receive any other treatments until this bill was paid. I came home and called my insurance only to find out that they had been paid every penny.

"While in that office, my husband and I finaly asked, 'Was I in remission or not.' And the doctor said, 'Wait a minute, let me go back and get your file.'"

Unbelievable. She did say that she has changed doctors, which sounds like a good idea.

I'm in Washington state, which is just about as far from Florida as you can get and still be in the Lower 48, so I'm asking cancer patients and family members in Florida: What's been your experience?

Is it true that people are being denied treatment because they can't pay for it?

@ Jeanne Sather 2008.

Comments

[Amorette]

I'd change doctors and pick up a lawyer, too.

[Carver]

I'm not in Florida but out of curiosity, I checked and that doctor is in a private practice. I'm pretty sure most states are like the one I live in, if you go to a State University Hospital, some of which have the best cancer centers anyway, they can't deny treatment. Same with other public hospitals but if it were me I'd be looking at the cancer centers at large research hospitals. The cancer center in FL where some people I know go to is Moffitt. They are a top notch NCI designated comprehensive cancer care center. I checked on their website and they will have a social worker discuss financial assistance for people whose insurance, medicare or medicaid isn't sufficient for a particular treatment. If I was in Florida, I would check out Moffit. http://www.moffitt.org/default.aspx
They are an hour and a half from Ocala but it might be worth it. Obviously individuals may find private oncologist they like and whose practice is sufficient. I'm talking off the top of my head as usual.

[jeanne]

Carver--I completely agree with your take on this. I went to the Unversity of Washington Medical Center when I was first diagnosed, and I'm really glad that I did. This all makes good sense, and thanks for looking up Moffitt.

[Lisa]

As a doctor and a patient this story makes me sick. In my doctor world I have the luxury of not caring about insurance. If babies are sick enough to need my care, I take care of them and someone else deals with the insurance or lack thereof. However, as a patient my experience has been quite different and it makes me mad. I no longer believe that hte US can afford to have a free market health insurance situation. A topic for the blogger reunion I think.

[jeanne]

Lisa--thanks. I agree--let's put that topic on the agenda.

[amy]

This is awful. But I do think about how expensive treatment can be. I'm not sure doctors need to front the costs of chemo drugs and lab work etc. for every person...That isn't the answer...Yet I think health care for everyone is fundamental. I do know that I could hear, in that email, the panic behind the words, the fear. We had it a year ago. It's unfortunately part of the cancer "experience" for so many people. Insurance fears, job worries, money problems.

[amy]

This is awful. But I do think about how expensive treatment can be. I'm not sure doctors need to front the costs of chemo drugs and lab work etc. for every person...That isn't the answer...Yet I think health care for everyone is fundamental. I do know that I could hear, in that email, the panic behind the words, the fear. We had it a year ago. It's unfortunately part of the cancer "experience" for so many people. Insurance fears, job worries, money problems.

[amy]

This is awful. But I do think about how expensive treatment can be. I'm not sure doctors need to front the costs of chemo drugs and lab work etc. for every person...That isn't the answer...Yet I think health care for everyone is fundamental. I do know that I could hear, in that email, the panic behind the words, the fear. We had it a year ago. It's unfortunately part of the cancer "experience" for so many people. Insurance fears, job worries, money problems.

[jeanne]

Amy--good points. I think these fears are a huge part of the experience of having cancer in this country. If we had guaranteed health insurance, then we could focus on getting well ... but I'm preaching to the choir here.

[Irene]

I am from Florida. I was diagnosed with breast cancer in 2005. Not old enough for Medicare, too old to buy a private insurance. I called Moffitt, left a message... They returned my call two weeks later.... I also called Winter Park -- another Nationally acclaimed Cancer Center is located there. I was told that an initial doctor's visit will be $585.00 (just to get to know you!). They refused to tell me how much a biopsy or operation would cost me. Plus, the doctor was "pretty much booked up until the Spring". If the situation was not life threatening, I would have waited six months for my operation. Finally I just got a ticket and went to my native Russia. Got my boob carved and radiated, bought two years supply of Tamoxifen (Was ready to fight the custom people tooth and claw if they would attempt to consfiscate it upon my return), and happily came back to sunny Florida. When I was nearing 65, I was offered several plans (in place of regular Medicare). I carefully chose the local one, Health First, one of the best in the nation. I did indicate that I went through the breast cancer treatment, but it was OK with them. I see my onc every three month, was switched to Arimidex immediately, and my insurance company pays for my drugs. The co-pay is $90.00 for the three months supply of Arimidex and Fosamax, each, and $10.00 for my bp meds. I know two women who were low-income (I am not), and both got free treatment from Medicaid. Florida is as good or bad as any other State. Last year our county collected $330,000.00 for the cancer cure during the "Walk for the Cure" event. Many doctors refuse to accept regular Medicare due to the necessary paperwork and long approval waiting period. It is their right, after all.
Thanks for the blog! It was mentioned on the Russian site called www.oncoforum.ru. A woman was amazed to find out about the high mark-up on Herceptin.

[jeanne]

Thanks, Irene. I don't live in Florida, so I don't want to criticize the doctors there for refusing Medicare patients--or not criticize them too harshly, anyway--but it hardly seems fair that the public hospitals have to care for all of us who are on Medicare.