The Maine Millennial: Health care screening results pose tough questions

Good news, everyone: The lump in my breast is benign. In the official medical phrasing of Dr. Cox, “It has no suspicious features.” (I wish someone would tell the Transportation Security Administration that. I have to get a pat-down every time I fly.) Of course, when the radiology tech said the doctor wanted to come in, I almost had a heart attack right there on the exam table, but fortunately the doctor just wanted to poke it twice (very professionally) before pronouncing it to be a lipoma – a fatty tumor – not cancerous. Then I almost had another heart attack, from the sheer relief. I will go back in six months to make sure it hasn’t gotten any bigger.

Turns out the inside of my breast looks like a weather forecast map done in grayscale, crossed with a psychedelic painting of the ocean. I stared at the ultrasound images because what else was I going to do, lying there 25 percent naked, while Miranda the very patient ultrasound technician wanded around my bosom? (I kept giggling and apologizing for giggling because I am ticklish and anxious.)

I’m not surprised that everything turned out OK. The odds – young age, no genetic history, non-smoker – were in my favor. But every single medical professional I’ve talked to along this bumpy journey – and there have been a lot, I get chatty when I’m nervous – has said that I did the right thing by coming to get it checked out.

If “first, do no harm” is the Golden Rule for doctors, “better safe than sorry” is the Silver Rule. If you see something, say something. Early detection and intervention saves lives, especially when it comes to cancer. I know this all too well. When my father started experiencing symptoms of what turned out to be metastasizing melanoma, he was misdiagnosed with fibromyalgia. Months were lost as the tumors grew unchecked. By the time they were discovered, it was too late for treatments to save him. I will spend the rest of my life with what-ifs crawling my brain.

In my case, they ended up not doing a mammogram – apparently my tissue was too “youthfully dense,” which I think is a good thing? I had a breast ultrasound instead. I have decent health insurance, and after reading the plan I’m about 80 percent sure that it’s covered, although, in the course of researching this column, I have discovered that breast ultrasounds are not covered by insurance plans as frequently and thoroughly as mammograms. There are resources for women over 40 to qualify for free screening mammograms; there are not similar programs and resources for young women, with our dense breast tissue, to get free screening and diagnostic ultrasounds. Costs vary, but they average about $250.

That’s a decent chunk of change for a woman with a slim chance of having breast cancer to get a confirmation either way. A young woman without the resources that I am lucky enough to have might feel the same lump in her breasts and, unable to afford the visits to a doctor, might easily choose to gamble on its being benign and seek no treatment. That’s a pretty big gamble to take, one that nobody wants their own daughter to roll the dice on.

The more I interact with the American health care system – as a patient, an employee and an observer – the more I become convinced that we need a universal health insurance system in this country. It doesn’t have to be a “Medicare For All” format, although all the senior citizens I’ve talked to seem pretty happy with their Medicare.

I do think we need to get rid of for-profit health insurance companies. They shouldn’t exist. Making money by denying people payment for health care is a morally bankrupt way to turn a profit. And no matter how many layers of paperwork you put between the patient and the denial, that’s what is happening.

My mom pays $800 per month for health insurance to cover her and my younger sister, and my sister still got stuck with a $1,000 emergency room bill because it was “out of network.” But the whole point of emergency rooms is they are for emergencies. Emergencies come with a natural time crunch. You don’t have time to shop around and see what ER is the cheapest. You go to the nearest one.

My sister is fine, thank god, but that bill is going to eat up the vast majority of my mom’s $1,400 stimulus check, with the leftover going to half of her monthly premium. Our culture thinks of health care as a consumer good, rather than a public investment. We are going to have to demand that shift in thinking if we want anything to change. Otherwise, health outcomes will be a matter of luck and money. If you don’t have one those things, you best pray for the other.

Victoria Hugo-Vidal is a Maine millennial. She can be contacted at:
themainemillennial@gmail.com
Twitter: @mainemillennial