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In 2017, Susan found that she carries a genetic mutation that can increase the risk of developing breast cancer by 72%.
Her doctor explained that people who have this mutation in the BRCA2 gene have the ability to cure. Some people choose a prophylactic double mastectomy. Instead, Susan might decide to undergo a heightened cancer screening, which would mean annual mammograms and annual MRIs.
Since she just had her first baby, Susan chose elevated supervision – which meant she could be able to maintain his ability to breastfeed.
And Susan and her husband who make their home in Brumalal, Pennsylvania, have insurance provided through their employers to help pay for medical treatment. But there is a hitchhiker: these annual scans that she needed would be expensive, and their companies offered only high-paying health care plans.
Susan's annual deduction for her plan (covering her and her child) is $ 6,000 a year. (NPR has agreed to use only Susan because she is worried that any advertisement may endanger her work. .)
"I worked on my work vtsya for 17 years, "she says." When I first started, there was no salary deductions for health insurance and my payment was only $ 5. But in 2011 my employer switched only to providing high-deductible insurance plans. "
Susan took up her first mammogram and MRI in February 2017. Her cost for MRI was $ 2000 in a pocket .The bill on mammography was $ 1088 ( although she could have challenged and blamed mammography for $ 191.
As a result of the high score, Susan decided to postpone annual displays until 2018. To deal with the repayment of accounts from 2017.
Susan's History of Delayed Care because it is not enough is not a release. A study published last month in reviewed claims from a large national insurer for a total of 316,244 women employers who have transferred health coverage from low health plans (that is, a deduction of $ 500 or less) to health plans (that is, a deduction of $ 1,000 or more) between 2004 and 2014.
The research team consisted of women who were in low pay plans a year and then switched to a high franchise plan for another month to four years. The control group consisted of women who remained in plans with low deductions.
In particular, researchers have looked at the relative implications of such plans for women with low incomes compared to those with higher incomes.
Low income women had insurance plans with a high franchise, expected an average of 1.6 months more for diagnostic breast imaging, 2.7 months for the first biopsy, 6.6 months for the first early diagnosis of breast cancer and 8, 7 months for the first chemotherapy compared with low-income women
In some cases, delays of this length can lead to poor health outcomes, says J. Frank Warm, an insurance and safety specialist. Healthy Head study.
Interestingly, high-income women who were counting on high medical aid were not protected from such delays – they felt lagging from 0.7 months for the first breast imaging, 1.9 months for the first biopsy, 5.4 months for the first diagnosis of breast cancer and 5.7 months for the first chemotherapy compared with high-income women with low franchise plans.
The researchers also found that a healthy high-deductible plan was associated with a delay in care whether women live in metropolises or not, whether they live in areas that were mostly white or mostly white.
"In general, we believe that the consequences of modern high-deductible plans of access to care are sometimes predictable, but often awesome," explains Vira.
"Except Well known factors that can affect how quickly a patient is diagnosed and treated – for example, income level and education – other aspects of her life are also likely to play a role – he says, for example, her acquaintance with her illness and insurance payouts, her previous experience with the insurer Its tolerance of risk and its familiarity and ease in health care & # 39; I and its jargon.
Other recent studies have noted similar delays in the diagnosis and treatment of complications from diabetes, cardiovascular disease, and other conditions. In a 2017 Kaiser Foundation report, it was found that 43% of adults with health insurance faced difficulties in completing their franchise, compared with 37% in 2015.
Dr. Vienna Shankaran is co-director of the Hutchinson Institute for Research on Cancer Research at the Fred Hutchinson Cancer Research Center, where her work focuses on the study of financial problems faced by cancer patients. Although he is not involved in the study Shankaran says the results will not surprise her.
"We see that plans with a high franchise really are the realization of the problem of access to help." "she says." People do not have liquid cash to meet their franchises, so you see a delay in care or even avoiding treatment as a whole. "
According to Centers for Disease Control and Prevention, from 2007 to 2017, Admission to high Health Care Retirement Schemes increased from 4.2% to 18.9% for adults aged 18 to 64 who had coverage. in the workplace, while the number of covered health insurance plans without HSA increased from 10.6% to 24.5%
Meanwhile, the entry in the b The more traditional plans in the workplace have been reduced.
Helps patients suffering from life threatening the lives of chronic or rare diseases, access to medicines and treatment, providing assistance at their own expense. Dan Klein, president and chief executive officer of the organization, says he noticed an increase in the number of patients who seek help with the PAN.
"One thing that worries me, says Klein, is that the Congress is very focused on reducing the prescription. Drug prices. This is a good goal, but it is senseless in an environment where patients still have no access to help. or medicines through their deductibles. "
Susan reinstated this year's show, she said she looked at patient care programs such as the" Right for Women "feature that helps people with a high risk of breast cancer get access to MRI screening, but it did not meet these criteria.
Under In preparation for the next scan, she set up a flexible organization of work expenses and a health care savings account so that she could pay at least part of her medical expenses for non-taxable income. And she is developing pay plans for healthcare workers. No less worrying about how she and her husband will pay for the testing and treatment they will be married to.
"After the first MRI account I wanted to give up," says Susan. "Because, in addition to diagnosing BRCA, insurance accounts were predominant."
"I sometimes think of choosing for surgery as a way to fight my mutation," she adds. – But then I'm nervous – that's why
Eric Stallings is a lawyer and independent writer from New York City, whose work focuses on health inequalities, paying particular attention to breast cancer and genetics. Her work was in HuffPost, New York Magazine Jezebel and O, Oprah magazine . Find it on Twitter: @ quidditch424 .