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Terry Kaye Headshot

Health Care: What Can We Do While We Wait for Meaningful Reform?

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We can help each other.

Health insurance certainly won't help us. "For-profit health insurance" is an oxymoron: To maximize profit for shareholders, you must deny services to policyholders. It's more cost effective to let you die than it is to help you live.

Health insurance didn't kill my mother; cancer did. But a delay in treatment, caused by her health insurance company, directly led to the complication that ended her life.

Perhaps the most shocking thing about my mother's story is that it isn't shocking at all. Google the term "health insurance horror stories" and you'll get 419,000 hits. And no one is immune, not even our own president:

For my mother to die of cancer at the age of 53 and have to spend the last months of her life...arguing with insurance companies because they're saying...they don't have to pay her treatment, there's something fundamentally wrong with that.

I couldn't agree more.

That's why I started The Saralee and Carol Foundation. Named for my mother and my best friend's mother, the foundation is based on the belief that every person should have access to high quality healthcare, the right to evaluate treatment options, and the power to choose among them.

Our mission is to help women with cancer get life saving treatment when health insurance says "no." We are a small, grassroots initiative aiming to make a big difference - one woman at a time.

A little background about my mom: she worked throughout her life, as a teacher, an assistant to a music contractor, and a court reporter. Then, when I graduated from college, she went back to school and became a Physician Assistant, fulfilling her lifelong dream of being a healthcare practitioner.

I'm telling you this to make it clear that Saralee Kaye played by the rules. She worked hard. She paid her bills on time. And she had health insurance. But having health insurance is no longer a guarantee of getting adequate health care.

As a Physician Assistant specializing in women's health care, my mom was knowledgeable about her own condition. Her oncologist, Dr. Giuseppe Del Priore, is one of the finest in the country. Yet Empire Blue Cross Blue Shield repeatedly overrode their decisions.

The final battle was over a "targeted therapy" drug that is now FDA approved for use in treatment of colon, kidney, brain, lung and breast cancers. Empire BCBS denied coverage, citing a lack of research for my mom's type of cancer. Direct appeals from her doctor made no difference.

My mother had endometrial cancer, which is considered "curable;" the American Cancer Society estimates a survival rate of 83 to 95 percent. Understandably, it's not studied nearly as much as "deadlier" cancers: the National Cancer Institute spent $16.6 million for endometrial cancer research in 2007, compared with $226.9 million for lung cancer and $572.4 million for breast cancer in the same year.

So here's the thing: if you're lucky enough to be diagnosed with a "curable" cancer, but you aren't cured, your treatment probably won't be covered.

In my mother's case, they never did approve the drug, but she finally decided to go ahead with treatment anyway. Turns out, it was too effective.

While we waited for insurance approval that never came, the cancer bonded to the walls of her carotid artery. When the drug was finally given, the tumor withered, rupturing the weakened artery wall.

If you or I practiced medicine without a license, we'd go to jail. Yet we allow health insurance companies to do it every day. I don't know how this situation arose, but I do know we cannot allow it to continue.

In the past year we've seen meaningful dialogue on health care reform erode into diatribes on "death panels" and other manufactured threats. The health insurance industry has, for now, protected its own bottom line. And we will pay the price.

I hope that others will join me in the effort to make change happen. If each of us can make a little difference, imagine what we can do together.

Please visit our website at www.saraleeandcarol.org. Join the cause on Facebook!

The Saralee and Carol Foundation is a project of Congressional District Programs, Inc. - a registered 501(c)(3) public charity. All moneys raised by the Program are sent to Congressional District Programs and become the sole property of CDP which, for internal operating purposes, allocates the funds to the project. The Program Manager makes recommendations for disbursements which are reviewed by CDP for approval.