11/01/2011 01:20 pm ET Updated Jan 01, 2012

Early Detection: Can You Afford It?

All of the organized breast screening programs in Canada offer free mammograms to women aged 50 - 69. That's the extent of the eligibility requirement list.

To receive a free mammogram in the Washington, D.C. area, you must be over the age of 50 as well, but there are a myriad of other eligibility factors. The GW Cancer Institute's Mobile Campaign for Breast Health program reaches to D.C., Maryland and Virginia, however, if you have symptoms or have already detected a lump, you are excluded and must get a doctor's referral for a mammogram and ultrasound through a hospital. In Prince William County, if you have no health insurance, you can visit your local free clinic; however, you must be indigent, or be able to prove your eligibility to receive food stamps, unemployment or Medicaid benefits (meaning your income does not exceed $1,180 a month).

With the intense campaigning in the media about early detection saving lives, and the importance of participating in cancer screenings, it blows my mind that this apparently doesn't apply to those of us without health insurance who are also not independently wealthy. Mammograms with ultrasound in this region can cost anywhere from $500 to $6,000. That's a bit much, don't you think?

I never really gave much thought to health insurance over the course of my adult life. I was diagnosed with endometriosis when I was 19 years old and living at home when I had that first surgery to remove the ovary that had ruptured as a result of it. I had health insurance through my employers for each of the subsequent multitude of surgeries I had over the next ten years or so, and never batted an eyelash when I had a central retinal vein occlusion in 2002 and my doctor ordered a battery of tests that included an MRI. I took blood thinners for several years with monthly blood tests to ensure my clotting levels were acceptable, and it was all covered by insurance. I just went, I never thought about it. Insurance was something I just had, it followed me like a welcome shadow, and I took it for granted, as I think most people do. If I felt ill, I just called up my doctor (I remember having a doctor, it was nice), gathered up my fifteen-dollar co-pay and trotted off to the doctor's office.

Then one day I didn't have health insurance anymore, and when I started shopping for it, the lowest quote I received was for $800 per month because I have had "issues" in the past. This was unaffordable for me, so I had to pass. And now this new shadow that follows me is more like a mischievous child threatening to push me down a flight of stairs if I'm not paying attention. What if I get hurt? What if I get sick? I have become a rather cautious and fearful person who self-diagnoses via the internet, keeping my first aid kit fully stocked. Too young for Medicare, too "wealthy" for state assistance, I am a person with a family tree rooted in cancer who cannot afford to get screened. I choose not to research the cost of treatment should I end up actually getting cancer; however, the good news may be that I won't know I have it.

The people who seem to scream the loudest against "big government" offering free health care benefits (who undoubtedly sleep soundly with their insurance policies under their pillows) should really pause to consider that the people most affected by this issue are not the homeless, the lazy, or the illegal aliens they picture in their heads. The people most affected are those caught in between the lines. Its an uncomfortable place to be, and I doubt anyone in this position ever thought it would happen to them. I know I didn't.