ObamaCare and My Mother’s Cancer Medicine

by Stephen Blackwood,

The news was dumbfounding. She used to have a policy that covered the drug that kept her alive. Now she’s on her own.

When my mother was diagnosed with carcinoid cancer in 2005, when she was 49, it came as a lightning shock. Her mother, at 76, had yet to go gray, and her mother’s mother, at 95, was still playing bingo in her nursing home. My mother had always been, despite her diminutive frame, a titanic and irrepressible force of vitality and love. She had given birth to me and my nine younger siblings, and juggled kids, home and my father’s medical practice with humor and grace for three decades. She swam three times a week in the early mornings, ate healthily and never smoked.

Carcinoid, a form of neuroendocrine cancer, is a terminal disease but generally responds well to treatment by Sandostatin, a drug that slows tumor growth and reduces (but does not eliminate) the symptoms of fatigue, nausea and gastrointestinal dysfunction. My mother received a painful shot twice a month and often couldn’t sit comfortably for days afterward.

As with most cancers, one thing led to another.

she wouldn’t still be here without that semimonthly Sandostatin shot that slows the onslaught of her disease.

And then in November, along with millions of other Americans, she lost her health insurance. She’d had a Blue Cross/Blue Shield plan for nearly 20 years. It was expensive, but given that it covered her very expensive treatment, it was a terrific plan. It gave her access to any specialist or surgeon, and to the Sandostatin and other medications that were keeping her alive.

And then, because our lawmakers and president thought they could do better, she had nothing. Her old plan, now considered illegal under the new health law, had been canceled.

Because the exchange website in her state (Virginia) was not working, she went directly to insurers’ websites and telephoned them, one by one, over dozens of hours. As a medical-office manager, she had decades of experience navigating the enormous problems of even our pre-ObamaCare system. But nothing could have prepared her for the bureaucratic morass she now had to traverse.

The repeated and prolonged phone waits were Sisyphean, the competence and customer service abysmal. When finally she found a plan that looked like it would cover her Sandostatin and other cancer treatments, she called the insurer, Humana, HUM -0.30% to confirm that it would do so. The enrollment agent said that after she met her deductible, all treatments and medications—including those for her cancer—would be covered at 100%. Because, however, the enrollment agents did not—unbelievable though this may seem—have access to the “coverage formularies” for the plans they were selling, they said the only way to find out in detail what was in the plan was to buy the plan. (Does that remind you of anyone?)

The news was dumbfounding. This is a woman who had an affordable health plan that covered her condition. Our lawmakers weren’t happy with that because . . . they wanted plans that were affordable and covered her condition. So they gave her a new one. It doesn’t cover her condition and it’s completely unaffordable.

Though I’m no expert on ObamaCare (at 10,000 pages, who could be?), I understand that the intention—or at least the rhetorical justification—of this legislation was to provide coverage for those who didn’t have it. But there is something deeply and incontestably perverse about a law that so distorts and undermines the free activity of individuals that they can no longer buy and sell the goods and services that keep them alive. ObamaCare made my mother’s old plan illegal, and it forced her to buy a new plan that would accelerate her disease and death. She awaits an appeal with her insurer.

The “Affordable” Care Act is a brutal, Procrustean disaster. In principle, it violates the irreducible particularity of human life, and in practice it will cause many individuals to suffer and die. We can do better, and we must.

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