Nancy Stordahl wrote a great piece this week on HuffPo about the dubiously named “BRA Day,” a new national, um, holiday, embedded in Breast Cancer Awareness month (let’s put the discussion of that aside for now) which is designed to educate women on reconstruction options after breast cancer. BRA Day even hired their own celebrity spokeswoman, the singer Jewel, who wrote a song, “Flower,” for the occasion. http://www.youtube.com/watch?v=2oX_yNOF6io
Now, I am deeply grateful to have had the option for reconstruction, which U.S. health insurance already has to cover by law. And I am grateful that I could have a type of reconstruction that was possible despite my previous radiation therapy, which wreaked havoc with my skin elasticity. I’m even abashedly pleased that the kind of reconstruction I had—using my own belly fat—had the bonus side effect of leaving me with a much flatter stomach. What the hell. I might as well get something out of it, right? Because part of what won’t be discussed on BRA day is that reconstruction can be absolutely brutal to go through. Also, no matter how great the result, it’s only cosmetic—you don’t get sensation back. It feels a bit like having a folded up pair of hiking socks attached to your chest.
I have friends who have done reconstruction and those that have not and both have their reasons. It’s a personal thing and both options should be respected—if they truly are freely chosen. It seems to me, too, that everyone is equally happy and equally unhappy with what they did as time goes on. There is no perfect solution.
Nancy points out that BRA Day (an acronym “that sounds patronizing and trivializing and somehow puts the main focus once again on saving breasts not women's lives”) is part of a larger attempt to pass a bill called the Breast Cancer Patient Education Act which would require the Health & Human Services Department to create an education campaign for mastectomy about reconstruction options, availability and coverage rights. Which sounds good, until you consider that the bill’s primary backers seem to be plastic surgeons:
While I do hold my plastic surgeons in the highest regard, it doesn't feel quite right to me for others in their profession to be so strongly backing a bill that if passed will result in further lining their pockets. Even if this is not their intent, it certainly can be construed this way. It seems like a conflict of interests to me.
...it seems to me doctors should be responsible for directing their breast cancer patients in regard to educating them about all their reconstruction options, not legislators. If doctors are not doing their job here, we have bigger problems
Finally, my biggest problem of all with this proposed campaign is its exclusion of too many women. I say what about the under-insured and the uninsured?What about their reconstruction rights? There is so much disparity with all aspects of healthcare in this country and this is one more instance where this disparity is being swept under the rug.
If the backers of this bill and BRA Day wish to get behind every woman in the United States who has had breast cancer and wishes to have reconstruction options offered to her, then I'm all for it. Until then, no thank you.
I'd go a step further. Even when, like me, you do have insurance coverage the procedure can be prohibitively expensive. I was lucky. The two surgeons who could perform my reconstruction, a type that involves microsurgery and is still relatively rare, were out of my insurance network. There was no way I could afford that. Or perhaps more accurately, no way I would. My family has needs more pressing than my new boob. But it sure didn’t make me happy. In fact, I was distraught. Not only did I have a recurrence of my cancer, not only did I need a mastectomy 15 years after I thought I was done, but now I couldn't afford the only method of reconstruction open to me.
Then one of them said, unbidden, “You know what? I’ll take whatever your insurance gives me as full fee.”
“Why would you do that?” I asked.
“Because it’s the right thing to do,” he responded.
I burst into tears. Wouldn't you?
What a mensch. Also, and I don’t think this is coincidence, he is Canadian. Our health care system probably just seems whack to him.
By the way, I’m still fighting with the other guy, by the way, over the cost of his “free” consultation that somehow has resulted in a $344 bill.
Even with all of that, even with my doc’s generosity, the whole enterprise cost me $8,000. That’s right, $8,000. It’s not the difference between eating and not eating—more like putting off the renovation of our 60 year old kitchen, hanging onto our twelve-year-old cars. A little belt-tightening. But still. My husband and I are both self-employed, so that $8k is on top of our Blue Shield insurance premiums which have spiraled up 30% a year for three years. Even after downgrading our coverage we’re paying way, way more for less.
That said, if I were uninsured, I’d be screwed. My hospital bill alone was—wait for it--$135,000. That’s right. All them zeroes. So rather than BRA Day how about those plastic surgeons back an “astronomical cost of medical care that makes it out of reach for all but the rich day?” Hey Jewel, why don't you write a song about that?
Or what if all those plastic surgeons who promote BRA day marked it by pledging to do a certain number of reconstructions this year for free or at cost?
What do you think, Nancy? For that would you be willing to say “yes, please.”