> By Sarah Yi   > Illustration by Eunice Choi

 

 

After several weeks of daily vomiting in Sept. 2005, my mother feared the worst. Until then, she rarely even caught a cold. Following a battery of tests, my mother was diagnosed with advanced stomach cancer at age 58. My mom did not have health insurance.

After immigrating from Korea, my father became a self-employed painter, while my mother held jobs ranging from an electronics assembly line worker to a cook in Korean restaurants. She was unemployed at the time of her diagnosis. Always barely making ends meet, my parents were in a precarious situation financially: they just missed the cut-off to apply for low-income government-subsidized health care, such as Medicaid (Medi-Cal in California). They were poor, but not poor enough.

My father, who turned 65 that year, became eligible for Medicare, the government’s health insurance program for senior citizens. My mother, on the other hand, trusted that her healthy lifestyle would protect her from any major illnesses until she qualified for Medicare. But cancer doesn’t operate according to plan. And hope doesn’t pay the medical bills. ??

For many lower middle-class Americans like my parents, health insurance is considered a luxury. They often must make the difficult choice between affording insurance and paying the bills. Because it is required by law, they insure their cars, but they can’t afford to insure their bodies.

My mother being uninsured was the greatest roadblock during her fight. Dealing with cancer, both physically and mentally, is grueling enough on its own, but there was the added emotional and psychological burden of worrying about financial repercussions. Because my mother did not have insurance, she went to a local Korean American doctor who welcomed cash patients. He ran her initial diagnostics for a fair but hefty cash price of $700. That would have cost only a simple $10 co-payment had she been insured.

Once the cancer diagnosis was confirmed, we weren’t financially prepared to pay for further tests, medication, surgery or even chemotherapy. We applied for the emergency assistance program for low-income patients through Medicaid, but we were told that it could take anywhere from two to six months to be approved. We found other need-based cancer charities and foundations that help low-income, uninsured patients, but even those programs take time for processing paperwork. My mother’s cancer was advanced and her time was running out. Meanwhile, we had little option but to pay in cash.

Outrageous out-of-pocket hospital fees are unaffordable for the general public, particularly the poor. While we were awaiting Medi-Cal approval, we sought a second opinion with a gastric surgeon at a local university hospital who only accepted my mother as a patient because she had been referred by a friend. Each consultation would cost upwards of $250, and diagnostic tests and facility fees left us nearly $7,000 in the hole. We were prepared to pay in cash, but like most hospitals, this hospital did not have an established system of accepting cash-paying patients. Each consultation or test was handled as a special case, and since the computer system didn’t recognize cash payments, the hospital staff wrote the receipts by hand.??