MY MOTHER and grandmother both died of breast cancer. For years I resisted having a mammogram because I couldn’t bear the thought of having to live through my own demise – should it indeed be thrust upon me. My resolution was to jump out of a window should I ever be diagnosed with cancer, and to that end, I always rented apartments in high-rise buildings near the top floors. This was easy to do in Toronto; there are lots of cheap low-income high-rises.
After a four-year battle, my mother succumbed to cancer when I was 16 years old; she was 49. I was on my own and immediately assumed the role of an adult. No siblings, no father, and relatives that have probably all drank themselves to death by now. Suffice it to say that losing both my mother and grandmother to a lengthy and horrible disease affected how I perceive my life and the world around me. For instance, I decided to never have children since I couldn’t be sure whether or not I would pass this disease on to my own child. Secondly, we were poor, and my mother’s death plunged me into a peripheral existence – always one step away from poverty. Thankfully, I am now an expert at negotiating a downwardly-mobile lifestyle.
Because we were Canadian citizens living in Toronto, my mother’s illness and repeated hospital stays were fully subsidized by the horrible socialist Canadian government. If we had been in America, she would have been left to die – maybe in a home and maybe in a hovel – and who knows where I would have ended up. I survived and moved to New York in 1982, full of anticipation and resolve, and completely ignorant of the miserable state of health care in this country; youth is sustained by resilience and fury.
The fear and anger and resentment all came back to me when I witnessed the media pounce on Angelina Jolie’s public announcement that she had undergone a double mastectomy. My heart wrenched for her. This could not have been an easy choice. Her decision will feed the frenzied entrails of news copy and be dissected and commented upon ad nauseam. On the other hand, her op-ed piece opened up a conversation that has lacked sufficient scrutiny. Namely, what choices are available to women who have neither the funds nor the means to endure extended medical procedures?
What happens to the single parent who has no partner – like my mother – and who is the sole breadwinner in a family? Can this woman undergo the extensive tests and treatments, and finally afford the recovery time necessary? Will she be able to afford reconstructive surgery? Currently, reconstruction is not covered by HMOs. Will Obamacare cover this procedure? Will some agitated, righteous contingent of the upwardly mobile intervene and determine that preventative care should not be covered? Without a strong support base, including a health care system that treats all economic communities with equal provision, cancer remains untreatable.
The issue of affordability has been swept under the carpet. The media has instantly polarized the debate in terms of women who may or may not entreat medical intervention, as pointed out by Denise Grady, Tara Parker-Pope, and Pam Belluck in the New York Times: “But some doctors also expressed worry that her disclosure could be misinterpreted by other women, fueling the trend toward mastectomies that are not medically necessary for many early-stage breast cancers.” Yes, this is part of the issue, but the bigger issue is that many women in America simply cannot afford to be sick.
Last week, House Republicans voted – for the 37th time – on repealing Obamacare. That a universal healthcare system is not viewed as an optimal condition for one of the richest countries of the world is a harrowing foreshadowing of what is to come. The unfortunate reality is that we are not all equal. A healthcare system embodies not only a medical team but also a more permeating support system that all women – all people – do not enjoy.