Copyright 1999 Federal News Service, Inc.
Federal News Service
JULY 27, 1999, TUESDAY
SECTION: IN THE NEWS
LENGTH:
1302 words
HEADLINE: PREPARED TESTIMONY OF
BARBARA
FLETT
RN
DIRECTOR OF THE WOMEN'S HEALTH PARTNERSHIP OF
SUFFOLK COUNTY
BEFORE THE SENATE FINANCE COMMITTEE
HEALTH CARE SUBCOMMITTEE
BODY:
Thank you Mr. Chairman, and members of the Committee for inviting me to
testify today. I am Barbara Flea, RN, Director of the Women's
Health Partnership of Suffolk County. The Women's
Health Partnership of Suffolk County that I represent is part
of the New York State Breast and Cervical Cancer Screening Program. Similar
programs exist in every county in the state and in every state in the country.
Congress adopted a National screening program for breast and cervical cancer
called the Breast and Cervical Cancer Mortality Prevention Act in 1990 (Public
Law 101354) to allow funding for screening uninsured and
underinsured women for breast and cervical cancer. The law prohibits federal
resources appropriated for the program to be used for treatment. States are
required however, under the law, to assure that women who are screened and
diagnosed with cancer through the program receive the treatment they need; yet,
the reality is that not all women are treated. Of the women who are treated:
some have to wait weeks or months for their care, others receive care that is
incomplete or inadequate.
I appreciate the opportunity to testify before you
today on behalf of the patients who are screened and diagnosed with breast and
cervical cancer through our program. The process of identifying available
resources for treatment services is incredibly labor intensive, and I'm afraid
it is causing enormous strain on our program. The time and energy required for
follow up is tremendous.The current ad hoc system of treatment is tenuous and
fragile. Resources for treatment are short-term. We do our best to find
treatment services through reduced rates or charity care but the lack of
coverage for treatment services and the time we must devote to finding treatment
diverts resources away from the program. Currently, the Breast and Cervical
Cancer Screening Program is only able to screen 12-15% of the eligible women
nationwide. I believe that if there was a treatment component, we'd be able to
screen more eligible women.
Last year, our program screened 2200 women - 10%
of whom required follow up care. Judy Lewis was one of those women, and I'd like
to share her story with you today. Judy was diagnosed with Stage 2 breast cancer
last year. Prior to her diagnosis, she was a waitress at a local diner where she
worked to supplement her husband's income to pay the family's bills and to
support her daughter and three grandchildren. Judy's job did not provide
health insurance, so when she felt a lump in her breast, she
was relieved to find out that she could be screened through the Breast and
Cervical Cancer Screening Program.
Her relief did not last long.
Judy
Lewis' mammography results came back showing breast cancer. Immediately, we
tried to find Judy a doctor who would be willing to provide her with treatment.
This was no easy task. After calling many doctors for almost one week, I finally
found one who agreed to see Judy. A lumpectomy confirmed our breast cancer
diagnosis. As you can imagine, Judy was devastated. In the next five weeks, she
required a wider margin biopsy and a partial mastectomy.
Following three
surgeries, she needed seven weeks of radiation. In order to get Judy treatment,
we were able to convince one doctor to provide his services at one-third the
regular cost. Unfortunately, we were unable to obtain similar arrangements with
other physicians or the hospital. As a result, Judy now owes bills for her
radiation,anesthesiology and other hospital charges and she is in debt more than
$20,000.
I tell you Judy's story not so that you will feel sorry for her,
but so that you will understand a typical situation faced by women who are
screened and diagnosed through our Program. Lack of guaranteed treatment means
that there is no way to tell how long a woman will have to wait to get care
following a diagnosis of breast or cervical cancer.Moreover, once a woman
receives treatment, she often must spend her time arguing with doctors and
hospitals (and sometimes creditors) over her bills, rather than focusing on
recovering from her devastating illness. No matter how hard Program Directors
like my colleagues and I work to find that treatment - and believe me, we work
as hard as we can every day to do that - there is no guarantee that we will be
able to find treatment for these women.
For some women, the possibility of
facing this situation is just too daunting.These are the women who would rather
not get screened and not know if they have breast or cervical cancer than be
faced with a situation where they can't find - and can't afford the treatment
they need.
Dr. Stanley Klausner, a board certified General Surgeon
specializing in treatment of diseases of the breast and Director of Breast
Services at Brookhaven Memorial Hospital in Patchogue, New York, understands the
situations these women face.
Dr. Klausner is one of the physicians who have
donated time and treatment to women screened through our Program. In his recent
testimony before the House Subcommittee on Health and
Environment, Dr. Klausner demonstrated the need to enact the Breast and Cervical
Cancer Treatment Act into law. (Mr. Chairman, may I introduce Dr. Klausner' s
testimony for the record?)
Dr. Klausner is all too aware of the difficulty
of getting treatment for women who are screened and diagnosed with breast cancer
through our program. He believes that with the advent and penetration of managed
care fewer and fewer physicians will be able to donate their services.
Dr.
Klausner and I have become aware of another, even more disturbing trend.Women in
situations like Judy's who, with no insurance, are often afraid to elect breast
conserving surgery. They are so terrified of medical bills that their medical
judgement is biased. Despite their awareness that their breast cancer may be
amenable to breast conserving surgery, these women are electing to have
mastectomies instead because they know the cost of the additional treatments
following breast conservation are too expensive. A woman should not have to make
the difficult decision to sacrifice her breast rather than incur medical bills
she cannot pay. As for reconstructive surgery following a mastectomy, this has
simply never been an option.
But the problem does not end them.
In
Judy's case, and in cases of many women like her, she was unable to afford the
physical therapy required following her surgery to regain proper use of her
arms. Without this therapy, she was unable to return to work. Left with no job
and thousands in bills,Judy is haunted by how she will ever repay her debt.
Moreover, she is terrified that her daughters and granddaughters may someday
receive a diagnosis of breast cancer like she did.
One thing Judy Lewis
knows for sure. If her daughters or granddaughters, or any other women like her
are uninsured and screened and diagnosed through the CDC
Program - they should be guaranteed treatment.
Take it from me. Judy was one
of the lucky ones. We were able to get her treated in time to save her life -
but at a great expense to her and her family. No woman should have to go through
what she did - and what women like her go through every day. When a woman is
diagnosed with breast or cervical cancer, she should not have to worry about
when or whether she will be able to find treatment. If Congress cared enough
about reducing the incidence of death from breast and cervical cancer to
establish a federal screening program, then Congress should care enough to
ensure that there is a treatment component as well. Screening must be coupled
with treatment to prevent death from breast and cervical cancer.
Congress
must enact S. 662, the Breast and Cervical Cancer Treatment Act - as soon as
possible. Women, like Judy Lewis, deserve it. Thank you.
END
LOAD-DATE: July 29, 1999 
