(C) South Dakota Searchlight
This story was originally published by South Dakota Searchlight and is unaltered.
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Costs of diagnostic screening should not stand in the way of lifesaving care • South Dakota Searchlight [1]
['Doris Caldwell', 'Seth Tupper', 'Michele Snyders', 'Tom Dean', 'More From Author', 'January', '.Wp-Block-Co-Authors-Plus-Coauthors.Is-Layout-Flow', 'Class', 'Wp-Block-Co-Authors-Plus', 'Display Inline']
Date: 2025-01-31
Watching someone die from cancer is hard.
I have done it more than once. I feared it would be me when I received an inflammatory breast cancer (IBC) diagnosis at the age of 38.
Our children were 10, 12 and 17 at the time. My husband and I both worked for a nonprofit that had just recently added health insurance benefits. If it would have been a year earlier, we would have been without coverage. We were building homes on the Rosebud Indian Reservation, money was tight. I am thankful we had good coverage then with a reasonable deductible.
Looking back through the process of diagnosis, I have to say if I had the insurance that I do now, I don’t know that I would be here today. Early detection saves lives and, with IBC, every day matters. It is that aggressive. I was able to get testing that I needed and finances were not a factor.
Unfortunately, the facts are that now, too many South Dakota women are left exposed to large out-of-pocket costs for diagnostic tests to detect breast cancer early, a loophole we could close this legislative session. Screening mammograms are usually covered in full by insurance carriers, but for women like me, the additional diagnostics required for follow-up testing after an abnormal mammogram can cost thousands of dollars, forcing patients to make a big out-of-pocket payment to get the work-up they need or gamble with their health.
Women like me, our daughters and granddaughters fall into high-risk categories. This means we often need testing beyond an annual screening mammogram. Breast density and family history are factors in that. These two things affect so many, putting many families in a difficult financial position.
In many ways I was fortunate. It wasn’t until I had been diagnosed that cost became a conversation for our family. For some women, out-of-pocket costs add up for the diagnostic tests they need even before they are diagnosed with cancer.
I say I am not sure I would be here today because with our current deductible $7,500 applies to everything past a screening mammogram. I might not be here because – like many South Dakota women today — my diagnosis required multiple tests. We could not have afforded to pay for those tests then and many women surely cannot afford it now.
I had more than one mammogram, ultrasound, lab work and two biopsies. Today, that would all be out of pocket. For way too many women, the cost of diagnostic testing causes delays. Delays in screening, in diagnosis and delays in beginning lifesaving treatments. Everyone agrees early detection saves lives, yet deductibles have increased across the board, creating a large obstacle for many.
It makes sense to remove barriers to early detection so women can get the care they need without facing grave financial consequences. Across our state, there is a growing group of women and families who work hard but are struggling to make ends meet.
South Dakota has done a good job for very low-income women. Our All Women Count program can cover a diagnostic mammogram. But this is only for women who fall within certain income guidelines. For example, a woman in a family of two must fall below $51,100 before taxes to qualify for those services.
For way too many women, the cost of diagnostic testing causes delays. Delays in screening, in diagnosis and delays in beginning lifesaving treatments.
We need to provide solutions for women above that threshold. They need to receive the benefit of early detection. I spent a few years working in the cancer center I received treatment in. I can’t tell you how often I served women who had advanced cancer. Many times it was not found early because of financial concerns. This should not be common.
Legislation pending in South Dakota, House Bill 1070, would eliminate cost sharing on diagnostic breast screening. Asking insurance companies to pay for diagnostic screening makes sense. This legislation has been enacted in nearly half of the states.
Some say legislation shouldn’t be needed for this. In that case, we should already have it.
Others say that breast cancer shouldn’t be treated differently than other cancers. I say we must start somewhere.
Breast cancer screening is expensive and some women need supplemental screening based on individual risk factors or family history to ensure early detection to save and extend our lives. Treating a localized cancer is easier and more cost effective than once it has spread.
My hope is that one day we have a world without cancer. Until then, we should do everything we can to facilitate early detection.
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https://southdakotasearchlight.com/2025/01/31/costs-of-diagnostic-screening-should-not-stand-in-the-way-of-life-saving-care/
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