It is breast cancer ‘pre-vivor.’ Why aren’t the presidential candidates talking much about health care?

October is Breast Cancer Awareness Month, which means that for the last few weeks everything around us has turned pink – football players, cakes and buses will all be decorated with pink ribbons . Women will be reminded to do breast exams, both at home and at the gynecologist. And we will be encouraged to have a mammogram, we are reminded that most women over 40 can be screened for free every year or twice a year.

But what happens when a mammogram finds something suspicious, turning your worst fears into reality?

Biopsies and other diagnostic tests are free, as are chemotherapy, radiation, or mastectomies. There is no free breast cancer care, only a free mammogram – which, for many, is no longer the recommended method of diagnosis (many experts recommend MRIs or ultrasounds for clear images).

I am unlucky enough to have BRCA1, a genetic mutation that affects 1 in 400 people, and is very common in Ashkenazi Jews like myself. Because of this, my lifetime risk of developing breast cancer remains in the region of 70%. You don’t have to be an expert gambler to know that those are pretty bad odds.

I still consider myself one of the luckiest people in this country, though: I have a very good health insurance that I don’t pay a monthly premium for. I get checked twice a year, with a mammogram and an MRI, and this winter, I will have a double mastectomy and reconstruction. It will be painful, no doubt, and the recovery will take a long time – but at least it won’t put me in debt or cost me money. Many other people in this country cannot say the same about their medical care needs.

Presidential elections are often the time when voters can expect to hear about health care from elected officials and those running for office. But health care has been absent throughout this campaign cycle, with neither Kamala Harris nor Donald Trump talking at all about the crisis affecting ordinary Americans.

In 2016 and 2020, Sen. Bernie Sanders (I., Vt.) gave voice to the concerns of many voters and made health care a central issue of his presidential campaigns — and, in the process, helped change national discussions on insurance. Even in the world’s wealthiest countries, nearly half of adults say it’s difficult to pay for health care, and one in four say they or someone in their family has struggled paying for it in the past 12 months, according to a recent survey. by the Kaiser Family Foundation.

The survey also found that a quarter of Americans have either skipped or delayed the care they need because of its cost, and this even includes those with insurance — half of all adults with insurance they worry about paying their monthly health insurance premiums and other health care costs.

Sanders’ signature policy proposal was Medicare for All, a single-payer, national health insurance program that would provide everyone in the country with comprehensive health coverage. health care – out of network, no premiums, no deductibles, no copays, no surprise bills. , and there are no conflicts with insurance companies. This is a dream, but it seems more distant than ever.

It is clear that health care in this country is a huge problem, so why did the politicians stop talking about it? My husband and I have amazing health insurance thanks to our unions – and I don’t take my luck for granted.

But jobs – and sadly – marriages, don’t last forever. I want to know that I will have health care, no matter where I work or who I am married to. But in this country, that is not possible.

Many women remain trapped in horrible jobs – and worse, abusive and dangerous marriages – because of their need for health care. No woman should have to rely on someone else for her basic needs, but none of the breast cancer awareness organizations or campaigns have addressed this basic and clear issue. .

Any organization that focuses on women and our special concerns, such as breast cancer, must also focus on our economic independence – something that can be provided in part by the health system. good like Medicare for All.

The Susan G. Komen website makes no mention of Medicare for All, or the National Breast Cancer Society, nor does Breastcancer.org. It doesn’t make sense to me that the organizations that are supposed to be at the forefront of breast cancer awareness aren’t raising awareness for what breast cancer patients, survivors and “first responders” like me need most: guaranteed coverage of health care, it can be both. help us prevent breast cancer but also cure it. This is something that a pink cupcake or pink shoelaces cannot do.

There have been advances in this area, of course. The Affordable Care Act made it a crime to deny someone like me — someone with a “pre-existing condition” — health care.

But getting health care doesn’t necessarily make it financially feasible, and many people are stuck in a situation where they don’t qualify for Medicaid but also can’t afford insurance in the marketplace. And insurance companies are always trying to squeeze every last penny out of patients, even though those people are going through some of the scariest and most painful times of their lives.

It is clear that health care in this country is a huge problem, so why did the politicians stop talking about it?

For example, the Blue Cross Blue Shield Association, a major lobbying organization for health insurance companies, asked the Centers for Medicare and Medicaid Services to stop using the three-tiered medical billing system. for breast reconstruction surgery that enabled doctors to collect more money for certain treatments. type of reconstruction, DIEP flap procedure.

Plastic surgeons and other experts believed the decision would limit access to this type of reconstruction to those who could pay $50,000 out-of-pocket — which would exclude me and about everyone I know. This sounds like a niche topic until you face it, and it covers the cold, hard greed of the insurance industry. Fortunately, after pushback from cancer survivors, doctors and surgeons, CMS reversed its decision.

In the rest of the month, we will hear about the need for Breast Cancer Awareness. But everyone already knows about breast cancer – it is the second most common cancer in women. We all know someone who has been diagnosed with it; many of us sadly know women who have died because of it.

What is the purpose of early detection if once cancer is found, you are alone? We need our elected officials to take the lead on this issue, and we need guaranteed free health care at the point of service. This October, put down the pink ribbon and pick up the phone, and call your member of Congress and ask them to support the Medicare for All Act. That’s what those with breast cancer – or the possibility of it – need most.

Mindy Isser works in a labor union and lives in South Philadelphia. mindy.isser@gmail.com