the "moral hazard" of healthcare

A very good article from The New Yorker, by Malcolm Gladwell: "The Moral-Hazard Myth."

I recently received an e-mail from one of my former computer art professors, who teaches the senior-year class intended to prepare students for life after college. She sends out a survey each year to alumni asking what they're doing in art, what kind of job they have, etc. Question 13 was, "Words of advice?" I replied:

Get health insurance. Please. Even if your future employer doesn't have it, get your own. I was a perfectly healthy 24-year-old last fall until I found a lump on my collarbone. I was diagnosed with Hodgkin's Lymphoma and went through 6 months of chemotherapy and one month of radiation therapy. From diagnosis to completion, this all cost about $125,000, but thanks to insurance, it only cost me $1500 (of course, that doesn't include the income I lost from missing work). I know a lot of young people think health insurance is a waste of money, and I said that too when I first graduated, but obviously I'm glad I had it when I got cancer. (I'm fine now, by the way. Hodgkin's has an 85-90% survival rate.)

People my age often live by the idea that "I never get sick." Having had only strep throat a few times in elementary school, I hadn't been sick since 4th grade until Hodgkin's came along, and was also proud of my seeming invincibility. And unlike lung cancer, which people feel free to write off as being "punishment" for smoking*, there is no known cause of Hodgkin's, so it's not as if I could've really avoided it (although some hippies like to blame it on processed American foods or fluoridated water or the like).

*This mentality holds even though non-smokers who even avoid secondhand smoke can still get it, especially those of us who have been treated with chemotherapy for other cancers. Hence, breast cancer gets more attention and funding than lung cancer, which has a negative vibe attached to it. That being said, I was about run over by an irony truck this morning when I saw a guy smoking in the rain, sitting on the curb, with his chemo IV pump in tow (the Cleveland Clinic campus is now entirely smoke-free, including sidewalks).


Speaking of health, I saw my oncologists today. I will have a CAT Scan every four months for two years, the first being at the end of October (four months after I finished chemo/three months after radiation). There will still be some scar tissue, but if the scans show it's growing, that would be an indication of a relapse.

I will also have a thyroid test the sixth month after radiation (end of January), because this is when thyroid problems due to radiation therapy usually occur. I will also meet with my radiation oncologist at this time. They can give me medication for this, but obviously we'd want to catch it early.

As far as sun exposure goes, he said I've received "lifetimes' worth" of radiation on the upper chest and neck area, so we're asking the skin to work extra overtime to repair it. It should be fine to go swimming without a shirt so long as I use sunblock SPF 30 (which I always do anyway), but the key is to simply avoid sunburn, especially during the first year.

It seems like I was diagnosed ages ago, but it's only been nine months. My oncologists even seemed a little surprised that I felt completely normal as if nothing had happened. Here's hoping this is the end of it. Stupid cancer.