Illinois Health Matters, August 12, 2008

Illinois Health Matters is a Sargent Shriver National Center on Poverty Law newsletter that describes health care in Illinois through the stories of state residents. Our intent is to show the reality of health care in Illinois. Our hope is that this reality will help Illinois celebrate, use, and safeguard what is already good and drive Illinois toward constant improvement and health care for all.

We want your stories for Illinois Health Matters! We are extremely careful about your confidentiality and will always clear any of your information with you first before we use it. Please click here to share your story (or the story of someone you know) and we will follow up with you. You may also submit stories to:

Melissa Cubria
Direct line: 312.368.1168

ALEX--Uninsured child lacks necessary preventative care

Alex is a young adult who lives in Chicago. While attending high school, he began to have severe pain in the upper part of his abdomen. Alex was eligible but unenrolled in Illinois' All Kids program-a successful program that enjoys wide bipartisan support and provides access to comprehensive, quality, affordable health care for all children in Illinois. Alex sought medical assistance with a physician at his school's onsite health center. When he first met with his doctor, his condition had not yet been diagnosed. After Alex described his symptoms, his physician thought that he may have suffered from chronic pancreatitis, a long-standing inflammation of the pancreas that is usually a symptom of a greater problem or illness. The next step in Alex's medical work-up would have been a diagnostic test called an endoscopic ultrasound to determine whether his condition was a genetic problem. If the test came back positive his condition could be managed fairly easily to prevent future attacks. Unfortunately, problems arose because Alex had no health insurance and his parents could not afford to pay out-of-pocket for the test. His physician called numerous doctors and hospitals but nobody would see Alex until they knew exactly who would pay for the procedure. As a result, Alex did not receive the diagnostic test and to this day has never had a proper diagnosis of his condition. Alex has since developed Type II Diabetes, another chronic illness that is common among individuals with chronic, untreated pancreatitis.  An early, proper diagnosis would have prevented future episodes and would have prevented Alex from experiencing the general symptoms of pancreatitis for the rest of his life, symptoms that often include severe pain in the abdomen and back, nausea and vomiting and fever. He cannot find an insurance company willing to take on a patient with two chronic conditions. He has subsequently relied on emergency room care for his entire life-because the ER cannot turn him away-- which is very expensive for the state and for taxpayers and drives up overall health costs.  Had Alex received the necessary preventative care and disease management that he needed early on he could be successfully managing his disease through a primary care physician, and could have developed into a healthy young adult.  Instead, he now suffers from two chronic, exacerbated and debilitating conditions, and will continue to rely on expensive emergency room care for treatment.  Alex's story shows the need to enroll children in All Kids so they can see the doctor regularly, and it demonstrates how hurtful and expensive it is for Illinois not to have guaranteed affordable health coverage choices for everyone.

MARTHA-Breast Cancer Treatment: Then and Now

Martha is a breast cancer survivor who lives in Chicago. In 2004, she was diagnosed with recurrent breast cancer for the third time and since then the cancer has spread to her lungs and bones. During her third battle with breast cancer, Martha dropped from full-time to part-time status at her job and lost all of the health benefits she relied on to treat her disease. She spent a year without insurance while waiting to receive Medicaid benefits. According to Martha, "This latest battle has brought me many struggles." She says that the impact of losing her "health insurance has become one of my toughest battles as of yet. I thought breast cancer would be my biggest challenge. I soon learned different…Becoming UN-insured has become my toughest battle in fighting this disease. Health care is a serious business, especially for under-served and UN-insured people. I should know, as I am a breast cancer survivor who fought my first and second diagnosis of breast cancer with health insurance. I now suddenly find myself walking a tight rope with no security beneath me."

Unfortunately, at the time of Martha's third diagnosis, there was no safety net on which she could rely. However, today, the climate has changed for uninsured women in Illinois thanks to the Illinois Breast and Cervical Cancer Program, a program that provides women in the State of Illinois access to free mammograms, breast exams, pelvic exams and Pap tests and provides coverage and care for all illnesses detected if they are uninsured. While Martha now has health coverage through Illinois' Medicaid program, her experience battling cancer without insurance was not only traumatic but eye opening as well. Martha believes, "Our country has reached a critical crisis resulting in many people dying due to their lack of health insurance. It seems unreal that one of the most powerful countries in the world can't find a way to help solve our health care system while finding a cure for the diseases that plague our nation. We are wasting a lot of time!!! Unfortunately, some of us don't have time!!" Martha is correct. Early detection is crucial to surviving breast cancer. Thanks to the Illinois Breast and Cervical Cancer Program women can now receive regular screenings and diagnoses can be made in a timely manner.