Think Yuck
A few weeks ago, when I was walking down JFK Blvd. toward Love Plaza, I noticed that the water in the fountain there was pink. I chalked it up to a bizarre prank. Then, a few nights later, Al and I noticed as we drove south on Broad Street toward City Hall that a few of the downtown buildings were lit with pink spotlights. "What's with the pink?" Al asked. I shrugged, and mentioned the fountain.
The following week I was walking around town with my sister-in-law, and I saw that the fountain in Love Plaza—and several others—were still filled with pink water. Suddenly, it dawned on me: October is "Breast Cancer Awareness Month", and as we all know, breast cancer is PINK.
I'm obviously being sarcastic here. The color I most associate with breast cancer is not pink, but yellow. It's the color my close friend and former roommate of 5 years, Pat Serino, turned when breast cancer spread to her liver, giving her a bad case of jaundice. Before that, she was an alabaster gray, as chemo drained her energy—and her stomach. I can't remember a single moment when she was pink. I can remember the angry red of a breast swollen with what doctors said was just a "systemic infection" a few months before she was diagnosed with cancer, and the purplish red of radiation burns between bouts of chemo, but she was never pink.
I'm glad that people are now more aware of breast cancer, and I don't deny that my awareness was a little lacking before Pat was diagnosed. But is dyeing fountains pink raising awareness? Is shopping for a cure really buying anything more than increased profits and brand awareness for BMW, American Express, Yoplait, and all the other companies with breast cancer campaigns? I can't help but think that associating pink and shopping with breast cancer is just a way to make breast cancer seem warm and fuzzy and feminine. Let me tell you, it's none of the above. Breast cancer, believe it or not, strikes men as well as women. Breast cancer is an ugly, disfiguring disease. Breast cancer KILLS. It killed Pat, it killed my family's dear friend Loretta Mercurio, and it's killed countless others. It's not pink, and no amount of shopping is going to make it go away.
To learn more about what CAN be done to end breast cancer, and why shopping isn't going to lead to a cure, visit www.thinkbeforeyoupink.org.
A Visit to Cancerland
Breast Cancer Action sent me this article, Welcome to Cancerland (also available as a PDF), a while back... possibly years back. I found it in a box of Truckee stuff, recognized Barbara Ehrenreich's name, and sat down to read it.
Much of what I read I already knew, but Barbara really puts it together. I found her insights about the infantilization of breast cancer and the positive-only focus on survivorhood particularly interesting, and although I knew that chemotherapy extends the average patient's life by only days or weeks, I didn't really understand the story behind that statistic. It's summed up in this paragraph:
Even if foolproof methods for early detection existed, they would, at the present time, serve only as portals to treatments offering dubious protection and considerable collateral damage. Some women diagnosed with breast cancer will live long enough to die of something else, and some of these lucky ones will indeed owe their longevity to a combination of surgery, chemotherapy, radiation, and/or anti-estrogen drugs such as tamoxifen. Others, though, would have lived untreated or with surgical excision alone, either because their cancers were slow-growing or because their bodies' own defenses were successful. Still others will die of the disease no matter what heroic, cell-destroying therapies are applied. The trouble is, we do not have the means to distinguish between these three groups. So for many of the thousands of women who are diagnosed each year, Plotkin notes, "the sole effect of early detection has been to stretch out the time in which the woman bears the knowledge of her condition." These women do not live longer than they might have without any medical intervention, but more of the time they do live is overshadowed with the threat of death and wasted in debilitating treatments.
It's a long but fascinating article, highly recommended. (Breast Cancer Action's Policy on Breast Cancer Screening and "Early Detection" has more information on the value of early detection and is shorter, if you just want the facts without the editorial insights.) I'd meant to mention it here before, but I got caught up in other things. It came to mind again today because of a NY Times article about the approval of a new drug for colorectal cancer ("F.D.A. Approves Cancer Drug From Genentech" -- free subscription required to view article), which contained this paragraph:
The drug, approved for patients with colorectal cancer that has spread to other organs, is far from a cure. But in a clinical trial in which it was used with chemotherapy, people who received the drug lived a median of 20.3 months, almost five months longer than those who received only chemotherapy.
Five months longer, at a total cost of $89,320 for the new drug alone ($4,400 x 20.3 months). This doesn't include the costs of chemotherapy (which include vomiting, hair loss, exhaustion, loss of libido, and other side effects, in addition to dollars). I'm just saying.
Be(A)ware
Yep, it's that time of year again: October, otherwise known as "Breast Cancer Awareness Month." By all means, be aware. Know that breast cancer still kills millions. That mammograms are great for detecting breast cancer, but they don't prevent it. That racing for the cure will make you feel great and will give you a chance to get informed, but it won't get much money into research for an actual cure.
By all means, get educated. And please, be an educated consumer. When a company puts a pink ribbon on a product, ask them where the money goes—and how much.
By all means, buy Yoplait yogurts if you like them—but don't bother mailing back three pink lids in an envelope with a 37-cent stamp on it. You'd be better off sending 67 cents (or better yet, $5, $10, $50) directly to a breast cancer charity and skipping the middleman. Feel free to test drive the BMW, buy the Avon lipstick, use the Eureka vacuum. But if you really want to do something for yourself *and* find a cure for breast cancer, skip the car, the makeup, and the dirt sucker and go straight for the tax deduction.
The Flu: Who Knew?
I saw this interesting item on Suburban Guerrilla about the difference in the British and American responses to the Chiron debacle, but I wasn't sure how reliable the source was (especially given the dodgy editing, the lack of attribution, and the numerous server errors I got on my first visit to the site).
It seems the story's accurate, if the Washington Post is to be believed. What's interesting to me is that this could be yet another example of the Bush administration and its agencies being overly optimistic in the face of bad news, of hearing what they want to hear rather than preparing for a worst-case scenario, as the British did. [I do wonder whether the CDC would have been so optimistic under any administration, or just this one; how much influence does the administration have over the CDC, anyway? I know it has some, based on what happened—or didn't happen—in the early days of the AIDS crisis...]
On a related note, I saw an article in a local Lancaster County, PA paper about how many people are positively panicking about the vaccine shortage, harrassing local doctors and calling every medical-related agency and private firm in the area looking to get on a non-existent waiting list for a shot, and that several states are considering making it a crime to give a flu shot to a healthy, low-risk individual. Freaky. I feel kinda bad that I'm high-risk on two counts (asthma and pregnancy), and that I'll have to jump on the give-me-a-flu-shot-now bandwagon. :-/
A Plea for Universal Healthcare
The bill for Austen's delivery and the subsequent 4-day hospital stay arrived yesterday. Together with the bill for the anesthesia, which arrived in December (I'm pretty sure they charged me for both the spinal and the epidural, even though I correctly predicted that a spinal wouldn't work), and the bill for the amniocentesis we got last summer, the total cost of bringing Austen into this world was roughly $20,000. The amount we were actually responsible for paying? $555.45. This doesn't even include all our pre-natal vists or the post-partum checkup, for which we made a single $15 co-pay.
Honestly, I'm shocked. I'm not asking anyone to hit us up for more money (though they might—an additional $200 or so is stil in dispute between the hospital and the insurer), but I wouldn't have been surprised or upset if we'd been asked to pay more. Of course this wasn't an entirely free ride; we do, after all, pay monthly premiums for insurance coverage. While those premiums have been rising steadily, however, they're still far, far less than the COBRA coverage I could have gotten when I left my old job. And what of the folks who don't qualify for or can't afford COBRA, or who don't have insurance for whatever reason? How can they afford to have babies? I know an uncomplicated vaginal delivery only costs in the neighborhood of $5,000 to $8,000, but what if you have a perfectly uncomplicated pregnancy, as I did, an still end up with a C-section (again, as I did)? If you budgeted $5K and end up owing $20K, you're screwed.
There's got to be a better way—one that doesn't involve charging the folks who can actually afford insurance less than those who can't. A way that doesn't involve charging the uninsured the "padded" amount designed to make up for the lower payments negotiated by Medicare and private insurers. (In our case, about one third of the total bill was knocked off because it exceeded the "contracted" amount.) I'm not sure what that way is, but it's got to be better than what we have now.
For the time being, I can be relieved that Austen's birth didn't break the bank. But I also can't help but feel a little guilty about it.
It's About Time
And by that I mean not only that it's about time the FDA approved Plan B, but also that the reason making Plan B available over the counter is so important is that it must be taken within 72 hours of unprotected sex. (See What Happens When There Is No Plan B?.)
It's about damn time.
Milk Break
Interesting article in today's NYTimes: On the Job, Nursing Mothers Find a 2-Class System. Something I'd never thought about, either while I was nursing or after. My current company has lactation rooms—I used one to nurse the Beaner in when I was visiting in March 2005—and since I worked from home part-time while I was nursing, I could nurse him with one hand while typing with the other. Luckily, I never had to pump on a daily basis.
While we middle- and upper-class working women are out picketing for lactation rights, we should give a thought to the women who don't have breaks long enough in which to pump, who have no place to pump, or who can't even afford a breast pump. As the article notes, "It is a particularly literal case of how well-being tends to beget further well-being, and disadvantage tends to create disadvantage — passed down in a mother’s milk, or lack thereof." It's a cruel irony that it's mothers with the lowest-paying jobs who have to pay the most to feed their babies (formula ain't cheap!).
The Return of the Pink
Ugh, it's that time of year again: The time when every building and fountain in Philadephia is lit up with pink. Stores sell bears in pink t-shirts (with a whole $4.50 from your purchase going toward breast cancer charities!) and tea with pink ribbons on the cannister and pink-enameled kitchen appliances. We're urged to buy! buy! buy! in the name of breast cancer.
Here's an idea: If you don't need the teddy bear or the pedicure slippers or the boxing gloves (!), why not make a direct donation to a breast cancer charity? (Link goes to a list of well-run breast cancer charities, as ranked by Charity Navigator.) Even if you give a tiny amount—say, $10 or $20—you're still giving more than you would be by buying most pink-ribbon products. Instead of mailing four pink yogurt lids in to Yoplait (you'd be spending 39 cents on the stamp to give 40 cents to the Susan G. Komen foundation), mail $5 directly to Komen... if Komen is the organization you want to support.
If you really would rather buy a breast health-related product than send money directly to a charity, please consider buying something that doesn't pander with pink. A sepia-toned calendar produced by Breast of Canada is one option. Not a whit of pink in sight, and real, actual breasts on every page. (You'd be surprised how shocking it is to see REAL breasts, after what we're used to seeing in advertisements, on television, and in movies. Seriously: it's shocking. Sue Richards gave me a sample calendar when I met her at BlogHer, so I've seen all the images. This article on the Breast of Canada website gives a good sense of how different this calendar is from the traditional pinup version you'd see in a gas station repair bay.) If nothing else, the calendar will make you appreciate the healthy breasts you have, and help you keep them healthy with reminders and instructions on how to do breast self-exams.
If all this pink makes you angry, as it does me; if all the sweetness and light and positive pinkness seems incongruous with the vomit-inducing toxicity of current cancer treatments; if you find it disconcerting that many breast cancer organizations are sponsored by chemical and pharmaceutical companies; if you want to find out what's CAUSING breast cancer and work to PREVENT it, not just detect and treat it, start by educating yourself, and then take action. Give yourself a breast exam. Eliminate harmful chemicals from your household, and lobby for a cleaner environment for yourself and your children. Whatever you do, don't just shop.
Un-Pinking
My annual rant against breast cancer in general and the pinking of the disease more particularly is over at Pink For October this year. I wasn't going to bother, since blogging is obviously low on my priority list right now, but when Matthew Oliphant posted this photo in his Flickr stream, I couldn't resist.
As I mentioned at the top of the pink post, I'm going purple for October. As I did last month, I'm doing it as a two step process because I ran out of steam after bleaching. :-) At the moment my hair is mostly white with pink streaks on top. I'm thinking of leaving the white and using the pink streaks as a guide for where to put the purple, but I'll decide for sure later. Oh, and I took the clippers to my head prior to bleaching.
The Health Fund
I just wanted to say a few words about the health plan I used to have at Adobe, and you can take those words for what they're worth. I'm saying my piece here because I never hear anyone talk about this sort of thing, and I think it's relevant to the debate.
I loved my plan. I'm sure there were problems with it—it probably had injunctions against pre-existing conditions and other gotchas that Obama and Congress are rightly trying to get rid of—but that I never ran up against. Here's the gist:
It was a health fund. I (or rather, my employer, who subsidized it to the point that it was either no-cost or very low-cost to me) paid money into this fund, and up to a set limit (which was something like $1K for me when I just covered myself, and $2K for my whole family the next year), all my bills were paid out of the fund at 100%. There were no co-pays. I went to the doctor, it was covered, done.
But here's the even better part (though the 100% coverage/no copay part was pretty damn good): I got to see the bills. The insurance company would send me statements showing what the doctor had charged, what they had negotiated to pay, and thus what had come out of my fund. I knew how much a visit to the allergist cost, how much a breathing test cost, etc. I could see for myself how much money was left in the fund, and *how* I'd spent what I'd spent so far. Because of this, I had a vested interest in questioning the reason for any tests that were ordered, how often I *really* needed to be seen, and whether that expensive drug was really effective. I loved having this kind of visibility into the cost of my care, and the incentive to try to lower that cost.
I also had an incentive to get routine preventative care in order to keep myself healthy, because using some funds to stay healthy meant there were funds left over at the end of the year that would roll over to the next year. So, for example, I had something like $440 left over from 2007, so for 2008 I would have had $1440 for myself or $2440 for my family (or maybe it was $3440, with $3K being the family baseline; I can't remember exactly). The cool thing about this was that it helped us save up for a bad health year. If we were going along great for a few years and then Al broke a leg or I got pregnant or the Beaner needed surgery, we'd have a pile of health fund money built up to help us cover costs before we had any out-of-pocket expenses.
If I exhausted my fund in any year, there was an out-of-pocket maximum of something, maybe $500 or $1000, and then the 80/20 coverage kicked in. So I was never out in the cold, never worse off than a relatively high-deductible plan, and often better off. I felt like the incentives were the right ones—staying healthy and saving money—and yet there was a safety net if I managed to fail at this mission.
I realize such a plan wouldn't be the best choice for everyone, but it seems like it should be a choice for more people. While I don't regret leaving Adobe for an opportunity to expand my skills and experience at a startup, I do regret leaving that health plan behind. I miss that health plan almost as much as I miss my former colleagues.