Highmark v. UPMC

Ok, so as if I didn't have enough to worry about, the battle between Highmark and UPMC has me seriously worried.  I wrote the letter below, but I don't know who to send it too, or even if, under civil service laws, I am allowed to send it to anyone. Anyway, what do you think?

To Whom It May Concern, 

Let me introduce myself. I am a 32 year old state-employee, and last year, I was diagnosed with head & neck cancer. I consider myself very lucky to work in a system where the support from my co-workers and management was overwhelming, I had plenty of sick leave, and health insurance covered nearly everything.  It took a while, but I found some doctors I really trust with my care. They happen to be at UPMC Cancer Centers and UPMC Eye & Ear.   

Despite getting the best of treatments, my cancer has since metastasized, and although I am not currently in treatment, I will require follow-up care for the rest of my life.  For now, I feel great and continue to work in the state system, and I would like to continue with the doctors who are familiar with my previous treatments and close to home.

Ironically, if I were seriously ill, to the point where I had gone on disability and was relying on Medicare and Social Security, I could continue to see my current doctors. However, as a state employee living in south-western Pennsylvania with a serious illness, the only real options for me are Highmark health plans. If UPMC and Highmark continue on their current paths, they will split ways next summer. At that time, it looks like I will lose access to my doctors unless UPMC and Highmark come to some sort of agreement.  I don’t know if the solution to the current impasse should come from legislation, the consciences of whoever is making the decisions for UPMC and Highmark, or if I should be pestering the PEBTF to offer a wider range of insurance options.  I don’t really care. I just want to keep my doctors.  

My oncologist assures me that if the split occurs, I can get my routine care at AGH and go to Cleveland for a top-notch research facility as needed. But Cleveland is 3 hours away, doesn’t have the doctors I know,  and I don’t want to waste the time I have driving to a city where I don’t know anyone.

I know my situation is not unique, there are thousands of people out there facing similar situations. Please don’t make us waste our days driving to great research facilities out of state when there is one so close to home. 

Lisa Moore

That is my rant for the evening. Thanks for tuning in!

A hard turn.

So, most of you know it's been a rough couple of days.  I had a scan on Thursday to follow-up with the treatment from last august, and see what else might be going on.  I got the results the same day from my doc. The good news is that the five spots that were treated are gone, leaving only cloudy looking spots on the CT.

The bad news  - two new spots on my lungs. They are small, but I had really hoped that this scan would be clear.   Since my type cancer is usually slow growing, and will sometimes just stop growing for no apparent reason my docs think the best approach for now is to wait 3 months and see what happens.  Honestly, I'm not sure what will happen if the next scans show more spots. There has been talk of doing more of the radiosurgery or trying some chemo.

One of the hard things about my type of cancer is that chemo doesn't work to keep it from coming back, which is why I haven't had any. Some people have had success with it keeping tumors from growing, but it is chemo and would likely have ugly side effects. 

So, I (and you, my friends & family) have to make the hard turn from thinking of this cancer as something that I will defeat to something that I will live with.   Victory will not be becoming cancer-free, but will instead be living my life as full as I can despite health issues. Lest you think you are getting rid of me that easily, people live many, many years with this type of cancer. And I plan to be one of them.

The best hope for a cure lies in new research, and since it is rare, large nonspecific charities like the american cancer society don't give much, if any, money toward this research.  If you would like to donate toward research that might help me, or others like me in the future, please consider accrf.org. 100% of donations will go directly to fund ACC research programs.