Jeffrey D. Allred, Deseret News
SALT LAKE CITY — Emily Young thought that with a lumpectomy, she had kicked breast cancer. The surgery was all she could afford at the time and she trusted doctors when they said they "got it all out."
"I just hoped for the best," she said.
Now the cancer is back, and with the pre-exisiting condition, 43-year-old Young doesn't qualify for a health insurance plan. She won't until 2014, when health care reform mandates officially take effect.
"I have to not be afraid of death at this point," she said. Young has been visiting a spiritual healer, trying to "come to grips with what might happen" if officials in Utah decide not to support Medicaid expansion, which would extend coverage to her and about 105,000 others like her in the state of Utah.
It would be a third of the state's uninsured population — people who aren't offered a plan from their employers, can't afford or get one on their own and don't qualify for Medicaid.
Gov. Gary Herbert told hundreds gathered at his second annual Health Summit on Tuesday that he is taking a "wait and see approach" to implementing provisions of the Patient Protection and Affordable Care Act, which was signed into federal law in 2010 and upheld by the Supreme Court earlier this year.
A discussion on the issues is ongoing, but Utah and other states are waiting for the results of the November election before anything becomes concrete. President Barack Obama instituted the plan while presidential contender Mitt Romney has vowed to repeal the health care act
"We need to come up with the best benefit with the highest quality of service for the most amount of people at the lowest cost," Herbert said, repeating his long-held sentiment that federal health care reform was hastily conceived and was passed without input from the states.
"We still don't know what's in those 2,700 pages of federal legislation," Herbert said. "And those 2,700 pages are spawning and will spawn thousands of pages of additional regulations."
He said "all states can be laboratories of creativity," coming up with health care solutions on their own, and taking the necessary time to determine whether any idea is affordable and efficient before signing it into practice.
Advocates for equitable health care say waiting on making a plan may end up being too late for some.
"There are sometimes situations where there are people who might die without health care insurance. They are not just statistics; these are real people and their families who are impacted by this," said Dr. Raymond Ward, a family practitioner in Bountiful. He said that if Young would have received the nine months of chemotherapy and radiation treatments doctors prescribed for her following surgery, she may not have a recurring cancer diagnosis.
"I am focusing on finding goodness in all things and seeing the love that is there," Young said. "It's all you can do when you've done all that you can. The one thing I can do to keep uplifted."
The MBA grad and entrepreneur said she's tried to do everything right in her life, but "some circumstances are out of our control. The plan I've mapped out for my life is no longer a durable plan."
Young said that without insurance, her options are limited.
Experts who spoke at the summit said the key to reining in health care costs is prevention, catching disease early on. But research has shown that only those insured can afford to be screened, said Susan Dentzer, editor-in-chief of Health Affairs magazine.
Those without health insurance, she said, can also expect increased premature death rates, receive fewer services and treatments, have higher morbidity rates and worse health outcomes, and they are less financially able to take care of health problems that come along. All of those factors then impact society as a whole.
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