Where Is the Governor’s Compassion?

Imagine that your mother, wife or sister goes for a mammogram and discovers, much to her shock, that she has early breast cancer. Your insurance company pays for the mammogram but refuses to pay for any treatment--not surgery, chemotherapy or radiation. Not plausible? Well, Gov. Pete Wilson just inaugurated Breast Cancer Awareness Month by vetoing a bill that would have paid for the treatment of poor women diagnosed with the disease.

For years, health departments have been cajoling poor women to come in for mammograms. The Breast Cancer Early Detection Program, which offered early screening detection for these women, proved quite successful. And so, the women came. The problem, however, was that many providers in the program did not have the funds to treat those women who ended up having the disease. Not surprisingly, the women, already terrified by the diagnosis, were aghast.

These women are among the 24% of all Californians, including children, who have no health coverage, including no Medi-Cal or Medicaid. They are largely those who work at minimum wage or slightly above or are between jobs. Assembly Bill 2592 was supposed to fix this deplorable situation. By using general state funds, the bill would have provided treatment for these low-income women whose screening resulted in a diagnosis of breast cancer. But our good governor, in a typical display of “compassion,” decided that it was in the best interests of the state to veto the bill. Why? Apparently, we don’t want such women to feel too entitled. After all, we’re already paying for them to be screened. Why should we be required to pay for their treatment too? In his own words, Wilson announced, “I am returning Assembly Bill No. 2592 without my signature. This bill would establish the Breast Cancer Treatment Program within the Department of Health Services to provide breast cancer treatment service to uninsured and underinsured women with income at or below 200% [twice] the federal poverty level. . . . This bill would create General Fund pressure to keep pace with expanding treatment demands.”

In other words, we’ll screen women, but not treat them. In a state now blessed with a surplus, does it make sense to deprive poor women of treatment for breast cancer? Of course not. It reeks of moral bankruptcy and indecency, a sign of Wilson’s disregard for the welfare of poor women and a statement of their dispensability. Shades of Jonathan Swift’s “Modest Proposal”: Perhaps if we allow poor women to die, we won’t have to worry about welfare anymore.

In California, 21,485 women died from breast cancer between 1990 and 1994. In 1998, an estimated 4,300 women will lose their lives to breast cancer and 17,600 new cases will be diagnosed. Between March 1997 and April 1998, the Breast Cancer Early Detection Program provided breast cancer screening and diagnostic services to 101,407 low-income women aged 40 and older. Approximately 1,300 low-income women will discover, through early screening during the next 20 months, that they have breast cancer, but no treatment will be provided.

To detect early breast cancer without providing treatment is like diagnosing serious heart disease and refusing to provide either drugs or surgery. It is a preposterous idea. I am alive because I am a privileged woman whose medical insurance paid for early detection, surgery, chemotherapy and radiation. So is U.S. Supreme Court Justice Sandra Day O’Connor, former state Chief Justice Rose Bird, Nancy Reagan, Betty Ford, actress Jill Eikenberry, Gloria Steinem, 18 friends and millions of other women. But every woman, whatever her income or background, should have access to the same screening and treatment that we received.

Wilson’s veto is a disgrace. It reveals a misogynistic indifference to poor women that borders on the pathological. What an incredible way to remind the public that October is Breast Cancer Awareness month.