A diagnosis of cancer is stressful. In addition to worries over survival and treatment, many patients experience problems with the cost of medical treatment. Only 20% of South African patients have medical insurance that covers treatment in private hospitals. Even if you do have medical aid, there are a number of considerations.
Navigating Medical Aids
All medical aids, even hospital plans, have to provide some cancer cover. This will include in-patient care but may also include specialist fees, chemotherapy and cover for radiation and medications. The amount and type of treatments covered depends on the medical aid plan that you are on, and may also require you to register with their cancer scheme. Please check, if you are chosing or changing medical aids, what type of treatments you are covered for.
Medical aids are not allowed to refuse cover for a patient with a pre-existing condition and that includes cancer. Always inform your medical aid of your diagnosis so that you gain access to appropriate care and do not disqualify yourself.
Check your policy! Many cover screening mammography and pap smears – even for patients without day-to-day benefits.
What if I don’t have medical aid?
There are many excellent public hospitals and superb academic cancer specialists who work in government hospitals.
There are also organisations (see the resource section at the back of the mag) that provide help in getting to hospital and/or managing treatments. As with all types of illness: knowledge is power. Magazines like this one, books and the internet can all provide information.
Public vs Private
Many women worry that treatment received in our government health system, at a fraction of the cost of private treatment, will be inferior. Usually the only difference between state and private is convenience. In a public hospital, due to resource constraints on staff and facilities, a patient might have to wait for treatment to start – but, in most specialist breast care centres, this should never be longer than international guidelines.
Public clinics may also run only once or twice a week. Breast specialists believe patients should have access to the same high standard of healthcare in public and in private: the same expertise, research trials, support groups and psychological care. All oncology specialists strive for this. Unfortunately Herceptin, for patients with a particular type of aggressive breast cancer, is unavailable in the public sector.
Breast Health Foundation counsellors guide and support government patients through diagnosis, treatment and recovery, allowing for seamless care and follow-up.
The Helen Joseph Breast Care Centre (HJBCC) is a government hospital unit set up in 2005 to provide world-class breast care to Johannesburg, in a provincial hospital setting. Units like this allow patients access to all the available methods of breast pathology, diagnosis and treatment through an integrated, education oriented, multi-disciplinary approach; ensuring cost effective service-delivery and high quality patient care.
To be really good at something, you have to practice. It is the same with breast cancer. Specialised breast clinics, public or private, ensure appropriate clinical assessment of women presenting with breast health concerns. Non specialised private or public clinics often result in inappropriate patient management.
Do not fear if you do not have medical aid, there are a number of specialist government breast units that will treat you well and manage your breast cancer without leaving you in debt. Call the Breast Health
Foundation helpline (0860 BUDDIE) for more information and to find your nearest clinic.
And remember: you cannot afford NOT to be treated for breast cancer.
Written by Dr Sarah Rayne