^{Posted on April 4, 2007}

Death by no insurance?

Doctor and patient had colon cancer. She was uninsured and died. He is alive, convinced she could be too.

By Lindsey Tanner
Associated Press
Published April 4, 2007

Dr. Perry Klaassen lived to tell about his frightening ordeal with colon cancer.

His patient did not.

Same age, same state, same disease. Striking similarities, Klaassen thought when Shirley Searcy came to his clinic in Oklahoma City. It was July 2002, a year after his own diagnosis.

But there was one huge difference: Klaassen had health insurance, Searcy did not.

His treatment included surgery two days after diagnosis and costly new drugs. He is alive six years later despite disease that has now spread to his lungs, liver and pelvis.

“I received the most efficient care possible. I was 61 years old and had good group health insurance through my workplace,” he wrote in a medical journal essay that contrasts his care with that of his uninsured patient.

The doctor didn’t name Shirley Searcy in his March 14 article. After all he’d been through, he couldn’t remember her name. But he dug for days through old medical files searching for her identity after he was interviewed by The Associated Press, hoping to shine a more powerful light on the plight of the uninsured.

The widowed mother of eight grown children, Searcy had little money. When she began to sense she might be sick, she put off going to the doctor for a year because she knew she couldn’t pay the medical bills. Deeply religious, she put her faith in God, according to her family.

By the time she saw Klaassen, her cancer had spread from her colon to her liver. She had surgery but rejected chemotherapy.

“She just really didn’t feel like she wanted to endure what that would cost physically or financially,” said her daughter-in-law, Karen Searcy.

Shirley Searcy died Dec. 22, 2003, about 18 months after her diagnosis.

Searcy’s is a story that’s far from unique. An estimated 112,000 Americans with cancer have no health insurance, according to Physicians for a National Health Program.

Klaassen’s essay in the Journal of the American Medical Association illustrates the issue “close and personal,” said the publication’s editor, Dr. Catherine DeAngelis.

It underscores that insurance can be a life or death issue, said Paul Ginsburg, president of the Center for Studying Health System Change, a non-partisan policy research organization.

Klaassen, now 67, no longer sees patients but works part-time as medical director of an Oklahoma City group that recruits doctors to give free care to needy patients.

Always healthy and vigorous, his diagnosis in 2001 came as a shock.

Klaassen had a colonoscopy within two weeks after seeing his doctor for pain in his lower abdomen. When the specialist with the results asked, “Is your wife with you?” Klaassen wrote, “I knew immediately that I had colon cancer.”

Surgery two days later showed the disease had spread outside the colon wall and to nearby lymph nodes. It was not as advanced as Searcy’s, whose disease had spread to the liver.

Searcy married young and had her first child in her teens. Her mechanic husband died in a 1978 car crash, leaving her to raise the family alone. Social Security helped, but the Searcys never had anything extra, family members said.

“Life dealt her more I guess than some people have been dealt,” Karen Searcy said.

She didn’t work outside the home, didn’t venture often beyond her 4 acres and the ranch house where she raised her children in Blanchard, about 30 miles from Oklahoma City. In her later years, reading stories to her dozens of grandchildren was a favorite pastime. She’d figured she’d live long enough to qualify for Medicare at age 65, family members said; she missed it by a year.

“She put off [seeing a doctor] because of no health insurance, and she wanted to trust the Lord. She was hoping to be healed,” said her daughter, Melba Spalding.

Klaassen knew immediately that it was colon cancer when she saw him. A colonoscopy weeks later confirmed the diagnosis and that it was incurable.

It was “heartbreaking to all of us,” Spalding said. The family had always been close, and Searcy “was pretty well the hub of it,” she said.

With insurance, Searcy would have sought treatment sooner, family members said.

“I believe with all my heart that if she had gone to a doctor early on, that she would still be living,” Karen Searcy said.

Klaassen also thinks things would have turned out differently if she’d been insured.

“If she had survived at least a year more, she would have had new pills available to her,” the same ones that have helped control his disease, Klaassen said.

“People say … nobody ever dies because they don’t have insurance, and I say, ‘Yeah, they do.”