Breast cancer bill will force insurance cos. to foot costs

Pennsylvania first lady Michele Ridge was shocked when doctors discovered a breast tumor during a routine mammogram last December. Although the tumor turned out to be benign, the experience made Michele Ridge and her husband, Gov. Tom Ridge, more aware of the concerns of the 10,500 Pennsylvania women diagnosed with breast cancer annually. Tuesday, almost a year after his wife's scare, Ridge signed a bill requiring insurance companies to cover mastectomies completely. The bill went into effect immediately. "Those brave survivors of this disease need to know that their lives will go on, that they will be whole again, and that they will heal," said Ridge, a Republican, before signing the bill in a ceremony in the state capital of Harrisburg. The legislation makes Pennsylvania the 12th state to outlaw the so-called "drive-through" mastectomies which force women to leave the hospital just hours after having breast-removal surgery. The problem arises when insurance companies and health maintenance organizations will not cover an overnight stay. Nancy Zieber, an oncology clinical nurse specialist at the Hospital of the University of Pennsylvania, said the bill will help HUP improve mastectomy patient care. "Now women will be able to get the treatment they need without having to worry about finances in addition to cancer," she said. The new legislation also requires insurance companies to cover surgery to reconstruct the breast for up to six years after the initial mastectomy, a move Zieber called particularly significant because "many women are not psychologically ready to undergo reconstructive surgery after they have just been operated on to have cancer removed." And although most women want to go home as soon as possible after having a mastectomy, Zieber said it is important that they have the option to remain overnight because many develop diseases or other complications following the procedure. "Under this bill, the choices are made by the women who are affected and not dictated by insurance companies," she said. Women's health advocates have been pushing for the legislation since July 1996, when State Sen. Joseph Uliana (R-Northampton) first received complaints from doctors in his district that their patients were having difficulty convincing insurance companies to cover post-mastectomy reconstructive surgery. Before the legislation, women had to personally lobby insurers and doctors to pay for reconstructive surgery. Julia Beekler, who lobbied for the bill in the state legislature, said she had to fight her insurance company to cover surgery after she suffered chest injuries in car crash, though her auto insurance gladly repaid her for damage to the car. "I'm going to have my car for just a few more years, but I have to live with my body for the rest of my life," she said.

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