Dying to Know

Trey Smith

Earlier this week actress Angelina Jolie revealed that she had a double mastectomy due to the fact she carries a gene that makes her more likely than most to develop breast and ovarian cancer. She has garnered a great deal of plaudits and admiration for her openness. At least one person -- Ruth Fowler -- is less than impressed!

What exactly has she done that deserves praise? She wrote about an invasive, often brutal medically (un?)necessary procedure which 56% of women with breast cancer in the US choose to undergo. Hands up everyone in the US who hasn’t heard of breast cancer and mastectomy! Anyone? Umm, anyone….?

OK. So now, thanks to Jolie, we’re MORE aware. And guess what? There are really, really expensive tests you can get which tell you beforehand how likely you are to get cancer and die! Hands up who knew about that one? Oh, quite a few of you? Mainly the ones who can afford it, am I right? The ones who can’t afford it – well what good is knowing that there’s a test out there only privileged rich people can get?

While it is not Jolie's fault that the genetic test that can detect whether or not an individual carries the BRCA1 gene costs thousands of dollars, Fowler's point is still well taken. Unwittingly, Jolie has showcased the crucial difference economics plays in our for-profit health care system. A wealthy woman like Jolie can get the test done for what she must consider chump change, while millions of women across the country will not be afforded the same opportunity. The first many of these women will know that they carry the suspect gene is when -- not before -- they are diagnosed with breast or ovarian cancer!

Jolie stated that one of the chief motivating factors for her is that ""I can tell my children that they don't need to fear they will lose me to breast cancer." I am happy for her children, but what about the millions of children with mothers who can't afford the test, whether or not they are covered by health insurance? Are their fears not as important? Are their mothers' lives not as important?

The way our system works, it would seem so!