Christina Aguilar sits in a converted storage room of a Las Vegas medical center, the best hope for underinsured cancer patients to get the treatment they need.
Drip by drip, Aguilar, 28, watches as chemo enters her body to fight advanced-stage ovarian cancer. She is here because her insurance company wouldn’t pay for her chemotherapy or her surgeries. “I thought, ‘Why am I getting insurance if it’s not going to pay for the most important thing’ ” she says, recalling the day she learned her insurance wouldn’t cover treatment. Getting chemo in an old storage space isn’t the most ideal situation, but it’s her only choice. Watch chemo in a closet » Earlier this year, state budget cuts in Nevada resulted in the slashing of the outpatient cancer center at the University Medical Center’s oncology clinic, forcing patients to find treatment on their own. “We’re supposed to be the safety net for patients, and yet obviously the safety net has holes in it,” says Kathleen Silver, the CEO of University Medical Center. Oncologist Nick Spirtos found a solution. He persuaded his partners to take on the patients pro bono, converted a storage area in his office into a chemotherapy room and got Clark County to pay for the expensive chemo drugs. One treatment can cost upwards of $10,000. He’s also sought more primitive ways to cover costs. He holds up a clear plastic box bearing the label “Cash for Chemotherapy.” Dollar bills and loose change jingle. There are 380 boxes placed throughout the county. “It helps,” says Spirtos, the director of the Women’s Cancer Center of Nevada. “If these boxes pay for one more patient’s chemo, that’s one lady who in the overall context wouldn’t be able to have her treatment.” With the nation debating health care reform, Spirtos says he does favor universal health care, but not without trepidation. Learn more about America’s health care debate » He says Medicaid reimburses doctors at a fraction of their costs, and he believes other government programs are poorly run. He wrote an open letter to President Obama and Congress earlier this month. “[I] respectfully suggest that instead of rushing headlong into ill-thought out proposals, you and your staff along with Congress take some time and thoughtfully review the issues facing us and formulate a plan that might actually meet our needs,” Spirtos said.
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But on this day, he’s focused on his patients. Decked out in a blue doctor’s gown, Spirtos makes the rounds to see the women at his clinic. Aguilar’s ovaries were recently removed and she is getting her latest chemo regimen. She’s reclined in a chair, a red blanket draped over her legs. She opens a laptop and flips through digital pictures of her mother, who died of lymphatic cancer 10 years ago. Aguilar says her cancer was detected almost by accident. She went in for a checkup and a small acorn-sized cyst was discovered. A month later, it was the size of a grapefruit. She broke down in tears just after her ovaries were removed. “I started crying. I was like, ‘Oh my God, I’m not going to be able to have kids,’ ” she says. Aguilar was a cashier at Toys R Us, making $8.76 an hour. She had insurance through work, but it wouldn’t cover her costs. Her salary made her inelgible for Medicaid. With the slashing of the county hospital’s oncology unit, her bills were racking up and she had few options. Luckily, her doctor referred her to Spirtos. Spirtos says cases like hers are becoming all too common, especially in the down economy. He treats 75 to 85 women per month; about 20 percent are in a similar situation as Aguilar. “If you’re recently unemployed, you have no insurance benefits and you don’t qualify for any of the public aids,” he says. “So amazingly, the people who’ve been working and supporting the system, the moment they’re out of work they don’t fit in any of the round holes — they’re square pegs.” If Aguilar wasn’t getting treatment from him, he says, “Over time, her cancer would progress and she’d pass away.” The doctor, who is bald, stops at her side. Aguilar rubs the doctor’s golden dome. “The great part about this is Christina’s hair is going to grow back and mine won’t,” he says.
The two laugh and smile. Outside the room, the doctor says he’s doing all he can to make sure the women who come to him have the best treatment possible. “I get to hug my patients, I get my head rubbed and I get an incredible amount of gratification,” he says. He pauses. “Getting a hug from one of these ladies is like my kids running up and saying, ‘I love you.'” He turns and walks down the hall. More patients await his help.