On treating the uninsured

Linda Halderman MD sees a lot of women in her rural practice--some without insurance are subsidized by the cash payments of the esthetics clients.

"Upon questioning Sherry S., a pretty 46-year-old seeking wrinkle relief, I learned that four of her immediate family members had been diagnosed with breast or colon cancer before the age of 50. Alarmed, I asked why she had not had the recommended screening mammogram for more than four years.


She said that she knew already that her risk for developing breast cancer was likely higher than that of most women.

"But I don't have insurance," she replied.

A screening mammogram could be obtained for about $90 and was discounted or free at local facilities every October for "Breast Cancer Awareness Month."

She smiled when I proposed a deal: if she were to get a screening mammogram within sixty days of her treatment, I would offer a discount on what she paid me for cosmetic services.

"I'll think about it," she said, then shelled out over $400 for BotoxTM injections that took me ten minutes to administer.

Five months later, when she returned for her next wrinkle treatment, she reported that she still had not obtained a mammogram."

Read her observations on those who don't have insurance.