The Great Divide: When Health Insurance Fails Women With Simple Breast Cysts – Dr Jason Chin Yu Aun

It is time to bridge the great divide in health insurance and ensure that women receive the care they need and deserve, regardless of benign findings like breast cysts.

This is the 12th woman I’ve seen in my practice complain to me about issues with their health insurance, due to findings of a simple breast cyst detected by a mammogram or ultrasound. I’ve had to help mediate this issue with their respective insurance companies numerous times.

These women faced exclusion, loaded premiums, postponed procedures, or outright denial of coverage to benign findings such as simple benign breast cyst.

Lifetime prevalence of developing a breast cyst is between 70 and 90 per cent. Most of them are benign, which do not require further testing and have no risk of becoming cancerous. Therefore, due to this issue, it deserves our attention and calls for urgent reform.

Mammograms and breast ultrasounds are important tools for breast cancer screening. They can detect benign or malignant findings. Benign findings indicate non-cancerous growths, while malignant findings suggest cancerous growths.

Simple benign breast cysts are harmless and do not pose a risk of developing into cancer. They require no treatment and do not increase the risk of future breast cancer. Complex breast cysts, which account for only 5 per cent of cases, have a small chance of becoming cancerous.

Disturbingly, numerous women have encountered obstacles and biases in dealing with health insurance companies regarding simple benign breast cysts. Denying insurance coverage for women with benign breast cysts places a significant financial burden on individuals.

Diagnostic procedures, such as imaging tests or biopsies, can be costly without insurance coverage. Many women may be unable to afford these out-of-pocket expenses, leading to delayed or skipped medical examinations, potentially compromising their overall health.

Medical professionals can attest to the harmlessness of simple benign breast cysts. They can be easily distinguished from cancerous growths through medical evaluation and imaging techniques.

However, denying coverage for these cysts may deter women from seeking further medical assessment. Consequently, there is a risk of missed opportunities for early detection of breast cancer.

Delayed diagnosis can lead to more advanced stages of cancer, necessitating more aggressive treatments and potentially reducing survival rates. In addition, denying coverage for simple benign breast cysts can have broader implications for public health.

As a preventive measure, breast cancer screenings aim to detect cancer at its earliest stages, improving outcomes and reducing mortality rates.

When insurance denials hinder women’s access to routine screenings, there is a potential decline in breast cancer detection rates, leading to delayed diagnoses and diminished public health benefits.

Denial of insurance coverage for a simple benign breast cyst can lead to heightened anxiety and worry. The uncertainty surrounding their health and the lack of financial support can intensify these feelings of anxiety.

Insurance denials can instil fear and uncertainty in women with simple benign breast cysts. Women may feel that their health concerns are not being taken seriously or that they are being unfairly penalised for a benign condition.

This sense of injustice can lead to anger and resentment towards the insurance company and the health care system.

In conclusion, it is imperative that insurance companies, particularly underwriters, re-evaluate their policies and become better informed about simple benign breast cysts.

Women’s health insurance should not be denied, excluded, postponed, or burdened due to these harmless conditions. It is time to bridge the great divide in health insurance and ensure that women receive the care they need and deserve, regardless of benign findings like breast cysts.

By recognising the benign nature of these cysts, insurance providers can ensure equitable access to necessary healthcare services for women and promote peace of mind during breast cancer screenings.

Dr Jason Chin Yu Aun is the operations lead and medical officer at the National Cancer Society Malaysia (NCSM).

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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