Worsening the Odds

By BOB HERBERT

Lonnie Lynam, a self-employed carpenter in Pipe Creek, Tex., specialized in spiral staircases. Friends thought of him as a maestro in a toolbelt, a whiz with a hammer and nails.

“His customers were always so pleased,” his mother told me. “There was this one family, kind of higher class, and he built them one of those glass holders that you would see in a bar or a lounge, with the glasses hanging upside down in different sizes. It was awesome.”

Lonnie had a following, a reputation. He was said to have a magic touch.

What he didn’t have was health insurance.

So when the headaches came, he tried to ignore them. “We’ve had migraines in our family,” said his mother, Betty Lynam, who is 67 and lives in Creston, Iowa. “So he thought that was what it was.”

Lonnie’s brother, Kelly, said: “He wasn’t the type to complain. And since he didn’t have insurance ...”

Kelly, 45, worked on different jobs with his brother. He was the one who rushed Lonnie to an emergency room one day last fall when the headaches became so severe that Lonnie couldn’t stand up.

It would be great if there were something unusual about this story: A person without health insurance gets sick. The person holds off on going to the doctor because there’s no way to pay the bill. The person is denied the full range of treatment because of the absence of insurance. The person dies.

Lonnie Lynam’s headaches had been caused by cancerous tumors in his brain. During surgery, doctors discovered that the cancer had spread from other parts of his body.

Cancer is no longer the all-but-automatic death sentence that it once was. Extraordinary progress has been made in fighting the myriad forms of the disease.

But, as the American Cancer Society has recently been stressing, the health coverage crisis in the U.S. is a major drag on this fight.

“A woman without health insurance who gets a breast cancer diagnosis is at least 40 percent more likely to die,” said John Seffrin, the cancer society’s chief executive.

According to the cancer society: “Uninsured patients and those on Medicaid are much more likely than those with private health insurance to be diagnosed with cancer in its later stages, when it is more often fatal.”

The uninsured (and underinsured) are also much less likely to get the most effective treatment after the diagnosis is made.

There are 47 million Americans without health insurance and another 17 million with coverage that will not pay for the treatments necessary to fight cancer and other very serious diseases.

The bottom line, said Mr. Seffrin, is that “the number of people who are suffering needlessly from cancer because they don’t have access to quality health care is very large and increasing as I speak.”

Part two of the Lynam family’s nightmare began when Lonnie returned home from the hospital. Lonnie had very little money, so Kelly stepped in and began paying most of his brother’s nonmedical bills.

Betty Lynam flew to Texas as often as she could to be with her son. She said he needed chemotherapy and radiation treatment, but since he couldn’t afford it, he couldn’t always get it.

“He was trying to pay a little bit at a time for the doctors and for the different treatments,” she said. “But he didn’t have a savings account or any collateral, except for his tools.

“I’d ask how he was feeling, and he’d tell me, ‘Well, I didn’t get the treatment today.’ And I’d say, ‘Why?’ And he’d say, ‘Well, I got in there and they found out I didn’t have any insurance and the woman told me I’d have to come back another time because she’d have to check with the doctor or somebody.’

“He suffered a great deal. Yes, he did.”

After awhile, as his condition deteriorated, Lonnie Lynam, carpenter extraordinaire, became all but consumed by the fear of death. Toward the end, he would sleep with a light and the television on, his mother said, “because he wanted to see something or hear something as soon as he woke up to know that he was still alive.”

She said: “Some nights he’d be so frightened he’d come crawl into bed with me and just say, ‘Hold me, mom.’ I just slept right with him in the hospital and just held him, you know?’”

Lonnie died on March 26 at age 45. The cause of death was cancer, aided and abetted by an absurd, unnecessary and utterly unconscionable absence of health insurance.