[Janet]
 
Well, I have been a night-club singer ever since I came to The City. I have always loved it. I have a couple of recordings out, and I have even written some of my own songs. But, like many singers, songwriters, and other kinds of independent and struggling artists, I don't have a regular job and I do not have health insurance. I always figured I was too young and too healthy to get sick. So, imagine my surprise when I found out I had breast cancer. My income was - and still is - very limited. Oh, I make enough to get by, but that's about it. So, I didn't have a problem qualifying for Medicaid. I had to have a mastectomy - surgery to remove my entire breast. My tumor was too big to be removed by a simpler operation such as a lumpectomy. At first, I only cared about getting rid of the cancer - I didn't give a lot of thought to what I'd look like or how I would feel after the surgery. But, once I got through treatment, and I wanted to go back to work, I was so depressed by the constant reminder of my cancer when I went to work. Work was always my wonderful escape - but now, I couldn't disguise or even forget for a moment that I had cancer: I couldn't wear the low-cut gowns that I usually like to wear and, that I think, are important to my career as a torch singer. I just didn't feel good about myself. I had talked to my breast surgeon about reconstruction, but Medicaid - at least in this state, considers breast reconstruction to be cosmetic surgery. Ha! - Cosmetic?! For me, how I look is how I feel about myself - as a woman - and as far as I am concerned, is important to my career. One day, I dropped by the hospital to talk to my cancer nurse, and she noticed that something was bothering me. I had been so excited about going back to work - but I guess she saw that now, I wasn't that thrilled about it. Anyway, we talked and I told her everything. She didn't make any promises - other than that she would see if there might be some kind of special fund somewhere in town - maybe in a teaching hospital - that would help me get breast reconstruction. It was really something -- she actually found a program in the community hospital where I had my surgery. They have a training program right there for plastic surgeons, and specialize in offering surgery to cancer survivors who wanted reconstructive or restorative surgery. It became sort of a negotiation process. If I would agree to have a plastic surgery resident do my operation, the fund would pay for the surgery and all of the follow up care. My nurse helped me make sure that the doctor who would actually do the surgery was qualified, and that the doctor who runs the training program would be right there to supervise. I was reassured by my nurse's confidence in the surgeons, and the reconstructive surgical team. For me, everything turned out just great. I know that some women don't feel they need to have breast reconstruction - or they just don't want to go through this. But, I did. It was important to me, and it was worth it. I had the surgery, I like my image in the mirror and feel good about myself. I'm back to singing - in my favorite dresses.

[Narrator]

Janet had given a lot of thought to what her needs were, and she finally told someone who wanted to help. Together, they explored the options that were there for Janet, and then negotiated the kind of services she would need. Janet is happy with the result of her surgery, and is now getting on with her life. Many people who have served in any of the U.S. Armed Services are eligible for, and entitled to some kinds of support provided through the U.S. Veterans Administration - the VA. The rules have changed, and veterans now need to enroll every year for services. There has been some definite tightening of coverage, and the VA encourages veterans to keep any health insurance they have. But, for those who qualify, the VA system can provide much needed help in finding and getting care. Glenn's story is not unusual.

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