Fact checked by Jim Lacy
“Can I afford this”?
I asked myself the question before dialing my oncologist’s office. Less than a year ago, my doctor told me I was “cancer-free” based oninitial blood work, but I needed to schedule a follow-up appointment.
For many cancer patients, remission does not begin once they learn the cancer is gone. Colorectal cancer recurrences are most common during the first two to three years after surgery. In my case, my oncologist told me I would remain under surveillance for at least three years, with regular blood work, checkups, and annual colonoscopies.
But can I afford all of that? I recently lost my job — a salaried position with a local news outlet — and I know I’m not alone. The U.S. unemployment rate is currently 4.3%, and the Bureau of Labor Statistics estimates that roughly 7.4 million people were unemployed as of January 2026.
Many people are feeling financial strain. Even those who have secured income have noticed companies are shifting toward freelance and contract-based employment structures. This shift enables businesses to avoid the costs associated with employee healthcare and benefits.
For a time, I convinced myself I could go without health insurance. Could I wait until I found another job or until my partner secured full-time employment and added me to his plan? I kept waiting for the right moment, hoping to avoid the tedious process of applying for Medicaid — and confronting the reality that this is where I am right now, despite a master’s degree and ongoing efforts to find work. Month after month, I postponed my follow-up appointment.
Then a woman in my cancer support group told us her cancer had returned. She was closest to my age and had been diagnosed with the same type of cancer just a year after I was. The news shocked all of us. By all accounts, she seemed healthy — vibrant, active, and without significant symptoms leading up to the discovery. My heart sank, and I felt a heightened urgency.
My waiting time was over. I’m still not ready to decide how to move forward with insurance, but I have to make the appointment.
I often reflect on the privilege of being able to pay out of pocket. It may set me back financially, but it will not bankrupt me. I will not miss rent or other bills. I can manage — for now.
Approximately 41% of U.S. adults carry some form of medical debt. Data from health policy group KFF and the Peterson Center on Healthcare show that about 14 million people owe more than $1,000 in medical debt, while roughly 3 million owe more than $10,000. Medical debt disproportionately affects low-income individuals, women, and communities of color — groups that also shoulder a high burden of diseases such as cancer.
As I review my monthly budget, I will likely need to use my savings to pay for my follow-up appointment. But given my medical history, I can’t assign a price to my health.
So I reframe the question.
Instead of asking, “Can I afford this?” I now ask, “Can I afford not to?”
