Women diagnosed with breast cancer may find BRCA 1/ 2 genetic testing useful in order to make decisions about breast cancer treatment options or in determining risk of future cancers. Through an ethnography of eight breast cancer survivors in the Denver Metro-Area this study reveals how access to BRCA 1/ 2 genetic testing differs depending on the type of private insurance coverage patients have. The political ecology of health (PEH) theoretical framework is used to analyze how the private insurance policies governing breast cancer patients' access to BRCA 1/ 2 genetic testing are tied to the political economy, culture, and environment of the United States. Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are the two primary forms of private insurance companies in the United States and their different policy structures have significant consequences for the health outcomes of the patients covered by these insurance organizations. Women battling breast cancer may or may not be able to obtain a BRCA 1/ 2 genetic test depending on their ability to negotiate for insurance coverage for the testing or how their insurance incentivizes physicians to advocate on their patient's behalf. The results of this study are used to develop a digital story and policy suggestions that are useful in educating breast cancer patients, scholars, health care advocates and health insurance policy makers on how private insurance policies could be changed to make BRCA 1/ 2 genetic testing more available to the breast cancer patients who want them. This study is especially relevant in light of the June 2013 Supreme Court decision making BRCA 1/ 2 genetic patents illegal and will be valuable as novel genetic testing technology becomes integrated into the United States' health care system.
|Commitee:||Horton, Sarah, Koester, Steve|
|School:||University of Colorado at Denver|
|School Location:||United States -- Colorado|
|Source:||MAI 52/02M(E), Masters Abstracts International|
|Subjects:||Cultural anthropology, Genetics, Medicine|
|Keywords:||Breast cancer, Digital storytelling, Genetic testing, Insurance policy, Political ecology of health|
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