-- by Donna Smith of the California Nurses Association/National Nurses Organizing Committee, originally posted on MichaelMoore.com [3]. Donna's battle with medical bills and bankruptcy was documented in the 2007 Michael Moore film Sicko.

There has never been any doubt in my mind that if I face another cancer diagnosis that requires prolonged treatments and has an uncertain outcome, I would rather die than fight it. As an insured American who knows first-hand how quickly a cancer in my body turns to full out trauma in my career and in my finances, I just cannot do it again nor can I ask my husband to risk his own life and security either. It wouldn't be fair.

More than five weeks ago, when some of my cancer markers were elevated, I began the process of bartering with the insurance company, doing the tests they said would be covered, and then coming all the way back to the start to finally getting the tests my doctors originally ordered. My full diagnosis and treatment considerations have been pending ever since, and that has given me time to think and to remember. Waiting, worrying, and wondering.

It's not that I believe every cancer is a death sentence. I certainly know that isn't the case. I am a uterine cancer survivor. My mom is a two time breast cancer survivor. But I am 57 years old now -- old enough to be an expensive liability in our society, especially if I get sick and need care, but too young to be covered by Medicare. If I face a serious illness like cancer again that costs me an awful lot in out-of-pocket expenses not covered by insurance and lost time from making the money we need for survival, I will doom my husband to struggles he doesn't need and that are not his fault. Bad enough that one of us should be sick, there is certainly no need for me to take him down with the ship.

I am not being morbid or feeling sorry for myself. I am trying to be pragmatic as an American trying to maneuver our broken, for-profit healthcare system. Working class people are expendable; sick working class people are costly. Better to die quickly and get out of the way for another healthier, less expensive worker, and better not to suffer needlessly if the outcome will be lousy anyway.

Perhaps waiting so long and worrying has clouded my thought process a bit, but I know that when my Medicare-covered husband is ill, he feels worried and upset about his health. When I am ill, I worry first about our finances, my job, and then finally about my health -- being privately insured creates pressures that are very real and damaging. So as I wait what seems like endless days waiting for the test results again since the initial insurance company denial of care delayed everything, I feel like I need a game plan in order to feel in control at all.

America needs Medicare for all, for life. The program needs to be improved, expanded, and extended to everyone. With all of us paying into one large, public risk pool, every life will matter equally. We are a nation of individuals who believe that equality is to be valued. It is simply wrong to have a healthcare system that dismisses that value and forces people who otherwise would not do so to ponder death as treatment option. In the meantime, I'll wait and smile and do my job like millions of other Americans do every day hoping we won't have to choose such a fate.

Medicare for all, for life is not an impossible dream. Support the American Health Security Act of 2011, S915/HR1200, and ask your elected officials to do the same. We can do better for one another. And we must.