Dean Spadaro is a strong man.

He told us he is weak.

“I used to be very strong and muscular. I’ve lost everything — no testosterone,” he said. “I tried working out and couldn’t do it.”

He became physically weak after undergoing 40 rounds of radiation treatment for prostate cancer diagnosed in January 2021; he is now at Stage 4.

But we believe he has inner strength and courage. We talked to Spadaro because of a change in insurance that is affecting his health.

After we heard Dean Spadaro’s story we wanted to share it with the public. We want town officials who make decisions about insurance for their retirees to read it. And we want the taxpayers of Guilderland, who are underwriting the cost for insurance, to read it.

“I don’t want to look like a troublemaker … ,” Spadaro told us. “I don’t think the town knows what’s going on.”

We believe the kind of trouble Spadaro and his friend, Dan Cocca — both retired Guilderland police officers — are making is the “good trouble” that the late civil rights activist and Congressman John Lewis referred to when he said, ​​“Get in good trouble, necessary trouble, and redeem the soul of America.” 

Cocca, who ended his career early because of an on-the-job injury, is still having neck pain 21 years later, requiring surgery that he says is not covered by the new insurance provider.

He was hit while directing traffic at Willow Street and Route 20 and, after seven surgeries, is still suffering pain, he said. “Now, I’ve lost all six of my doctors —  cardiologist, pulmonologist, radiologist, rheumatology, gastroenterologist, and my primary-care doctor,” he told The Enterprise.

“What value do we place upon a human being’s health and life?,” Cocca asks in a letter to the editor this week. “Is this the way we say thanks to the many who dedicated their lives to the town, and to the ones who lost parts of their lives?” 

The Guilderland officials who have decided to change their retirees’ health insurance coverage from Capital District Physicians Health Plan to Humana told our reporter, Sean Mulkerrin, last month that switching providers is a good thing for retirees and will save the town money.

The monetary savings are clear: Under CDPHP’s Medicare Advantage, Guilderland’s cost was $278 per person per month; with the switch to Humana, it went down to $167 a month.

But the cost to retirees who depend on the insurance is less clear. As an example, Community Care Physicians is one of the groups that will no longer participate with Humana.

“We need insurance partners who understand our patient and provider needs, allow for independent provider decision-making, and don’t have burdensome processes that delay care,” CCP wrote in a letter to patients.

CCP’s senior vice president for marketing told us that patients who continue with the practice will have to pay up front when they come in for an appointment and “any reimbursement from Humana will be given to the patient at Humana’s discretion.”

“Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations,” says Human on its website.

This puts patients in a precarious position.

Imagine what that is like if, in the midst of weakness from cancer treatments, you are fighting for your life. We don’t have to imagine; we can instead hear Dean Spadaro’s story.

Spadaro, a Guilderland High School graduate, started his police career as a sheriff’s deputy for Albany County and became a Guilderland Police officer in 1989, retiring in 2011.

“I loved it,” he said of his work. “I liked the freedom of being outside, being able to help people.”

He even relished working during snowstorms because he could help people who were stuck. “It’s a good job, protecting people,” he said.

After he was diagnosed in 2021, Spadaro was covered by Medicare and, as a retired Guilderland town worker, had been covered by Capital District Physicians’ Health Plan.

“Insurance-wise, everything was smooth,” Spadaro said of his initial three years of cancer treatments.

He got those 40 rounds of radiation treatment locally at New York Oncology Hematology. He also takes medication and gets shots, he said.

Last April, Spadaro said, although his tumor had shrunk, he was told the cancer had metastasized to his lymph nodes and spine.

The radiation tired him out. “I was not myself,” he said. “They decided to give my body a break, waiting to see if my PSA goes back up.”

The PSA is a blood test that measures prostate-specific antigen, a protein produced by prostate cells whether the cells are normal or cancerous. PSA levels increase with prostate cancer.

Spadaro, who turned 65 on Jan. 7, said he was then forced by the town to switch to Humana insurance. “They tried to push me to Humana last year; I told them no,” he said. “But, when I turned 65, I had to switch over. I switched in late December. Then I got a letter from NYOH that, as of Feb. 14, I couldn’t be treated there.”

So, last Thursday he made the drive to the New Jersey center of Memorial Sloan Kettering, accompanied by his 23-year-old daughter. He pays up front for MSK because it’s out of network.

“When you get bad news, you zone out,” he said, glad that his daughter made the trip with him. “I don’t catch everything.”

During Thursday’s visit, the MSK doctor was worried Spadaro had to drive so far and suggested a closer doctor he trusted, working out of Saratoga Hospital. Spadaro told him that Saratoga Hospital was part of Albany Med, which doesn’t take Humana. The doctor then said they could do telemed visits to save Spadaro the wear of travel.

A telemedicine visit wouldn’t be covered by the new insurance, Spadaro said. He bristled at the suggestion someone made that he could enter a different code to get telemed visits covered.

“That would be cheating,” said the former cop. “I wouldn’t do that.”

The change to Humana is problematic not just because of the long drive to Memorial Sloan Kettering, he said, but also in dealing with other complications from the cancer.

His tumor bent his ureter, the tube between the bladder and the kidney so, every three to four months, he has to have a stent put in. The next procedure is scheduled for Feb. 9.

He used to go to his primary care doctor, Monica Mundra at CapitalCare Family Practice on Carman Road in Guilderland, for the required preoperative urine tests and bloodwork.

“I love her. She’s so attentive. You don’t feel like you’re being rushed,” he said of Mundra. “I don’t want to lose her.”

“Now I have to look around. I went to St. Peter’s for the blood and urine tests,” he said. “Albany Med is done with them,” he said of Albany Medical Center deciding not to participate with Humana.

The added stress of navigating through the medical bureaucracy is difficult for Spadaro but he worries more about how it is affecting older Guilderland retirees.

“Someone older than me that doesn’t have their wits the way my mother was, how are they coping?” he asked. “It’s terrible trying to navigate.”

He went on, “Aside from being jerked around, the biggest thing is all the unknowns …Who will take you? I’ve been told since December, ‘We’re still in negotiations.’”

Spadaro said, “I had nothing but good from CDPHP. They always got right back to me. Telemed visits were covered. Now, with Humana, I have to drive two hours to MSK.”

Experts have long known that being uninsured or underinsured are linked with poorer cancer care and survival — it is a strong predictor of a poor outcome after cancer treatment. A 2020 study also found that changes in health insurance coverage — caused, say, by a change in jobs — can lead to limited access to treatment and reduced survival.

This study, published in the Journal of the National Cancer Institute, reviewed 29 observational studies about health-insurance coverage disruptions and cancer care in the United States between 1980 and 2019.

The reviewers found that, compared to people whose insurance coverage was continuous, those with disruptions were less likely to receive cancer prevention, screening, and treatment.

If they were diagnosed with cancer, they were more likely to have an advanced disease at the time they were diagnosed, less likely to receive recommended treatment, and more likely to have worse survival.

The findings were the same for multiple types of cancer, including breast, cervical, and colorectal cancers.

“Health insurance coverage disruptions are common and adversely associated with receipt of cancer care and survival,” the study concluded.

Fighting cancer takes all of a person’s mental, physical, and emotional capacity.

Having that patient leave a trusted doctor, have to scramble to find new venues for required preoperative procedures, and have to drive hours to a cancer center that will treat him rather than being cared for locally where he was comfortable all add to the stress.

We have provided here the story of just one patient but we can imagine many other Guilderland retirees are also suffering.

Fortunately, the town has time to change course.

But it needs to act quickly. Patients already in a Medicare Advantage plan, as are the Guilderland retirees with Humana, have until March 31 to change their plans.

We urge the town to provide them the chance to return to an insurer that allows retirees to continue with the providers they know and trust.

It is more than a matter of convenience or finances; it could be a matter of life and death.