Saturday, October 8, 2011

The Cost of Cancer

Generally speaking, I have no idea how much my cancer treatments are costing; I am tremendously grateful for decent health insurance so that I don't have to think about much more than my $30 co-pay at each visit. Chris and I did some quick calculations, and we figure we're going to be out-of-pocket about $1,000 when all of this is said and done. $1,375 if you count the naturopath I saw who was not covered by insurance. This sum includes my doctors visits; my surgical biopsies; my MRI, CT, PET and PEM scans; my ultrasounds and mammograms; the surgery to place my port through which I receive all of my medicine; my weekly Herceptin treatments; and my triple-cocktail chemo every third week.

It also includes a follow-up drug called Neulasta to boost my white blood cell counts that I receive after every round of chemo. Prior to my first dose of Neulasta, the nurse called my insurance company to make sure it would be covered because it is a six-thousand dollar shot. Since I'll get six of these injections over the course of the next three months, I am happy to say insurance pays for them.

But all of this has me thinking: what if I didn't have insurance? You can bet your ass Chris and I would do all we could to borrow and beg for enough money to pay for top-notch medical care, but I know that it would very quickly become a heavy burden to bear. I cannot imagine going through this while worrying about how to pay for it. Cancer gives you plenty to worry about as it is.

For about a year before I found the job I have now, I practiced bankruptcy law. It was a rough year. I came home crying several nights a week because of the sad, sad stories people were sharing with me day-in and day-out. Sure, many of them had simply overextended themselves in boom times, but a good number of my clients were in dire straits through no fault of their own - just unlucky circumstances beyond their control.

One of the most common reasons people turned to our firm for help was that they couldn't afford their medical costs. Bankruptcy provided a way out from under their bills and some breathing room. The ugly truth, though, is that clearing your record of money owed to a physician makes it highly unlikely that that doctor will treat you again anytime soon. Doctors need to make a living, too.

Recently, I read another breast cancer survivor's story. She is self-employed and had high premiums to pay throughout her treatment. Now, eleven cancer-free years later, she is still not eligible for better insurance because of her pre-existing condition. With cancer, apparently, insurance companies insist on fifteen cancer-free years before they'll consider whether you're healthy enough to qualify for a new plan.

I don't begin to believe that I know what the solution to our country's healthcare system is, but this diagnosis has certainly made me think things need to change. Not to get too political, but it doesn't seem right that if you're unemployed, you don't get health insurance. I'm pretty sure cancer doesn't discriminate.


  1. My mom was diagnosed with melanoma in 2002 at age 55 - 9 years later, she is still working full-time instead of retiring because she could not afford health insurance for her and my dad any other way (yes, COBRA would cover them but the premiums would be prohibitively expensive). But thank god they're still covered.

    Luka has already run up a six-figure hospital bill in his first 6-months of life, and he has been a healthy preemie! However, we got to witness "socialized medicine" up close when he was born in Australia. We had to pay for Luka's care (or the insurance did), since we are not citizens or permanent residents. Everyone else in the hospital received the same extraordinary care and compassion as we did, but didn't pay a dime. The billing department in the hospital is one small office the size of a janitor's closet, hidden behind the elevator. When I went there to pay for Luka's care, they said not to worry about giving my credit card until they sorted it out with our insurance. Given the remote conditions of many of the communities in the Northern Territory (the "outback"), the hospital has a travel agency to book helo and small plane flights out to the cattle stations and mining camps - all paid for if it's for medical reasons.

    I don't have the answers either. I don't know if Australia will be able to afford their health care when their mineral wealth runs out (or China stops buying everything they can mine). But I do know there has to be a better way than the US.

  2. Thoughtful post Jen! Having experienced both pay-for medical care in the US and socialised medicine in the UK I can say for sure that I prefer the UK's system. My maternity care in the UK was exceptional. Better than I am getting in Boston. (And my care in Boston is far more expensive.) And I believe that socialised medicine has a huge impact on entrepreneurship. I wouldn't have started my own company and become self-employed if I had to worry about how I was going to pay for healthcare. Who knows how many other people are in my place? It's not been well-researched. Also James has patients who seem to get taken advantage of, being told they need XYZ care when in the UK they wouldn't have the same threshold for giving that treatment and his medical opinion is that they are unnecessary, invasive, even dangerous, but the hospital makes money off giving the treatment so they are deemed necessary. I could go on for ages, but I think socialised medicine is fairer medicine. It horrifies me to think that Americans with cancer might go bankrupt if they were unemployed at the time of diagnosis.

  3. hi jen. finally am getting your blog/good positive info. way to go,girl! CA,no ins,no money,no chance! its lousey! sending good vibes to you. KK

  4. Hi, love your blog! I actually totaled up all of my bills just out of curiosity. For 4 rounds of chemo and 10 rounds of radiation, I was over $150,000. Like you, I am thankful for good insurance as it only cost us about $4,000 out of pocket (which is still a lot, but much better than $150k!). I broke down my expenses here: Thanks for sharing your experience!

    1. Thank you for the kind words! Isn't the financial aspect insane?! Now that I am 2.5 years into treatment, I'm sure my bills are close to the $1 million mark. I am still lucky to have incredible insurance, but I cried with relief when the Affordable Care Act was passed into law. It's not perfect, but if anything ever happened to my current insurance (through my husband's job), it's nice to know we couldn't be turned down due to a pre-existing condition. I'm so glad to see you're doing well!

  5. I am gonna have to go along with you this time around!
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