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Even cancer patients with insurance face difficulties with financial toxicity.
A recent focus of my blogs has been complimentary therapies, which is the use of therapies such as acupuncture, exercise, nutrition and other non-medical ways to heal. One of the most successful of these is stress reduction, which has been shown to have an impact on immunity and delay recurrence when stress is managed.
Unfortunately, one of the major stress centers for cancer patients and their caregivers is the cost of cancer treatment. A flurry of current research has shown that the cost of cancer care can be much more than patients expect and lead to some refusing treatment that could save their lives.
One study that caught my eye looked at oncologists and their lack of communication with their patients about the cost of their therapy. This surprised me a little because when have oncologists known the cost of the therapy they are providing enough to discuss it with patients. Another report on the topic from the Cancer Support Community (CSC) showed that going through cancer is a “financially toxic” experience that leaves patients exposed to stress and depression.
The key findings from this report found, among other things, that 30 percent of patients depleted their savings because of treatment costs.
If having no savings doesn’t increase stress, what does?
I know that few people think cancer patients have such financial battles, assuming that the hospital or someone takes care of the bills when there is no money. But they don’t. If the patient doesn’t have the funds, they just bill them until they can’t pay or send them to collection agencies.
I had one friend who showed up for her chemotherapy appointment in the middle of treatment only to be handed a $13,000 bill that had to be paid, BEFORE she would be given her next treatment. It seems the hospital told her they didn’t’ take her insurance anymore so she would have to pay for every visit in cash. She was told the insurance company sent her a letter. Nope.
She called me and I called the head of the cancer center who said such a situation should not have happened because she should have received a letter explaining the situation in time to move her treatment elsewhere. If he could have seen the look on my face across the phone wires he would have seen what incredulity looked like. I repeated to him, “She was SUPPOSED to get a letter telling her to find a new treatment center.” He said yes. And that would make this all right??
They said they would let her pay off the $13,000, which they ultimately dropped. How kind.
She moved to another hospital system in the city, which meant finding another doctor and jumping through all the hoops required to set up treatment.
Can you imagine the stress this caused? In her case, she had a bad prognosis as it was, and with the moving of doctors and everything else that happened, she and her husband were both stressed to the max.
According to one study that came a few months ago in JAMA Oncology, monthly out-of-pocket costs average $703 for cancer patients. Now add all the things insurance does not cover, like wigs, driving, food while traveling to and from, clothing.
I can remember asking a plastic surgeon how much something cost when I was getting ready to have reconstruction a few years back. He looked at me like I had asked for the vault access code to Fort Knox, which begs the question whether physicians have a clue how much something costs. How can they discuss it when they don’t know? He finally said, “You have insurance, don’t you?” I said yes, but I wanted to compare the cost of one kind of reconstruction to another.
Finding out how much an insurance company will pay is probably harder. They look at a number of factors. I am grateful for Medicare, but I also have a supplemental that I pay for, and together they cost $300 a month.
This does not include prescription insurance costs, and if you want a real challenge, try to find out how much your medication will cost. I went to fill one prescription yesterday and was told that it was considerably cheaper for me to use the free Good RX coupon instead of my insurance. And you can’t shop around on these because unless you go to them and give them the prescription, they can’t tell you what it will cost. An added note on that is to be careful about January, when all the renegotiated costs go through. I got caught in that one last January and paid significantly more for one drug I had taken for three years.
Probably the saddest piece of information regarding cancer care cost is that the sicker a patient becomes, the greater the chances his or her family will have to declare bankruptcy before they die, ultimately losing their home, their savings and their loved one to cancer.
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