Even people with health insurance may face financial toxicity as they try to stay on top of medical bills and other disease-related costs.
Unfortunately, a major stressor for patients with cancer and their caregivers is the cost of medical care. Current research shows that the price can be much higher than patients expect, leading some people to refuse potentially lifesaving treatment.
A study that caught my eye looked at oncolo­gists and their lack of communication with patients about the cost of therapy. That sur­prised me a little: When have oncologists known enough about the cost to discuss it with patients?
Another report from the Cancer Support Community found that going through cancer is a “financially toxic” experience that leaves patients exposed to stress and depression. The key find­ing: Thirty 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 that patients with cancer have such financial battles, based on the assumption that the hospital or someone takes care of the bills when there is no money. But they don’t. If a patient doesn’t have the funds, the hospital just keeps billing or turns 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. The hospital told her they didn’t take her insurance anymore, so she would have to pay for every visit. She was told the insurance company sent her a letter. Nope.
She called me. I then called the head of the cancer center, who said that should not have happened — she should have received a let­ter explaining the situation in time to move her treatment elsewhere.
If he could have seen the expression on my face across the phone wires, he would have seen what incredulity looks like. I repeated, “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? She had a bad prognosis as it was, and what with changing doctors and everything else that hap­pened, she and her husband were stressed to the max.
A study published in The Journal of the American Medical Association found that monthly out-of-pocket costs average $703 for patients with cancer. Now add up what insur­ance does not cover, such as wigs, clothing, transportation, and food while traveling to and from treatments.
I remember asking a plastic surgeon how much something cost when I was getting ready to have reconstruction surgery a few years back. He looked at me like I had asked for the vault access code to Fort Knox, which begs the ques­tion of whether physicians have a clue about costs. How can they discuss it when they don’t know? He finally said, “You have insurance, don’t you?” I told him that I did, 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 more difficult because many factors are considered.
I am grateful for Medicare, but I also pay for a supplemental, 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.
An added note: Be careful come January, when all the renegotiated costs go through. I got caught in that once and paid significantly more for a drug that 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 chance that his or her family will have to declare bankruptcy, ultimately losing their home, their savings and their loved one to cancer.