As a breast cancer survivor, my thoughts on the health care system may be unique compared to those that have not gone through cancer. To give a background, I have an HMO for insurance, which I am actually very lucky to have. I have 100% coverage with a $20 co-pay for each doctor visit. Our premium is $600 a month and this is all through my husbands work. At one point throughout my chemotherapy treatments, I ran out of checks to pay my co-pay, so I asked to be billed. Because of being on an HMO, I have never seen a bill so I was shocked when the bill came to my house and a charge for one chemotherapy treatment was $16000! I had no clue this was how expensive a treatment was!
The Neulesta injection was another shocker to me. This injection is given after each chemo treatment to keep my WBC count up. This injection alone cost $12000 per shot! I had 8 chemo treatments, that’s 8 shots, or $96,000, not including treatment. Even now that I am finished with treatment, I have to take Aromasin. After women go through menopause, they take you off tamoxafen and put you on aromasin, which is a fairly new drug, and because of it being a fairly new drug, it doesn’t come in generic form. This leads to a high cost, even with my HMO. My co-pay is $75 per month. If I did not have insurance, this drug would cost $350 per month. They are now saying that they want women to take it for the rest of their life. LOTS OF MONEY. I am just lucky that I had an insurance company that worked with me so I did not have to pay these bills and it does show that there are good insurance companies out there.
However, a friend of mine just finished radiation therapy treatment and she doesn’t have an HMO. Her insurance is a %80-20%, and she has a yearly deductible. This lead to a lot of out of pocket expenses. During her treatment, she wouldn’t be feeling well and would still come into work because she had too many medical bills to pay and not enough sick time. The insurance company was badgering her for money even after she would pay the minimum payment. I feel this is just terrible! At least let her get through treatment!
She recently finished her 2nd round of radiation and for some reason her insurance is denying coverage. She now has a $27,000 bill because the insurance claimed her treatment to be experimental. Since I work with insurance, I know how it works and the various medical codes used. I am currently helping her to draw up letters to her insurance to get covered because I feel that maybe they need to re-think or re-code or something because she is being denied coverage, even with documents from her doctors to back her up. She has now hired an attorney to try and get this covered as well.
In the meantime, they are trying to send her to collection. This is a big financial burden which is causing a lot of stress. She is trying to recover from treatment and doesn’t need this added stress on her life over something like money. When you see some of these prices, this makes me wonder what happens to someone who doesn’t have insurance at all. They would probably get denied treatment because they don’t have enough money. I feel that the financial issues with the healthcare system is one of the first things that needs to be addressed when trying to improve American health care. I also believe that everyone has the right to coverage, and good coverage, along with payments that are affordable and livable. Overall, health and quality of life are the most important things and the health system needs to remember that.
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I agree that when fighting for your life, money should not be the issue. It is eye-opening to hear these two stories and how different the outcome can be because of the insurance you have. I hope that in the future everyone is fortunate enough to have the insurance coverage to be able to receive the care that is necessary to survive and not be in financial trouble. As a young woman about to graduate from college this issue is very real to me. Also, personally knowing one of these two brave women from above who has not only survived cancer, but is strong enough to tell her story and explain how her insurance coverage has been such a vital part of her health and well-being makes this issue very near and dear to my heart.
ReplyDeleteThe bottom line is that when you're sick and need treatment, money shouldn't be the deciding factor. My family has seen first hand as well the stress of money issues when we needed treatment. My dad's hospital stays, ambulance rides, and the operation itself came to a total of roughly 1.5 million dollars over a span of three years. All we wanted to do was focus on him when all the insurance company wanted to do was focus on their money. If there's a way our health care system can lower their costs and decrease stress for families, then just tell me what to do!
ReplyDeleteThere is a quote that says "Time is more valuable than money," and this saying could not resonate more to a family who is trying to buy as much time as possible with a loved one who is fighting for their life. It is so unbelievably saddening to think that people suffering from cancer have the factor of money to accompany their already surmounting stress. Having a mother who works in the oncology field, I have seen many patients and their families struggle to pay their dues. To help out in whatever way possible, my mom has often allowed her patients who travel from out of state to receive treatments to stay at our house rather than paying hotel rates for stays that could last days or even weeks. It may not seem like much, but she is doing whatever possible to make those patients feel a little more at ease with the many hardships they are experiencing. Hopefully, somewhere in the near future, these insurance companies will realize that these patients aren't just clients, they're people too.
ReplyDeleteThis is sad to hear the huge difference between the two women. One is very fortunate, while the other will probably be troubled financially for awhile. I think that the health care system needs to be able to lower costs for everyone, but especially for those whose current insurance is not as supportive in treatment costs.
ReplyDeleteThank you for sharing your story. I cannot imagine the stress that comes along with having a cancer diagnosis along with the added financial worry. In most of the radiation therapy departments I have seen there is a social worker that is available to assist patients in workin through financial trouble. The cost of some of these treatments are outrageous! Something needs to be done in order to provide coverage to all people struggling with disease. No one should be denied a life saving cancer treatment just because they cannot afford it.
ReplyDeleteThanks for contributing to this class blog; I appreciate the important points you offered in your post. Please feel welcome to comment on any other part of this blog.
ReplyDeleteEveryone knows health care is expensive, but when you find out the figures like you have provided it makes it so much more real. This story is a perfect example of the differences in health care coverage, and how like you said that everyone needs to remember there is a common goal. It's not making money, it's saving and helping lives.
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