Money worries during cancer and other illnesses

First there is the whammy of you have cancer, followed by many more whammies including hair loss, surgeries, chemotherapy, and then finally money. You cut back on work during treatment and the bills get bigger. And cancer bills aren't little. A chemo infusion or surgery might hit 5 digits for each one. Your insurance covers some of it but there is always your portion. And the bills keep coming.

Barbara, over at Let Life Happen blogged about an interesting option on how to fix cancer costs by charging by patient instead of by each treatment. Cure Magazine recently ran an article on medical bankruptcy fears during cancer. (And if you have cancer and don't read Cure Magazine, you are missing out big time.)

Cancer is stressful enough without having to worry about money as well. I personally think that if you get cancer, you deserve a financial fairy godmother to swoop in and take care of you during treatment. You shouldn't have to worry about bills, cleaning your house, doing laundry, taking the car to the garage, or standing in line anywhere. That would be nice - but really not likely.

So if we aren't going to get financial fairy godmothers, I think we need to start focusing on changing the medical system to help reduce the financial worries when diagnosed with any major illness. Doesn't it seem illogical that the sickest people get the biggest bills? They are most likely not to be able to work full time and earn the big bucks. They get all the expenses and are least able to pay.

I have a friend with MS who used to have a great career. Now she writes articles for a local paper and lives on social security. I used to work full time and now I struggle with 15 hours a week with RA and fibromyalgia. And I get giant medical bills. This year so far, I have already hit $2500 in copays. And its only April.

Let's fix the system and stop causing medical bankruptcies.

How the hell did that happen?

I have a very responsible system for my medical bills. Every couple of months I call and say I want to pay all balances over 30 days old and put them on a credit card that I pay off regularly. I used to pay bills each month as they came in. Then I would get refunds from the hospital all the time. So I gave up on that system.

For the record this week when I went to the doctor they said I didn't need to pay my co-pay because I had a credit balance.

So to my surprise, yesterday I got a statement showing a balance going back to February which had a note that it would go to collections if not paid asap. So I called this morning and paid three outstanding bills, one each from January, February, and March. The January one had just gone to collections. I asked about that since I knew it took about six months until the insurance company decided what they would pay. I was told basically they look at the visit date and not the date it was actually billed before deciding to send things to collections.

How helpful. I have never had anything in collections before. How mortifying. And why couldn't I pay all these bills last time I called in October?

Specialty Drug Prices are Killing the Patients

I know I have blogged about this before but it just irks me of the inequalities that I see in this system. I do not have a grudge against big pharma. I really do not. I just wish there was more change in the system where drug companies seem to be tightening the noose on patients who are trying to survive.


Is your life worth $100,000 annually? Can you afford $1000 monthly in drug copays? If you ask the big pharma companies, it is. The majority of the new drugs approved last year by the FDA are specialty drugs, 19 of 28 (which is an appallingly low number of approvals to me but that's another story for another day). These come with the hefty, specialty price tags.

"Fewer than 4 percent of patients use specialty drugs, but they account for 25 percent of total drug spending in the United States; and the growth of specialty drugs is a key factor driving up health care spending, according to PricewaterhouseCoopers."

Many insurance plans provide affordable co-pays for the drugs. But more and more, as a cost saving effort, are switching to tiered plans. I have one where generics are very cheap but brand names drugs can be very expensive. They can be 35% of the retail... I can avoid much of that by mail order but still when one month of one drug has a co-pay of $105, it begins to add up. More and more insurers are moving to this type of coverage as they cannot afford to keep up with the new drug prices. I do not blame them with the costs of these drugs.

We have an industry which is full of employee perks and generous salaries and we have insurance companies who are trying to balance their budgets and patients who are being killed by their drug payments. Where does that problem lie?


This system needs to change. Its not all the pharma companies fault, there is some blame to be borne by the insurance companies as well. Moving costs to the patients is not the best option either.

Secrets of medical costs

Someone referred me to this article which I read with great interest. First I started with this video:

Then I read the article called the "Bitter Pill: Why Medical Costs are Killing Us"

FInally I watched the second video where the writer answers questions on reactions to this story:

So where does all this education leave me? I am not as smart as I thought I was.

All along I was blaming high medical costs on pharmaceutical manufacturers who were passing on the research costs long after they were paid to the patients through high drug payments. I was blaming insurance companies for high insurance premiums, denial of claims for stupid reasons, and general ignorance.

I did not know that hospitals are a big part of the problem with their secret lists, huge mark ups, and high profits - even if they are non profit. They hide behind the HIPAA laws on patient privacy to hide their 'chargemaster' list of billing amounts.

There is also the issue of the standard CYA tests ordered by doctors out of fear of lawsuits instead of best treatment for the patient. But that is another blog post.

My take away from these videos and article is that our health care system is more messed up than I previously thought. People are getting rich at the costs of the poorest people or the ones forced into bankruptcy due to medical bills. More action needs to be take in this area.

While the Healthcare Reform Act focuses on getting insurance and medical care for more American's, it does not go far enough in addressing the financial side of patient billing and who pockets the money at the end.

Evil, sneaky balance billing

And its legal in most states, unfortunately. Balance billing is when you use an out of network medical care provider and your insurance company covers $2000 of the $5000 bill. Then the caregiver turns around and bills you for the other $3000. How sneaky is that? But it gets worse. After a scheduled surgery you could find out the anesthesiologist, radiologist, and assistant surgeon are not part of your network could bill you for thousands of dollars.

The really super sneaky part is:

The medical care provider could be very quick to start billing you, send you to collections, and report on your credit rating.

And then sometimes your insurance company will pay all or a portion of the balance billing leaving you to undo all of the damage.

A portion of balance billing is illegal in Illinois and the is legislation in the works in New York. But if you get billed for teh balance, don't sit there, start dialing and researching to protect your bank balance and your credit rating.