New Study: Death or Debt?

buttonsmachine

Hi All,

I just wanted to throw this out there, especially for those of us living in the US, and who are navigating the sometimes crushing cost of healthcare after a cancer diagnosis.

According to this study, nearly half of us will totally deplete our assets paying for cancer treatment within two years, and average losses were around $92,000. Importantly, the study notes that "large financial burdens have been found to adversely affect access to care and outcomes among cancer patients."

I don't want this thread to devolve into a political argument. In my opinion, the blame game that goes on in our political discourse is unproductive. This issue affects all of us, and should transcend political divisions. We need sensible, pragmatic solutions. We need major modifications to our healthcare system, while still maintaining its strengths.

Anyway, I am going to send some letters out to our elected officials. Healthcare has not been high up on the agenda lately, and our politicians seem to have reached an impasse on this issue. Maybe if more of us make ourselves heard, things will get better.

Best wishes to everyone.

I copied and pasted the abstract below, but the full article can be read here: https://www.amjmed.com/article/S0002-9343(18)30509-6/fulltext#/article/S0002-9343(18)30509-6/fulltext

ABSTRACT

Purpose

The purpose of this study was to evaluate the impact of cancer upon a patient's net worth and debt in the US.

Methods

This longitudinal study used the Health and Retirement Study from 1998–2014. Persons ≥50 years with newly-diagnosed malignancies were included, excluding minor skin cancers. Multivariable generalized linear models assessed changes in net worth and debt (consumer, mortgage, home equity) at 2 and 4 years after diagnosis (year₊₂, year₊₄), controlling for demographic and clinically-related variables, cancer-specific attributes, economic factors, and mortality. A 2-year period before cancer diagnosis served as a historical control.

Results

Across 9.5 million estimated new diagnoses of cancer from 2000–2012, individuals averaged 68.6±9.4 years with slight majorities being married (54.7%), not retired (51.1%), and Medicare beneficiaries (56.6%). At year₊₂, 42.4% depleted their entire life's assets, with higher adjusted odds associated with worsening cancer, requirement of continued treatment, demographic and socioeconomic factors (ie, female, Medicaid, uninsured, retired, increasing age, income, and household size), and clinical characteristics (ie, current smoker, worse self-reported health, hypertension, diabetes, lung disease) (P<.05); average losses were $92,098. At year₊₄, financial insolvency extended to 38.2%, with several consistent socioeconomic, cancer-related, and clinical characteristics remaining significant predictors of complete asset depletion.

Conclusions

This nationally-representative investigation of an initially-estimated 9.5 million newly-diagnosed persons with cancer who were ≥50 years of age found a substantial proportion incurring financial toxicity. As large financial burdens have been found to adversely affect access to care and outcomes among cancer patients, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance.

KCMC

I have read articles where the insurance companies are using different verbiage when it comes to bills in order to prepare us for the future when we are expected to payout of pocket up to 30 percent of our total bills including hospital stays. I understand that supposedly in the future one will have to save for healthcare like one saves for a down payment on a house. It is getting out of control. I have contacted my representatives office and have written letters. I am one of the luckier ones, my husband is retired military and I am also covered under the 9/11 WTC Healthcare so I have absolutely no cost whatsoever when it comes to my breast cancer, but I am worried about my sons future and the future of their families. I talk to friends and they have deductibles of up to $10,000 a year plus copays, pharmacy bills etc. All I can say is that people need to get out and vote and be vocal.

NotVeryBrave

It is astonishing to see what providers bill and what insurance pays! I have a PPO plan through Aetna. It's similar to an HMO but more choice and no referrals. I have copays of $20-45 for office visits and higher amounts for things like surgery, hospital, MRI. I would be bankrupt if not for my insurance. Chemo alone with the targeted drugs was billed at like $28,000 a pop! My surgery was around $50,000!

Yes - something needs to be done. I find myself worrying about this "pre-existing" condition for the rest of my life.

corgi09

We had self paid really good insurance when I was diagnosed. I was working part time, looking for full time (but that never happened). Maintaining that insurance until the ACA came along thoroughly depleted what savings we had after the crash. 6 years out I'm healthy but still on Tamoxofin so I'm considered pre-existing. Every ache and pain its a question of is this worth spendiing the money on the deductable. This is so anxiety inducing.

edwards750

We were blessed too to have health insurance coverage with BC/BS. We do have a high deductible of 5k but we also have a flex plan we can draw from for medical expenses but it maxes out at $2500.

When I was DX 7 years ago we reached our deductible in 3 months. I had radiation treatments(33) months later but by then we were at 100% thank goodness. Idk how we would have paid for those treatments if not for insurance.

Something definitely needs to be done. BC care and treatments are bankrupting a lot of people. More focus needs to be on the financial difficulties associated with BC.

Diane

buttonsmachine

Bumping this ahead of the midterm elections!

Whatever the outcome, we still need to advocate for ourselves and others affected by cancer.

Lumpie

Many of you have probably seen news about the TX judge who has ruled the ACA unconstitutional. Never fear! It will take more than that to derail the ACA. So I think we are ok for now.

If there are coverage junkies out there watching the various healthcare proposals, there is a good summary of the various Democratic proposals here: https://www.vox.com/2018/12/13/18103087/democrats-...

and an interesting libertarian-leaning proposal here: https://niskanencenter.org/blog/ahca-catastrophic-... (aspects seem promising but it achieves cost savings primarily through lifetime caps - so that's a no-go.)