THE FINANCIAL DEVASTATION OF CANCER TREATMENT
This is an important issue of concern for all Americans, when dealing with the often overlooked problem of surviving financially, as well as physically, when going through cancer treatment. This article was published recently in the San Francisco Chronicle. At the end of the article, I share my personal experience. Sarah Dees
STUDY FINDS MANY CANCER PATIENTS PAY A FINANCIAL TOLL, TOO
by Victoria Colliver
Chronicle Staff Writer
San Francisco Chronicle, 2/6/09
"A cancer diagnosis can threaten anyone with bankruptcy and financial ruin, no matter what your earning power is ....There are many paths you take, but they lead to the same destination: loss of all resources."
When Christine Franklin was diagnosed with breast cancer, she spent at least $7,000 in out-of-pocket medical expenses, but was able to continue working as a busy sales executive.
But when the disease recurred last year, she had to quit her job because of the debilitating side effects of her new medications. With her income greatly reduced, she was forced to sell her Vacaville home. Franklin, who pays the monthly premium for her former employer's health coverage along with high co-payments for drugs and care, has stopped adding up the costs.
"When you have cancer, you not only lose who you were-your body no longer looks the same- but you can lose your job, and before you know it, it's a slow spiral." said Frankin, 57, who is divorced and lives on disability payments. "You feel yourself going down, like you're sliding down a hillside and the earth gives way and you're just grasping to hold on."
A report released Thursday by the American Cancer Society and the Kaiser Family Foundation found that even those cancer patients fortunate enough to have private health insurance face severe challenges paying for life-saving treatments.
Hefty out-of-pocket expenses, high cost-sharing requirements, caps on benefits and lifetime maximums on some policies are among the factors that can contribute to financial problems and lead many people to resort to bankruptcy, the study found.
"You would at least think the health care system would work for the people who are sick," said Drew Altman, president and chief executive officer of the Kaiser Family Foundation. "What this study shows is there are lots of gaps and holes and problems for the people who are the sickest in our society. That's the opposite of how health care should work."
In 2008, about 684,850 people under 65 were diagnosed with cancer, according to the American Cancer Society. The majority-estimated as high as 70 percent by at least one study-had private health insurance.
PROFILES OF 20 PATIENTS
Rather than compiling statistics, the study profiled 20 patients whose experiences were representative of the types of problems reported to the American Cancer Society's Health Insurance Assistance Center. Of those profiled, nine had coverage through an employer, one paid for employer coverage, seven had individual insurance, two received coverage through a state high-risk pool, and one became uninsured. The problems they experienced included delays in treatment as well as debt and stress. People who became too sick to work usually can continue their employer's coverage for up to 18 months by paying the full premium, but the added expense of that coverage can pose a hardship because patients often are living on a reduced income. Getting alternative coverage, even years after the diagnosis with no recurrence, can be a nonstarter. Insurers in the individual market routinely restrict applicants with a history of cancer. Public programs such as state high-risk pools or Medicare, which is available to those under 65 who are disabled, often have high costs and long waiting periods.
MAKING TOUGH DECISIONS
A 58-year-old Florida woman profiled in the study reached the $100,000 annual limit on her policy in 2007 after her breast cancer diagnosis. Jamie Drzewicki wound up amassing $75,000 in uncovered medical costs, a sum that was reduced to $30,000 after her hospital forgave some of the debt.
"I am a hard worker, and now I am making decisions between paying for my groceries and paying off some of my bills," Drzewicki told the study's researchers.
Tammy Witt, a 40-year-old mother of two from Ohio, initially was covered for her breast-cancer treatments with her employer's insurance, but the company changed ownership and switched to a policy that had a meager $2,500 annual benefits limit. The strain contributed to her separating from her husband and eventually forced her into bankruptcy.
Another patient, 62-year-old Thomas Olszewski from Texas, has been cancer free for nearly ten years after his 1999 prostate cancer diagnosis, but is grappling with high premiums.
Now retired, Olszewski said he has a tough time affording his individual policy, which costs $437 a month and comes with a $3,750 annual deductible. He said he often delays lab work and follow-up care due to costs.
"A cancer diagnosis can threaten anyone with bankruptcy and financial ruin, no matter what your earning power is," Peggy McGuire, executive director of the Women's Cancer Resource Center in Oakland stated. "There are many paths you take, but they lead to the same destination: loss of all resources."
Sometimes patients who lose their jobs eventually qualify for Medi-Cal, McGuire said. Others may be able to get help through resources like pharmaceutical patient assistance programs, which cover the cost of certain drugs.
STRUGGLE TO PAY FOR DRUG
Franklin, who was not part of the study, pays $450 a month to remain on her former employer's plan while she waits to qualify for Medicare due to disability rather than her age.
She is relieved to have insurance, but struggles to pay $658.73 each month for a cancer drug that does not have a generic equivalent and $600 every three months for follow-up scans. She now has a $100 co-payment each time she sees her oncologist because her employer switched coverage and the doctor is not in the new physician network.
Franklin, a mother of two and grandmother of three, feels fortunate to be cancer free after a clear scan in December, but always has to steel herself for the possibility of bad news in her next round of tests. Still, she manages to keep her sense of humor. Franklin considered the cost of all the treatments she's had and compared herself to the Bionic Woman: "Sometimes you sit there and think: Am I really worth this?"
Email Victoria Colliver at firstname.lastname@example.org.
More information: the full study can be found on the Kaiser
Foundation's web site at http://www.kff.org/.
This article above was published in the San Francisco Chronicle, on February 6, 2009. I share it here because I found myself in a similar situation.
I am a professional artist, and I had owned a successful wholesale art and picture framing manufacturing business for twenty years. In January of 2002, I was hit from the rear by a truck, which caused me to sustain a permanent sciatic nerve injury. This injury causes chronic pain to my lower back and left leg. Due to the injury from the auto wreck, after trying many nerve block procedures and treatments that didn't work to heal the injury, I had to close my business, and in doing so, lost my income.
I went through a divorce in 2005, and bought a house by paying in full with cash from my lump sum divorce settlement. I worked for a year to renovate the house, to start over and create a comfortable new home for my daughter and me. Just when I thought I was about to get back on my feet again, a tumor was discovered in October of 2006, and I began my new full time job of being a cancer patient.
Radiation treatments five days per week, and chemo drugs pumping into my heart 24 hours a day through a chest port, operated by a fanny pack pump worn around my waist, kept me in pain and too sick to work in any capacity.
After a year of cancer treatment and then a long period of recovery from the side effects of chemo and radiation, I hit the wall financially. I had borrowed all the money I could, and there was just nowhere else to go. I still had no income or means to begin repaying the debt.
Although I had survived cancer, the stress and anxiety of all the financial struggles made recovery much more difficult, and the thought of returning to life completely overwhelming. I didn't have a clue about how to "come back" from the financial devastation of cancer treatment. Financial survival seemed even more out of reach than surviving the disease.
Although I had full major medical health insurance coverage through my former husband's employer when I was hurt in the auto accident in 2002, and when I was diagnosed with colorectal cancer, the auto insurance and health insurance only paid the doctors and hospitals for medical bills. I was unprepared to face the financial costs that still had to be paid even though I was hurt or sick, such as high medical bill co-pays, prescriptions, living expenses, and mortgage payments. I was overwhelmed by the rush into tests and treatment for cancer to save my life. I didn't take the time to research and avail myself of some of the programs that are available to help cancer patients during treatments. I paid for medical bills and living expenses on credit cards and loans. I mortgaged our home to get the money to live on while I was too sick to work.
I was told at first that my treatment would last six weeks. I thought I could get past the treatment, get back to work and pay off the mortgage. Instead, my treatment went on for a year, and the side effects from the chemo and radiation, combined with my wreck injury and other health problems, made it very difficult to work for the next couple of years. I became a statistic, one of many who face financial devastation because they are simply unprepared to deal with those expenses. Like so many others, I am now in debt for over $30,000 and facing losing my home to foreclosure. This is a situation I hear repeated again and again in cancer support groups, people having to sell their homes to pay for treatment or losing them one way or another due to cancer treatment.
When I began to regain my health, I searched for new employment. It seemed too difficult to start over again and rebuild my art business from scratch, with no financial backing, still struggling with chronic pain and chronic fatigue. I looked for jobs and did find some temporary teaching jobs, working in schools and teaching in a museum. I tried selling insurance and other "regular jobs", but haven't managed to keep steady employment.
I’ve worked hard all of my life, and I always thought that I could work my way out of any problem. That had always been my method of handling any situation. I've done a lot of volunteer work to benefit children and for health-related causes, and I have always strongly believed in each person's responsibility to make a contribution toward their own communities. It just never occurred to me that something would happen to me that could prevent me from being able to work.
Now that I can work again, I want my effort to have meaning, beyond my own financial healing. I have always put my heart into my work; it was easy to love creating art, and my heart went into each and every project I created. I've also got my heart invested in making a positive contribution toward helping people. I don't think it's right that people should have such a tremendous struggle, after first fighting for life, then fighting for financial survival, with all the stress related to that making it even more difficult to heal. As I post this site on Facebook in March, 2010, I am starting over again, trying to work as a professional artist. I'm sharing an art portfolio I created online, and hanging out my "back in business" sign, trying to work from my home to make art and provide for my daughter and myself.
No one should have to live in fear. Because of my journey through all this adversity, I advise people to please find out how you can protect yourself from the financial devastation of cancer treatment.
If you are well now, but have cancer in your family, you might be in a high risk group. That makes it all the more important to do something now, to protect yourself, while you still can.
If you can find a way to afford an insurance policy to provide money for cancer care or critical illness if you are diagnosed, that might be a good option for you. You just can't assume, like I did, that your major medical insurance will be enough to save you from a major financial crisis.
If you have been diagnosed with cancer, I hope you can utilize the links on this site's list to find out ways to help yourself during treatment, and take advantage of assistance with the cost of medical bills, transportation, housing, whatever help you may be qualified to receive.
I am so grateful to the people who work hard to raise funds for all of these organizations. They understand that there are real faces and lives behind the unemployment, homeless and foreclosure statistics. They don't accept it as okay for people to work all their lives, be responsible and decent citizens, but then get wiped out financially because they got hurt or sick.
Thank you for allowing me to educate you about this very serious, often overlooked aspect of dealing with the dread disease of cancer.
I posted this story as a Discussion on a social - business networking site, and this comment was posted in response:
Sarah, thank you so much for sharing this story, and it is so very true. As a Senior Debt Consultant, I have been able to help people like this who have faced impossible medical expenses, by placing them into a "debt negotiation" program. One couple was facing over $2,000 monthly payments on debt from helping their daughter who had cancer. They both worked and faced the possibility of "never being able to retire." In their "debt negotiation" program, they are now making payments of about $1,300 per month for 39 months, and then they will be done with the problem. These programs (2 different ones I represent based on state) are both lawyer-coordinated which is very important.