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Don't hate me but insurance companies aren't to blame.

Donswife48
Posts: 291
Joined: Nov 2015

 

Fighting any disease is expensive, with the new drugs costing $25,000 per treatment, it's simply not going to happen for most of us.  I hate to say that we are denied treatment simply because it's too expensive, but that fact is, how best to spend insurance dollars?  Do we help a few with whatever it costs, regardless of the initial stage/diagnosis, or do we spend less to help the most?  Or do we say whatever it costs, everyone gets the most expensive treatment to help prolong their life?  I look at all the wonderful people who have crossed these discussion boards, some had private funds to explore treatments, yet did it help in the end?  Damn cancer. 

 

derMaus's picture
derMaus
Posts: 555
Joined: Nov 2016

We would never hate you. This is an open and supportive community and everyone is free to express their opinions. I think we all just fixate on insurance because it's SOMETHING we can point to when everything seems out of control. I know that even if one has all the money in the world it's still going to be a rough road...but that's just my opinion. 

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2572
Joined: Mar 2013

Donswife, none of us would hate you!  As B said, this is a supportive community, and sometimes I think people say things that they don't realize may a hurtful response to what someone's opinion may be. (I think there are some of us - I know I have - felt attacked for something we wrote, so I am asssuming I can't be the only one.)  For me, it is why I have posted less here and on another gyn board.  The written word can be interpreted very differently than if we said it verbally, and why it is a difficult form of communication.  Just my opinion

As for insurance - any form of insurance:  health, dental, car...they all make us crazy.  I was fortunate that I had a full time job and had a good insurance policy.  For those not so lucky?  It is chilling to me that some of you ladies and others had to fight so much.  There appears to be different levels of care and, having sisters with some of those insurance policies, worry if something happened to them.  I wouldn't hesitate to fight like heck for them and reach in to my pocket to help them.  

I hate cancer.  It seems like it is more prevalent than when I was a kid, maybe I was just very protected from it all, and all of them demand attention.  As Eldri posted on the comments from the doctor (dated Jan 2018) on how chilling of hands and feet may help prevent neuropathy - WHY are all doctors not aware of this??!! 

Just my opinion ladies.  

MAbound
Posts: 854
Joined: Jun 2016

Nobody always has the right words to express what they want to say all of the time. It's another of the risks of being on this board for any length of time. Sometimes you're just going to put your foot in it. I've done it, too. It's quite upsetting when it happens, but for the most part this is a very understanding group and we get past it. No one should think they always have to walk on eggshells because sometimes blunt talk is just what is needed. It always makes me remember someone who gave me some blunt talk back when I was in treatment and I'm forever grateful to her for it and I really miss her words of wisdom. 

LisaPizza's picture
LisaPizza
Posts: 208
Joined: Feb 2018

To be fair, the article only indicated one inconclusive study. Doctors have a legal obligation that we don't to be objective abd scientific and not recommend things with little reason. I think most would agree that icing on your own is not likely to harm,  but there's already a flood of info without adding speculation to it, and it's pretty hard to complain about healthcare costs in this country while also expecting unproven therapies to be covered. Its definitely tough all around.

MAbound
Posts: 854
Joined: Jun 2016

I think I get upset with the drug companies more because they charge whatever they can get away with rather than enough to recoup their costs plus a reasonable profit. Drugs should cost the same for all wherever they are sold. There should not be this shell game where they justify astronomical costs by relying on insurance or giving out "coupons" or "rebates". I don't get excited so much about new drugs that are coming out because my first thought goes to how much it's going to cost and will anyone be able to afford it?

CheeseQueen57's picture
CheeseQueen57
Posts: 797
Joined: Feb 2016

My happiest time was with a non-profit HMO. Unfortunately they went bankrupt. I also spent 10 years with a pharmaceutical company. If you only knew how they waste money. There’s a lot of fat there beginning with outrageous salaries. 

MoeKay
Posts: 202
Joined: Feb 2004

Yet what about insurers paying for opioids for things like back pain?  https://www.sciencedaily.com/releases/2018/06/180625122611.htm.  Should these payment decisions have been scrutinized more closely?  Could this money have been more appropriately spent on treating diseases, rather than fueling an epidemic of addiction?  There's only so much money in the pot, so decisions on how to apportion funds must be made based on the best available medical science. 

EZLiving66's picture
EZLiving66
Posts: 1337
Joined: Oct 2015

I worked for a large insurance company for almost 10 years. It wrote multiple lines including health. After over 100 years, it went bankrupt and what it came down to was the large reserve we had to maintain for medical malpractice. When we wrote the policies we based the premiums on current court interpretations of laws. As the years went on, those interpretations changed radically. Even though we got out of the medical malpractice business, we had to maintain and even increase those reserves until the last child born under the policy was 28 years old (21 years plus seven) as medical malpractice settlements increased exponentially. 

The same principle is involved in health insurance.  A premature baby can cost millions. My three chemos and surgery were almost $300,000. As far as drugs go,

"In the United States, it takes an average of 12 years for an experimental drug to travel from the laboratory to your medicine cabinet. That is, if it makes it. Only 5 in 5,000 drugs that enter preclinical testing progress to human testing. One of these 5 drugs that are tested in people is approved."  On top of this, the US produces about one-third of the world's drugs and develops an even higher percent.

This website offers an explanation of why drugs cost so much in the United States.https://thehill.com/opinion/healthcare/369727-us-drug-prices-higher-than-in-the-rest-of-the-world-heres-why

Yes, drug profits are high but malpractice claims are also high. As in any industry, there is waste. 

So, what do we do? Go to a single-payer plan? What people don't realize is that health care MUST be rationed in order for it to be financially viable. I have a friend (I met her on the ovarian board) who lives in Great Britain and her doctor thought Avastin could help her. It was denied because the government felt she was at the end of her life and the cost of Avastin was too high to give her. She started a GoFundMe page to buy the Avastin on the open market there which costs about $3800 per dose. Her doctor would give it to her under their government insurance so she didn't have to pay for that. She only raised enough for two treatments. "....so to find out there is a drug choice available to me but will not be available through the NHS as NICE consider the potential six plus months it could give me, not financially viable, was a shock."  They weren't willing to spend $3800 per infusion on her because THEY determined she wasn't worth it. 

Of course, when we or a loved one is dying we want to try everything humanly possible to keep them alive but, again, at what cost? Can we afford to keep a premature baby with multiple medical conditions alive at a cost of multi-millions? At what quality of life?  How much should be allocated to an 80 year old? A 90 year old? At what age do we cut off care?  When my grandma was 94 years old she decided she wanted to die. She was of sound mind but felt the quality of her life was going downhill fast and all her friends were gone. She developed a bladder infection that she refused to have treated. I had to fight tooth and nail to have her wishes respected. Our doctors and hospitals are set up to save lives at all costs - "ALL" being the operative word here.  

I don't know what the answer is and I'm glad we can discuss this subject here openly. 

Love,

Eldri

SF73
Posts: 257
Joined: Oct 2017

My oncologist thought I would benefit from Avastin. Oncologists from Stanford agreed. They pleaded to the insurance company many times. It got denied. I work at a technology company and have the best possible insurance money can buy. Eventually the insurance company made a cost benefit analysis and decided the cost was too high and the benefit is either too small or unlikely. No matter how many payers there are - single or multiple - these decisions will have to be made. 

I think stories about rationing of the healthcare in other countries are told to scare people from logical solutions. Most European countries have a single payer solution and cancer treatments there are as effective as it is here. What is not acceptable is having some people who do not have access to any healthcare at all. Going what I have gone through I cannot imagine a person receiving a cancer diagnosis while uninsured. This country is better than that. We cannot leave some people behind. It is cruel. 

EZLiving66's picture
EZLiving66
Posts: 1337
Joined: Oct 2015

I just found this and it explains why the US drug prices are so high. https://www.vox.com/science-and-health/2016/11/30/12945756/prescription-drug-prices-explained

Donswife48
Posts: 291
Joined: Nov 2015

It is truly a trade off.  Do we want do limit research so that we can better afford what's available now, or do we want to pay big to keep research developing new drugs/treatments.  I mentioned my son, at age 15 was diagnosed with non-hodgkins leukemia.  He had a young doctor, who tried radiation on the one growth above his eyebrow.  It didn't work, and he got another "hot spot" below his knee on his leg bone.  This time, the doctor tried a combo of chemo's.  This was not a old standard treatment, but something the doctor saw in clinical trials as new and possibly good.   Nedless to say, it put the cancer at bay, my son is now 49!!!  I remember thinking when I was told my treatment regime, that it was the same as 10 years ago, nothing new which may result in the same statistics that were written years ago.  I want NEW, and I don't want to tie the hands of the doctors and scientists that research.  I also know that insurance companies cannot afford to treat patients with expensie drugs if they are unproven.  Thus the dilema, some of who rely on insurance, or Medicare, will not be treated equally.  Mom always told me "life isn't always fair", she was right.  Hugs Nancy

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