Posted on Fri, Apr 16, 2010
When one looks back on a terminal illness, bitter lessons emerge. Along with the more than $600,000 price tag, come countless emotional costs stretched over a 7-year period. This is a real life glimpse inside the lives of those who endured that 7-year battle. To protect their privacy we have omitted their names.
Terence the 67-year-old well-educated Renaissance man ran up medical bills of $618,616 for the 7 years he spent fighting kidney cancer, but was lucky enough to have good medical insurance that took care of the vast majority of those bills. 66% of those costs accumulated in the last 2 years of his illness. In those 7 years, his daughter grew from a child to a young lady. His son graduated from high school and went to college. His family had the chance to take a dream trip to Italy. He beat the odds and survived much longer than many others who were faced with his diagnosis.
The cancer was discovered by accident when in 2000 when Terence was admitted to the hospital for unrelated stomach pain. He had surgery for colitis and returned home, but an attentive hospital employee reminded him and his wife that a shadow had been seen on his kidney during the initial ER tests and should be followed up on.
It was kidney cancer. The surgery to remove the affected kidney cost $25,000. The family's out of pocket amount was $210. The medical insurance company paid $14,084 after discounts. It turned out that that surgery represented only 4% of how much it would eventually cost to keep Terence alive. Upon biopsy, the cancer was deemed to be the most aggressive type and spelled death within months, if not years. The doctor recommended that they keep an eye on it. It did not progress. Terence got better.
Until in 2002, when Terence was told that he had 6 to 9 months to live because the cancer had spread to his lungs. He initially kept it a secret to protect his family. When his wife found out, it was because of a bad reaction to a drug he was taking to fight the lung cancer. That drug had a price tag of $735 per dose and a success rate of only 10%. He stopped taking it after a few weeks.
The quest for experimental drugs and procedures led the couple to a specialist who also recommended a wait and see approach. Luckily the cancer was slow growing. When it did start growing more rapidly in 2005, they got into drug tests that were promising. The drugs were free because of the clinical trial, but a billing error charged the couple's medical insurance over $8,000 for the drug during the clinical trial period.
In 2007, Terence took a turn for the worse again and restarted the same drug that had worked last time. However, it was no longer a trial, so the hospital billed the insurance company $27,360 per dose. The insurer paid $6,566.50. Terence paid nothing. However, the fact of the matter is that the healthy people pay for the sick ones when it comes to health insurance, therefore insurance continues to go up while those who are sick struggle with difficult decisions about treatment, regardless of cost.
When this drug failed to help as before, he was given a new one, costing $200 per day. This one failed too. Terence had a series of mini-strokes that put him back in the hospital. In his final 7 days of life, medical care totaled over $57,000. $43,711 was for the hospital care in the first 4 days of that week. $14,022 was for the final 3 days in hospice.
Sticker prices for the different services proved to be a starting price for bargaining. Some companies prove to be better than others at bargaining. The hospital sticker price for a chest scan was $3,232. United Healthcare paid 80% of that amount in 2006 or $2,586. In 2007, Empire BlueCross paid only 20% of that amount or $776. Even the total amount of Terence's medical care, which came to a sticker price of $618,616, was negotiated down to $254,176. Terence and his family paid $9,468 out of pocket, or 4% of the total.
The amount spent on healthcare for one dying man could have provided 250,000 children from a developing nation with vaccines. However, for people facing cancer and life threatening illnesses, they will do anything for more time. Terence survived 17 months following the clinical trial. He was the exception. Most averaged 14 months longer than anticipated.
When faced with these tough decisions, even knowing how much medical insurance cost, family members would do the same thing again. The cost of beating serious illness is nothing compared to the joy of having their loved one a little while longer.
It is our hope that in the years to come more families will have the security of a good medical insurance plan, so that they can devote their time to their sick loved ones.