[cancer] The long and grinding road

Another hard swerve on my cancer journey. Finally got the insurance benefits statement for session one of chemotherapy. They’re allowing about 9% of the $16,100 pharmaceutical cost. (This is before clinic charges, lab fees and physician fees.) Of the $1,500 they’re allowing, about $600 is being billed back to me as out-of-pocket and deductible.

While my out-of-pocket and deductible is limited to $2,000 per year, that leaves $14,600 per session, of 12 sessions unaccounted for. As it stands today, the hospital will be looking to me to make up about $175,000 in shortfall over the next six months.

So to my conservative friends who oppose HCR because our current system is ‘the best in the world’… my advice is to fall on your knees and pray to whatever god you believe in that you’re never in my position. Because it ain’t conservative principles and leadership that will rescue you from this. Even by your own standards, I’ve done everything right — good job, good insurance, good income. This will bankrupt me in a few months if I don’t fix it. Or kill me in 2-3 years if I can’t keep it going. Which of those choices is ‘the best in the world’? Please tell me, so I can really understand the rosy worldview of conservative America.

In my case, hopefully a hell of a lot of phone calling will help. But guess what I don’t have the time, energy and resources for? Full scale battle with my carrier, that’s what.

6 thoughts on “[cancer] The long and grinding road

  1. Dave Robinson says:

    Yep, this is what happens when you put health care in the hands of people who benefit financially from not treating sick people.

  2. At this point, the sad truth is that the insurance company hopes you die. The premiums you pay aren’t worth the cost of your (completely doable, sensible, and life-saving) care. They are a corporation, first and foremost, and as a corporation, they are inherently amoral. The bottom line is, as they say, the bottom line.

    I hope that makes you angry enough to ream them a new one until they decide not covering you isn’t worth the PR disaster.

    (Note for folks who work in insurance: I don’t believe you are evil on an individual basis. It’s the organization you work for that is evil.)

  3. This kind of shit makes my head explode.

    My dad was on Medicaid, so he had pretty good coverage. My mom had insurance through Walmart, and it was a constant battle to get them to do what we were paying them to do. Once she went inactive at her work we were allowed to keep her insurance by paying the full amount, which was a struggle but was better than paying untold thousands of dollars for her care. But even that was a battle because they would move the due date of the payment and sometimes paying over the phone was delayed and . . . yeah, a struggle. They did all they could to try to get off the hook, and more.

    And of course today my daughter caught pneumonia in AZ (where she and my wife are) and we discover that no pediatricians will take out-of-state insurance, so off to the ER for a 4 hour wait, puncutated by having to pay for meds out-of-pocket.

    Yeah, anyone who says this system is good is blind or numbed. And sadly, the current bill on the table is not going to do a lot to help. I really hope it gets strengthened (hell, I think we need to discard the health insurance system altogether), but I am afraid that fights like this will continue.

  4. Stevie says:

    I’m really sorry about this; I live in Britain where medical care for citizens is free at the point of use, and I use rather a lot of it.

    And my daughter qualified as a doctor last year, so I’ve got a functional ‘grow your own’ programme working for me as well.

    I’d offer to join the phone team but the Atlantic is a bit of a problem…

  5. I think the conservatives usually argue that the quality is tops, at least somewhere with someone in the U.S. Then they stop thinking. It’s “the best” so why change it?

    Of course the cost to individuals or our society is far, far from the best. And they think if they have coverage they have access to that theoretical best. They only change their tune when they get sick, and most people don’t get so sick, so most people are ignoramuses.

    Good luck, Jay! I’m sure you have enough friends to help raise some real cash (I’d pitch in) but $175k is an incredible amount…

  6. Meran says:

    I do think the med systems charge too much for what they do.
    Last year, to do a timed blood draw, I was put into the special brand new cancer ward at providence hospital in Portland. three hours in a nice comfy chair in a shared room, with cookies and a soda (neither of which I could have on my gluten free diet but I’m sure it was still factored in) without the lab charges OR blood pull charges was $1250. It wouldn’t have been separated like that nor have that price tag in the regular hospital lab. I was not given a choice of where to go either.
    Gotta pay for that new wing somehow! (my bill was $280. Prob what the whole thing would have cost in the normal lab)
    yeah, the whole system needed an overhaul, something that won’t be done in my lifetime)

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