A week after I was diagnosed with cancer, I found myself on the phone, crying and yelling. I wasn't crying about my diagnosis or my impending treatment, yelling about the unfairness of being hit with cancer at age 25. I was upset about an Explanation of Benefits (EOB) I had already received from my insurance company, informing me of the thousands of dollars I would now owe for my first appointments, tests and scans. What frustrated me most was that I didn't get a choice. Being diagnosed with a rare and hormonally active cancer calls for treatments and decisions from a whole team of specialists, not to mention uncommonly expensive blood and tissue tests and unusual scans.
Three and a half years later, I am still juggling treatments, a team of physicians and near-daily EOBs, bills, phone calls and fights. Along with fighting to keep living, I feel like I'm fighting not to lose all my money; and there's no end in sight.
We are told we have cancer -- more and more of us each year. We are told what our treatment options are. We are told what tests and scans we need, what pills will make us feel better. And then we are responsible for paying for it. Regardless of our health insurance plan, it's like someone who we don't know very well picks out a new car for us even though we don't want a new car, and then they stick us with the bill.
This is not the way an economic market is supposed to work. Markets function best when consumers are able to weigh costs and benefits of various goods and services and make their purchasing decisions based on these factors. In the health care market, patients don't get to make most of their treatment choices. Doctors decide on treatments based on what option is likely to work the best. Many of them aren't aware of how much different treatments will cost the patient and, if they are, they often choose the treatment they believe will be the most effective regardless of cost.
Even if patients could make informed treatment decisions, even if doctors knew the costs upfront, it might not even make a difference. Medical costs are so inflated and insurance companies so unpredictable that choosing which chemotherapy, surgery or procedure to get would be like choosing whether to get the stereo upgrade or a sunroof on a luxury car. It's prohibitively expensive for most people either way. Unlike the cost of cars, health care costs, particularly for cancer, are projected to rise. And let's not forget -- the patient's life and livelihood are on the line.
On average, cancer care cost $85,201 per patient in 2010-2011, according to the latest Medical Expenditure Panel Survey. Heart conditions were the most expensive, at over $100,000. Cancer patients actually paid a lower percentage of their overall health care costs out of pocket compared to other conditions; but because costs were higher, cancer patients still end up paying a lot. On average, they paid $3,664 for health care out of pocket in 2010-2011. And that doesn't include health insurance premiums. Until the Affordable Care Act (ACA), people who had a pre-existing condition like cancer couldn't even get health insurance if they didn't already have it or change to a better plan.
A study done last year found that unpaid medical bills were the number one reason people filed for bankruptcy in the United States. Aside from bankruptcy, approximately 20 percent of the adult population between the ages of 19 and 64 (56 million adults) struggle with health care-related bills. Of those 56 million adults, 10 million have health insurance.
In the United States, patients are drowning in health care costs. In France, people with chronic health conditions actually get free health care. According to a European Observatory on Health Systems and Policies study, health care is free in order to protect patients with long-term illnesses from financial hardship associated with treatment. It sounds so logical. In economic market terms, this saves people who can't really make choices about the amount and frequency of medical care from making these choices. They don't have to pay for the luxury car with the upgraded stereo system they don't want.
In the U.S., the economic market expects us to make these choices or join the millions who leave medical bills unpaid. It expects us, the cancer patients, to not get scans our doctors recommend. It expects us to leave prescriptions unfilled -- or to expend the energy getting prescriptions filled through mail-order pharmacies or getting financial help from pharmaceutical companies if it's offered. It expects us to forgo medical care if we can't afford it. It expects us, the tired and the sick, to take on this enormous financial burden, no questions asked. If medical cost projections are any indication, the situation is only going to get worse. The ACA may help a little, but the U.S. still has a long way to go if it really cares about its cancer patients.
This article originally appeared on reimagine.me a new online magazine, community and education resource aimed to help those who have been touched by cancer, and others facing adversity.