Unethical Cancer Pricing

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

MARCH 05, 2018

Posted in

  I have written many times about the economics of cancer: the deductibles, co-insurances, restrictions, camps, and plain uncovered services. I have written about drug pricing, and the ridiculous cost of many new treatments. This is more of the same and also a little different. The article from Medscape discussesthe charges from treatment centers. As we all know, we are billed for any drugs that are infused on site as well as for professional services and facility charges.

  At the beginning of the year, many of us see bills that are even higher than usual because we have not yet met the annual cap. For me, that means that my monthly shots cost me $1000 in January, and are then fully covered for the rest of the year. I understand how that works in my insurance policy, but it does seem kind of nuts. I am well aware that many other people face much higher charges.

  Here is the start and a link to read more:

'Unethical': Cancer Bills Inflated 5 to 15 Times Higher

Neil Osterweil

Patients with cancer can get a cruel surprise when they receive unexpected bills for costly "outofnetwork"
services provided in their ostensibly "in network" hospital.

Add in high monthly insurance premiums and deductibles, substantial copays, and the euphemistically named "coinsurance," and the unsuspecting patient can get a very nasty surprise indeed, says a team of physicians and healthcare analysts.
In a study published online February 17 in The American Journal of Managed Care, they found that wide
variation in markups on outpatient oncology services in the United States can impose severe financial hardships on many patients.
"What we found in the marketplace is that over one quarter of the medical centers that provide cancer services are charging more than 5.1 times the Medicare allowable amount, and in some cases the centers are charging more than 15 times the Medicare allowable amount," said lead author, Martin A. Makary, MD, MPH, a cancer surgeon at Johns Hopkins Hospital in Baltimore, Maryland.
Either this is a game that's gone awry, or it's just outright price gouging in the marketplace. Dr Martin
Makary
"Either this is a game that's gone awry, or it's just outright price gouging in the marketplace, and I think it's fair to ask, in a vulnerable time in someone's life, is it fair or reasonable to inflate a bill that much without their prior consent?" he added.

Read more: https://www.medscape.com/viewarticle/893178_print