Sky-Rocketing Cancer Bills
Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology, Social Work
DECEMBER 17, 2021
Having cancer and going through cancer treatment are bad enough. I have always thought cancer patients ought to be given the equivalent of a Monopoly “Get Out of Jail Free Card” for the duration of their illness. As we all know, that is unfortunately not the case. As we move through cancer, all sorts of other life problems continue to surface. We can still have dental issues, broken appliances, or family issues. Most certainly, we have other concerns that are indirectly related to cancer such as difficulties at work or rifts in relationships.
In 2019, cancer patients faced $21.09 billion in costs.
And then there are the bills. The recent Annual Report to the Nation on the Status of Cancer considered the most recently available financial statistics. These numbers are from 2019, and we can be certain that things have become even worse in the subsequent two years. In 2019, cancer patients faced $21.09 billion in costs. The better news in the report included continuing declines in mortality for 11 of the 19 most common cancers among men and 14 out of the most common 20 among women. Interestingly, women faced the highest out-of-pocket costs. Women with breast cancer were billed an estimated $3.14 billion as compared to men with prostate cancer who were billed $2.26 billion. People with early disease had smaller bills, and the costs were highest at the end of life.
Let me remind you that these figures are the costs of cancer treatment: drugs, medical appointments, procedures, hospitalizations, and all of the uncovered expenses that even people with good medical insurance face. What about all of the other costs? Going through cancer treatment means time away from work (perhaps unpaid), travel expenses, and all of the household obligations that may increase during a time of illness and less robust health.
One of the more surprising pieces of the financial stresses of cancer usually is out-of-pocket expenses. Generally, people over 65 (which translates to mostly people on Medicare) have smaller totals than others. However, as an example, the average 65-year-old on Medicare who is being treated for chronic myeloid leukemia faces more than $4,000 in out-of-pocket costs the first year and more than $3,000 annually in subsequent years. This is a very big hit, and the numbers can be much higher. Especially for people being treated with new drugs, the co-pays or deductibles can be thousands of dollars each month. The economic burden of being diagnosed with cancer can feel almost as difficult as the psychological and physical costs.
It is unfair and very hard to begin to think about finances soon after a cancer diagnosis. However, it is helpful to try to plan for cancer bills rather than await the inevitable flood of expenses. Any one person’s costs depend on a number of things, like diagnosis, type of treatment, duration of treatment, and medical insurance. Most of us have not paid close attention to the fine print of our medical insurance policies until we need it. Pull it out now and read it carefully or ask a trusted family member or friend to do this for you. Can you identify possible gaps or problems? Are there questions to be asked of your employer, provider, or insurance company?
More people in the United States file for bankruptcy because of medical expenses than for any other reason. No one wants to be part of that group. Being aware of the possible problems, trying to plan, and talking with your doctor about your concerns are all good strategies. Cancer.Net has a good list of possible financial resources. You can also speak with an oncology social worker or patient navigator to learn of other possible resources. Be aware, however, that the biggest expenses are likely to be for medications, prescriptions, and medical appointments or procedures. Although those things may feel out of your control, there may well be ways to ameliorate the costs without compromising your care. Speak up and listen well.