Cancer: How Much Does Your Health Insurer Think Your Life Is Worth?

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Can you afford to get cancer?  The answer may surprise scare you.

The cost of cancer treatments are skyrocketing, and more and more insurance companies are choosing to pay less and less for life-saving treatments.  Did you know that 20% of people with insurance still can't afford their cancer treatments?   And that's not counting the millions who have no health insurance at all.  Basically, if you're rich or you have exceptional medical insurance, this isn't something you need to worry about.  But for the rest of us, it's a real concern.

I wanted this post to ask the question -- How much is your life worth? But it's a lot more complicated than that.  The real question is -- How much does your health insurance company think your life is worth? Let me tell you, it's often not very much, and sometimes it's even worth nothing.

In a recent Associated Press story, the sad reality for cancer patients is being brought to our attention, and it's not pretty.

How Much Is Your Life Worth?

Cancer patients, brace yourselves. Many new drug treatments cost nearly $100,000 a year, sparking fresh debate about how much a few months more of life is worth.

Job losses have led some people to stop taking Gleevec, a $4,500-a-month drug by Novartis AG that keeps certain leukemias and stomach cancers in remission. Three such cases were recently described in the New England Journal of Medicine, and all those patients suffered relapses.

Another big problem that cancer patients are running into is that more effective and less invasive cancer treatments are not only more costly than the traditional intravenous treatments, but patients are often not given a choice because their insurance company makes the final decision.  So even if the oncologist recommends an approved chemo treatment that is less invasive and more effective, insurance companies are saying NO.  In other words, a decision that should clearly be made by the doctor along with the patient, is being made by insurance companies (whose interests are with making money not saving lives).

BALTIMORE - AUGUST 15:  In this photo illustration, leading chemotherapy treatments for lung cancer patients are displayed at the Kimmel Comprehensive Cancer Center at Johns Hopkins hospital August 15, 2005 in Baltimore, Maryland. Since its inception in 1973, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins has been dedicated to better understanding human cancers and finding more effective treatments.  (Photo Illustration by Win McNamee/Getty Images)

My main thought is that you can't (and shouldn't) put a price on what someone's life is worth.  Everyone should have equal access to effective cancer treatments, regardless of the cost.  And I don't believe that just because intravenous chemotherapy has been the mainstay for administering chemo, that insurance companies should be allowed to put new pill forms of chemotherapy in the category of prescription medications (thus making them more costly to the patient).  Chemo is chemo, and it shouldn't matter how it is administered.  Chemo drugs should be paid for equally by insurance companies, and the decision about what treatment is best for each patient should be made by the patient and their doctor (not by for-profit insurance companies).

What do you think?

In most other cases, when it comes to medical treatments, the less medically invasive option is also the least expensive.  And because it is less invasive, the risks for infections and other complications related to treatment are minimized as well.  A good example of how invasive treatments are more costly than less invasive treatments is heart bipass surgery vs. stents.

For many patients with triple-vessel or left main disease, drug-eluting stents provide similar outcomes to bypass surgery -- and for less money.

[t]he stented patients reported feeling better overall and, in the two month period following the procedure, stents patients recovered their quality of life far more quickly. In the end, at one-year, the results for both arms of the trial coincided with no significant difference.

Dr. Cohen's presentation broke down the costs of the treatment according to low, medium and high risk patients and found that, for low risk patients, stenting initially cost about $6,000 less than surgery, which reflected the higher hospital costs and much higher physician fees for surgery. For medium risk patients, the difference was about $4,000.

There are two significant comparisons here.  One, the less invasive treatment is also less expensive.  And two, the patient along with their doctor makes the choice about what option is best (not the insurance company).  Neither of which is true when it comes to these newer cancer treatments.  Why is that?

Here is what happens from the patient's perspective:

Cancer Patients' Dilemma.

When Jere Carpentier learned last year that she had advanced colon cancer -- her third malignancy in a dozen years -- she worried about spending hours in a clinic tethered to an intravenous line, enduring punishing chemotherapy that would make her hair fall out. Her veins ruined by earlier treatments, Carpentier was elated when her oncologist said this time she could avoid needles and take a pill at home that would specifically target the cancer cells and spare her hair.

"I let that be the thing that made this okay," she recalled.

But the former human resources manager, who lives in San Jose, soon discovered that her insurer would not pay for the pill called Xeloda, which cost $4,000 per month, because a cheaper IV drug was available.   Read the full article at Kaiser Health.

My personal thoughts:  When I was growing up, the word cancer really scared me. I thought anyone who got cancer would die.  As I got older, I was comforted by all of the research and life-saving treatments that were becoming available and making cancer a little less scary (and not always a death sentence).  But I never thought for a minute, that a day would come when cancers that are treatable and even curable would become deadly simply because money is being placed ahead of lives.  This is beyond scary, it's a national disgrace.  When did life become so devalued in our country?  How do you explain this kind of thing to your kids? Please let me know your thoughts in comments.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com

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