I intend to triple with this piece: deets about the cost burden of cancer, a bit of personal history, and a plug for the ACA.
Cancer is an industry that for many reasons that make sense and some that are disgusting and controversial (but I’m not fighting that battle today) is full to bursting with money. Especially compared with other diseases having higher morbidity and mortality rates. But in America to die is to break our greatest taboo, so I find it unsurprising that we are willing to spend spend spend so much on a disease where it is routine to, in the same breath as it’s diagnosis, give survival statistics. Hard numbers on your own death will scare all the dollars out of your wallet.
And those dollars go to imaging, surgeries, pharma therapies, infusions, radiation therapies, specialists, and hospitalizations. In the initial months after I was diagnosed with stage 3 melanoma (survival odds 60% at 5 years if you must know) I had more scans than I could count. I didn’t even try to count the scans. In fact, sometimes I wasn’t even aware a scan was happening because I had fallen asleep in an MRI tube, the hammering no match for my fatigue. I was ending my second month of radiation when the bills started rolling in. I recall the total coming to around $15,000. And you want to hear something insane? Convinced I wouldn’t live very long and wanting to spare my husband the debt, I used my student loan money to cover the bill. Student loans that I knew would be discharged upon my death. Thinking and being ill don’t go together.
All of this is to say if I were capable of using the price transparency tools made available to patients by regulations of the Affordable Care Act I probably could have saved thousands. But at the time I didn’t even question the necessity of a scan, much less how much it would cost where. I deffered entirely to plans of the doctor, the NP, the scheduler. In hindsight this surprises me as I was at the time a nursing graduate student who previously managed her own healthcare like a total scrooge. Fear of death, fear of leaving a child orphaned, it dulls the shrewdness of the consumer.
So here we are almost three years post-diagnosis and I am, for the first time, feeling up to shopping for my scans. I am shocked at how much money I just about threw away for convenience of proximity and a communicating EMR. Top image is least expensive estimate, bottom most expensive.
I’d cross the Wilson bridge for $1200 any day. I’m glad to have made the investment in time to save some cash–but I believe it is a relatively small number of health care consumers availing themselves of the service be it for reasons of urgency of care or force of habit.
When I listen to great policy minds like Austin Frakt or Aaron Carroll of Healthcare Triage they don’t talk about a massive rebuild of the American health system or some sort of copy paste of British National Health. They speak of the improvement of our health care system as the fixing of hundreds of problems potentially a handful at a time. Price transparency is one of these fixes. It feels small in the face of the so much waste and dysfunction, inequity and unconscionable suffering…but hey! I am about to save a thousand freaking dollars. That is not nothing. I recommend you look into doing the same.