The Cost of Breast Cancer Treatment

PJ Hamel Health Guide December 11, 2006
  • A just-released report in JAMA, the Journal of the American Medical Association, cites some frightening statistics. The Agency for Healthcare Research and Quality, in studies done in 1996 and 2003, found that 49 million Americans (that’s one-fifth of the population under the age of 65) spend at least 10 percent of their family income on health care. And for 18 million of those Americans, a full 20 percent of their income goes towards health care. Is there a healthcare crisis in America? Reading statistics like this, what do you think?

    If you’ve been through breast cancer, you know how staggering the bills can be. Breast cancer isn’t one of those ailments whose best cure is rest, liquids, and a couple of aspirin before bed. Most of your cancer care will be administered in a hospital or cancer center. And, as you walk the halls, on the way to your appointment, you might notice how many folks in hospital greens and whites are rushing past, how many signs you see pointing the way to well-staffed research labs, and waiting rooms full of folks standing by to be X-rayed or MRI’d or cat-scanned or cardiogrammed…

    All of this costs money: the people, the machines, just running the physical space. And these costs–to say nothing of the staggering costs for drug development–are passed along to us, the patients.

    This is, after all, American business. Health care isn’t part of our country’s social fabric, as much a citizen’s right as driving the roads or drinking clean water. No, there’s a reason they call it the healthcare industry. Like any business, it runs on money, and that money (unlike in some countries) doesn’t come from the government; it comes from you and me.

    When I got my breast cancer diagnosis five years ago, my first thought was, “Am I going to die?” My second one, close on its heels, was, “How am I going to pay for all this?”

    Even though I was insured at my place of work, I knew it was going to be expensive. Doctor’s appointments, blood work, scans, to say nothing of the Big Three–surgery, chemo, and radiation–were going to burn a hole in my pocket, a pocket that had little enough in it already. But what was my choice? Do nothing, let the cancer advance, and wonder which would grow faster: the tumor, or my 15-year-old son? Roll the dice, hope for a miracle cure?

    I wasn’t feeling that lucky. I opted for treatment: the whole nine yards. Five years later, I’m still getting calls from collection agencies. The tangled web of charges bouncing back and forth between insurance company and hospital, the $523 for a bone scan here, the $410 for a lymphedema sleeve there, continue to haunt me. I don’t like feeling like a criminal, someone who’s trying to duck out on her bills. I’m just having a really hard time paying them. And a recurrent question keeps running through my head: Why can’t we as Americans, with all of our know-how, figure out how to take care of our health without breaking the bank?

  • As of January 1, we’re switching insurance companies at the place I work; this will be the fourth change we’ve been through in 5 years. I know the agony my small, employee-owned company has gone through, the HR folks spending grueling hours playing Let’s Make a Deal with the very few insurance companies offering coverage in Vermont. As my friend Suzanne said, after yet one more session with insurance brokers, “It’s not up to our little business to solve the national health care crisis.”

    So here we are, looking at another rise in our premiums, another rise in our co-pays, another cut in services. I take Arimidex; if I take it for 8 more years, it should lower my risk of recurrence significantly. It costs about $238 a month. Our new policy, unlike our old one, doesn’t cover it all. I’m already teetering on the financial edge. Do I keep taking Arimidex? And cut back on heat-–the $2.86 I pay for each gallon of fuel oil that keeps my house warm? Ask my 142-pound, ever-hungry son to quit eating so much? Tell my 80-year-old mom, living alone in Florida, that I can’t afford to come see her this winter? What, exactly, am I willing to give up to keep that murderous foe, cancer, at bay? And why do I have to make these choices?

    And an even more chilling thought: what kind of heart-rending decisions do those 49 million Americans spending over 10% of their income on health care have to make? Here, in the richest country on earth, is it really possible that we have to choose between health and food, or health and warmth? Apparently, according to the new JAMA report, it is.