Due to an unfortunate error on Medicare’s part, they hadn’t corrected my mistake by the time I went in for radiation treatment. This meant that the cost of 44 radiation treatments and diagnostic tests – approximately $40,000 – at a major New York City cancer center, was to be picked up by me!
Clearly, this news was upsetting.
I was not in any position to pay that kind of money. Pleas to Medicare and to the hospital made no difference. I went into a deep funk. Then, luckily, I realized that my senator (Daniel Patrick Moynihan) might be able to help. A wonderful specialist in his office quickly rectified Medicare’s error. In the end, Medicare and my Medigap policy paid the bills.
All of this came to mind today when I read a report in the Journal of the American Medical Association (JAMA) that says that 49 million Americans are spending 10 percent or more of their family income on healthcare, and that this constitutes a “burden” on those families.
The Federal Agency for Healthcare Research and Quality (AHRQ) looked at the costs of Americans under the age of 65 and found that one in five are burdened by health costs, in other words spend more than 10 percent of the family income. Eighteen million Americans spend more than twenty percent of family income on healthcare.
Without even beginning to argue whether 10 or 20 percent of income is burdensome (after all, we spend 30 to 40 percent on housing costs) let’s look at what that would mean for someone pre-Medicare (i.e., before 65) and then ask what it means for someone with Medicare coverage.
First, the costs of prostate cancer care:
This depends when and how you’re diagnosed, and where and how you’re treated; while my particular costs soared past $30,000 (or, at least, that’s what the hospital charged for radiation), according to the Mayo Clinic, for surgery, radiation, or seed implantation, the average cost was about $6,500, no matter which treatment was chosen.
If I had been making $60,000 a year (gross), that would certainly mean that my prostate cancer costs were already more than 10 percent of my income.
Health insurance costs Americans – on average – about $2,700 per family (if the costs are shared with an employer), about twice that if paid for without employer help. But what about health insurance? Maybe you’re one of the 40 million Americans who don’t have it.
All of this makes figuring out how prostate cancer affects you extremely difficult.
If you’re paying $5,000 for insurance, then you pay only 20 percent of the cost of treatment – or $6,000 in the case of my example above, or $1,200 as a co-pay if you have that lower cost treatment.