medical costs

Hospital Care for the Wealthy Differs from What the Rest of Us Receive

September 21, 2015 By Guest Writer Leave a Comment

With health care costs rising at a rate of 7 percent each year, hospital care is increasingly unaffordable for many Americans. In fact, thousands of Americans file for bankruptcy each year because of expensive medical bills they cannot pay. However, one group of Americans are having no problem affording the increased cost of hospital care: the wealthy.

Recent studies have shown that many people considered to be wealthy have no problem with paying top dollar to be treated like royalty in the midst of a medical crisis. When Sen. Edward M. Kennedy was diagnosed with brain cancer, he had the wealth to convene his very own group of national cancer experts to discuss his case and recommend treatment. While this may seem excessive to many of us, for the wealthy, it is just a matter of course. Here are some other ways that hospital care for the wealthy differs from the hospital care the rest of us receive.

Access to Health Care

The wealthy enjoy better access to doctors and are rarely required to wait for appointments. You never hear of the wealthy waiting in emergency rooms for hours. You never hear of the wealthy being left on a stretcher awaiting an available room. In some cases, the wealthy have their own hospital floors with better nurse-to-patient ratios, better bedding, and concierge service. In New York-Presbyterian/Weill-Cornell Hospital, wealthy patient even have spectacular views of the East River. They can afford to pay about $2,400 per night.

More Attention from Doctors And Nurses

Many doctors and nurses treat wealthy patients differently. They may even deviate from usual protocols for the comfort of the patient. Doctors act differently with the wealthy because they know their decisions will be examined in detail by hospital administrators and possibly the press, and the public. The most senior doctor on staff generally performs the procedures needed.

More Testing and Treatment Options

Wealthy patients are often made aware of more costly treatment options. Some health insurance programs for corporate executives pay for routine full-body CT scans as part of their annual physical. While these expensive and detailed tests have never really been proven to improve health outcomes, doctors do them with little question for wealthy patients that demand them. If there is an incidental finding, more testing is often scheduled to pinpoint the problem. The wealthy also have greater access to treatments that are experimental and not covered by traditional health insurance.

For many, it is not surprising that someone with fame, stature, and/or wealth would receive more attention at the hospital. However, this increased attention doesn’t always result in better medical care. As the recent death of Joan Rivers has shown us, even routine procedures can go terribly wrong and sometimes physicians are more concerned about their reputation than they are about treating the patient. Illness is a great equalizer in our society and the wealthy are not immune.

New Tool Helps Diagnose the Financial Pain of Cancer

June 20, 2014 By Jeffrey Strain 4 Comments

Simply getting a diagnosis of cancer would send the stress level of most people through the roof. It’s not news that anybody visiting a doctor wants to hear. The stress of the disease, however, is not the only stress which comes with a positive diagnosis. Another huge stress factor which comes with the disease is financial in nature.

To better help those diagnosed with cancer and their families, a group of University of Chicago cancer specialists have come up with a new tool which can help determine how much “financial toxicity” a cancer patient is able to tolerate. The new tool is called COST (COmprehensive Score for financial Toxicity) and was published in the July issue of the journal Cancer.

Healthcare is expensive, but those dealing with cancer are hit even harder by the cost. Cancer care costs are rising at a faster clip than healthcare overall, and the cost of new cancer drugs is increasing even more quickly than the overall cost of cancer care. In other words, when it comes to getting a sickness, cancer ends up being an expensive disease to treat, and that cost is rising more quickly than other healthcare costs.

Financial hardships aren’t limited to those who have cancer. Even those who recover fully to become cancer-free continue to have to deal with financial issues of the disease. As many as 30% of those who survive cancer and become cancer-free, still aren’t able to work, or can only work in a decreased capacity after they recover, according to the Centers for Disease Control and Prevention (CDC).

Then there are the extra annual medical expenses survivors incur. Men who have had cancer will end up paying approximately $4,000 more a year in annual medical expenses than those who haven’t had the disease. It’s not much better for women, who can expect to pay an additional $3,300 a year as a cancer survivor.

The COST tool was developed to help doctors better discuss with their patients the financial burdens which come with being diagnosed with cancer, something few doctors do these days. By providing a tool which helps predict how a patient will react to the financial burdens that come with cancer, it’ll give doctors an initial step to allow them to begin the discussion. For example, knowing how patients are feeling about the financial aspects of the disease, doctors may be able to offer less expensive alternatives which still meet their treatment needs.

The tool consists of 11 statements to help elicit the information the doctors need to determine the financial risk the patient has. Those who score high for financial toxicity can be referred to support and counseling to better address the stress and their needs.

The initial study consisted of 155 patients. The researchers expected to find a correlation between income and financial hardship, but they didn’t. Instead, they found one between less education and financial stress. Since the first study was small, bigger studies need to be done to confirm these findings.

(Photo courtesy of 401k)

Raising an Autistic Child Can Exceed $2 Million: What You Can Learn from This

June 10, 2014 By Jeffrey Strain 4 Comments

Study: raising an autistic child can be more than $2 million

Raising a child with autism spectrum disorder (ASD) is a challenge in the best of circumstances. ASD is classified as a neurodevelopmental disorder which can result in impaired social and communication abilities. It also often comes with a pattern of repetitive activities, behavior, or interests. ASD is currently considered the fastest growing developmental disability in the US according to the Autism Society, and it is estimated to affect one out of every 68 children.

Not only does an ASD child take an emotional toll on a family, but it can also take a huge financial toll. How much? Well over $1 million in the best case scenario, and as much is $2.4 million with children who have autism and combined with other associated disabilities according to a comprehensive analysis by USA and UK scientists in regard to the different costs which come from raising a child who has autism. These figures are much higher than previously thought, but also take into consideration the lifetime cost associated with the disorder since many who have ASD can never live fully on their own. The authors submitted an editorial on their findings and thoughts which was published online at JAMA Pediatrics.

The bulk of the costs (79%) accumulate from a variety of services which directly help the child. This includes such things as home healthcare, medical care, special education, and after school care which would be expected. What surprised the researchers was the amount of money the family ended up spending on indirect costs to help the child.

For example, 9% of the figures were attributed to the loss of wages and other parental income by family members who leave the workforce to become a caregiver to the child with autism. David Mandell, the senior author of the research, notes that it’s the indirect costs and consequences which aren’t discussed thoroughly enough when it comes to families with this disabilities.

As Mandell expressed, “One of the largest costs in childhood was lost parental earnings. We think this happens because parents have to drop out of the workforce to care for their children. They give up their jobs because of the struggle of advocating for and managing their child’s care becomes a full-time job. If we had more comprehensive, family friendly care in place, families wouldn’t be faced with this drop in income right when they’re incurring many more expenses.”

Even if you don’t have a family member with ASD, there is an important monetary revelation which you can take away from this study, and it can help you in a lot of ways with your own personal finances. When it comes to the actual cost of many things you buy, activities you do, or responsibilities you take on, the cost often goes beyond the amount of money you end up directly paying for it. Almost everything has hidden costs, and these hidden costs can be quite expensive if you don’t acknowledge they are part of what you’re spending.

(Photo courtesy of Allen Sheffield)

Lifestyle Diseases and Personal Finance

February 25, 2009 By Jennifer Derrick 20 Comments

If you watch the news or read many magazines or newspapers, you’ve probably heard about “lifestyle diseases.” These are diseases and ailments that we get because our lifestyle and/or environment are unhealthy. Some examples:

Obesity
Alcoholism
Diseases associated with smoking such as lung cancer, asthma or emphysema
Drug abuse
Depression/anxiety
Some forms of cancer related to diet, sun exposure, or other lifestyle factors
High blood pressure
Heart disease
Diabetes

As with any medical problem, the cause is not always only your lifestyle or environment, but for certain diseases lifestyle has been proven to be a big contributing factor. And in cases where your lifestyle is the cause, correcting the lifestyle can cure, or at least improve, your condition. This means that a lot of your health is under your control. So what does this have to do with personal finance? A lot.

Lifestyle diseases are expensive to come down with and to live with. They have a lot of costs that more people don’t even think about. Not only do you have to pay the increased health care and pharmaceutical costs, there are often other costs associated with having a lifestyle that is out of whack and leading to disease. Here are some examples of the hidden costs of lifestyle diseases.

Once you are diagnosed with a lifestyle disease, health and life insurance become very expensive (if not impossible) to acquire. Without health insurance, your financial troubles will mount very quickly as your disease progresses.
If you are obese, you face many hidden costs. You probably pay more for food. Plus-size clothing is often more expensive than standard sizes. Travel costs are higher if you have to buy two seats. Your fuel costs are higher because your car has to work harder to haul the weight. And your car will likely need more repairs because the engine and suspension are always under strain.
If you smoke, you have to pay for the cigarettes (and the insane taxes associated with them). You might have to pay for special clothing or upholstery cleaning to remove the smell. Unless you like yellow tinted walls, you probably paint more often.
If you drink, liquor itself is expensive. Drink so much that you miss work, you don’t get paid. Drink even more and you’ll get fired because you miss work too often. Drink and drive and kill someone and the lawsuits will bury you. Same with drugs.
If you are constantly under stress, not only are you flirting with a heart attack, stroke or depression, you’re probably also eating out more and shopping more to cope with your stress. Retail therapy is expensive.
Colon cancer and heart disease are often found in people who eat a lot of fatty, high calorie, and over processed foods. And these foods are more expensive than their fresher, less process counterparts.
Any lifestyle disease can cost you in terms of productivity and time. You have less energy and ability to get things done and you may miss work more often, leading to missed paychecks or missed income opportunities.

And the even worse news is that one lifestyle disease easily leads to another. Once you have one, you’re well on the road to having more. You’re obese so you get depressed. You get depressed and your risk of heart disease goes up. You’re stressed out so you smoke or drink to calm yourself. You’re stressed out so you eat out a lot to save time. Then before you know it you’re obese from all the calories. Then you’re headed for a heart attack. It can become a never ending cycle of disease and expenses.

Once you have a lifestyle disease, you spend more and more to make yourself feel better, too. Self-medication can be just as expensive as medical costs. You may engage in a lot of retail therapy, pay for experimental treatments, try special gizmos and gadgets designed to alleviate the condition, and so on. The more lifestyle diseases you come down with, the more expenses you incur. Even if you have great insurance that pays for all of your health care, the associated hidden costs can drain your finances. You can go bankrupt paying for diseases that were preventable. Most people just shrug and say, “Well, that’s just what it costs to live,” and don’t make the association between their poor finances and the lifestyle diseases that are plaguing them.

So what’s the answer? Make the connection between your lifestyle disease and your financial problems. Prevent the disease (or reverse the course) and save yourself the extra costs. Obviously if it were so easy to lose weight, stop smoking or drinking, relives stress and be healthy, I wouldn’t even have to write this piece. We’d all be super healthy. But sometimes a financial motivation is a more powerful force for change than anything else. I know a woman who wanted to lose weight in the worst way. She was about 200 pounds overweight and miserable. She was tired all the time, got sick easily, had high blood pressure and her joints hurt. She’d tried every diet known to man and had failed at them all. She was about to give in and pay (by raiding her 401K) for gastric bypass surgery. While the surgery might have cured her problem, it would have left her at forty-nine years old with nothing saved for retirement. She asked me what she should do. She didn’t want to be broke, but she didn’t want to be fat anymore, either.

I asked her how much her lifestyle was costing her. She looked at me like I was nuts and then handed me a stack of medical bills. I told her that was certainly a lot of money, but what about other costs? I got her thinking about her food bills, her clothing costs, retail therapy (money spent avoiding the truth), her travel costs, and other more intangible costs such as lost productivity (she was self-employed, so every minute away from her business was lost income). She thought about it for a week and then came back to me with a number. Based on her own estimate, being obese was costing her (not counting medical care) about $20,000 per year in other costs. Add in health care, co-pays, diet aids, unused gym memberships, and medication for the associated joint pain, fatigue, and high cholesterol and the total ballooned to about $40,000 per year. Not coincidentally, she had about $45,000 in debt. Hmmm.

She got mad. And then she got furious. For a couple of weeks she wasn’t without her calculator and notepad. She tallied everything she spent on her “condition” and then planned ways to stop. She purged her pantry and bought only healthy, less processed foods. She ate at home almost every meal. She cancelled the gym she wasn’t using and started walking outside. She got smaller every time I saw her. She was never without her notepad and calculator, constantly tabulating the costs of her condition and the savings she was reaping as her condition improved. As she lost weight, she plowed her savings into various investment vehicles.

I asked her what happened. What was finally the last straw? She said, “I can’t believe how much money I was just wasting. And I was wasting it on something I could prevent. I didn’t have to lose all the money I did. I could have lost weight sooner and saved myself a ton of money. I assumed that life was just expensive, but I was making it expensive.”

Today (about two years later) she’s a healthy weight and out of debt. It wasn’t easy, but the financial losses were the motivating factor she needed to improve her lifestyle and cure her “disease.” Calculating the financial damage of your lifestyle disease might be the kick in the pants you need to quit smoking, stop drinking, lose weight, manage your stress, and start taking better care of yourself.