Buy a health ins. plan that excludes chemotherapy?

[irmanator]

really?? I didn't know that. So why is it so expensive then?

[disneysteve]

really?? I didn't know that. So why is it so expensive then?

Why is Viagra $15 per pill?

I suspect chemo agents are incredibly expensive to develop and get FDA approved and their target market is relatively small as compared to a broad market drug like something for high blood pressure or diabetes or cholesterol.

Lots of chemotherapy is still given IV but even that stuff is much better tolerated today partly because there are better drugs to give along with it to reduce side effects, but those drugs are expensive, too.

[Scanner]

DisneySteve,

I am glad you pointed that out, about chemotherapy having a bad rap, because that is true for the most part. It's not as "devastating" as it used to be to undergo it so I am not even saying I would nix it as a choice right off the bat, like some people jump the gun and say.

The good news: Cancer was once a terminal disease (most types). Now, it's a chronic disease.

The bad news: Cancer was once a terminal disease (most types). Now, it's a chronic disease.

And there's the rub. . .forget about the chemo. . .what about all the follow-up speciallst visits, CAT scans, MRI's, blood work, etc. In a way, you sometimes live out the rest of your life in a "diseased state" after the cancer is subdued (but never cured). Is this the lifestyle we are electing to live as Americans?

Would I elect to do that?

Like you rightfully point out - maybe.

I suppose even if you have $30,000 in uncovered insurance charges related to chemo. . .well, that's the cost of a new minivan with a nice options package. Most people drop that without even thinking. I would think my life would be worth that (a minivan maybe, but not a $50,000 Mercedes )

Please excuse my black humor. . .one of my favorite movies is THE END with Burt Reynolds and Dom Deluise .

Related to that though, the ins. plan has a "cap" of $500 on diagnostic tests per year. . .with a dx. of cancer, that would be eaten very quickly. That being said, I would get to pay the "contracted rate" of lab, MRI, CT, bone scan, etc. Point is, I am going to have to set extra money aside regardless - an "uncovered medical/dental care" charges savings account.

[disneysteve]

I would gladly construct a policy that covered cancer treatment, including chemotherapy, but did not cover treatment of more common conditions like high blood pressure or high cholesterol. Why? Those conditions can be safely and effectively treated for next to nothing. I can treat a patient with high blood pressure, diabetes and high cholesterol for a total of about $20/month thanks to the $4 generic drug plans from WalMart, Target and others. In contrast, chemotherapy might run $10,000/month or more.

Why do we buy insurance of any type? We buy it to protect ourselves against catastrophic losses. I can pay for the day to day stuff myself. I don't need or want my insurance to cover cough syrup, anti-inflammatories or even most antibiotics. I want my insurance to cover the major stuff that nobody but Bill Gates or Warren Buffet could handle out of pocket.

[disneysteve]

The good news: Cancer was once a terminal disease (most types). Now, it's a chronic disease.

The bad news: Cancer was once a terminal disease (most types). Now, it's a chronic disease.

And there's the rub. . .forget about the chemo. . .what about all the follow-up speciallst visits, CAT scans, MRI's, blood work, etc. In a way, you sometimes live out the rest of your life in a "diseased state" after the cancer is subdued (but never cured). Is this the lifestyle we are electing to live as Americans?

Yes, I do think that is where things are now and are going even more in that direction. That's a good thing IMO. People are living normal lives with what used to be terminal conditions. Sure there is a monetary cost but how do you possibly put a price on having a family member being an active and productive member of society for an additional 10 or 20 or 50 years?

Look at HIV. I have patients in my practice who were diagnosed HIV positive 20 or more years ago. It is far from the death sentence it once was. It is just another diagnosis on the flowsheet in their chart. Yes they have to take meds and get regular bloodwork and take certain special precautions, but they're alive and well and working and raising families and doing everything life has to offer.

[Seeker]

Why do we buy insurance of any type? We buy it to protect ourselves against catastrophic losses. I can pay for the day to day stuff myself. I don't need or want my insurance to cover cough syrup, anti-inflammatories or even most antibiotics. I want my insurance to cover the major stuff that nobody but Bill Gates or Warren Buffet could handle out of pocket.

Yup, exactly.

Which is why people end up seeking these policies when they lose the workplace providing ones by whatever means. It's for necessity, not for abuse. It's also why out-of-pocket costs are rising.

But by the same token, if we purchase whatever policy, we don't need to find out later that whatever we get is not covered by that policy. Things need to be clearly stated and defined as to what exactly is covered and what the limits are. Insurance companies should not be allowed to deny a claim on those things that are covered and that we as consumers seeking protection in this way, read and understand the terms of the policy.

[zakity]

If you could pick between a policy that covered cancer treatment and one that didn't, and you could afford either one, would you voluntarily pick the policy that didn't cover cancer treatment?

Yep, I would pick the one with it in case it was a cheap, easily survivable one. But, on the other hand, my little trip to Hell has totally made me decide that I would rather die than ever go in the hospital again. So, the policy wouldn't have to cover me.

For some reason, that Star Trek line pops into my head... The one where Spock is dying. Awww... Google is a wonderful thing. "The needs of the many outweigh the needs of the few."

[Scanner]

Zakity,

I don't think you are alone in your sentiment. I somehow a lot of times think patients get "sucked" up into treatment they really don't want. . .maybe they have the pressure of family, of the doctor in front of them, religious expectation maybe, maybe even "Gee, I have the benefits. . .why not use it because some unlucky sap doesn't have the choice". . .again, it comes down to questioning what kind of lifestyle are you willing to lead.

I work in a hospital and they are god-awful places to be sick. The whole experience is geared around nurses shifts and doctor's work schedules in getting tests done by the time they get in at 7 a.m. so patients are being awoken at 5 a.m. for portable chest x-rays, blood work, etc. . .not to mention the constant noise.

The patient's rest and wellbeing and healing are secondary to "what needs to be done."

I hope I never have to stay for an extended time at a hospital and you can bet that would factor into my decision for chemotherapy or not, should I ever face that choice.

[disneysteve]

I work in a hospital and they are god-awful places to be sick. The whole experience is geared around nurses shifts and doctor's work schedules in getting tests done by the time they get in at 7 a.m. so patients are being awoken at 5 a.m. for portable chest x-rays, blood work, etc. . .not to mention the constant noise.

The patient's rest and wellbeing and healing are secondary to "what needs to be done."

I think this is gradually changing for the better. For example, my wife just had surgery on Friday. The hospital has "room service" for meals. Rather than bringing trays at a set time for all patients (with food that is lukewarm at best), each patient calls and orders their meal from a hotel room service style menu at the bedside and the food is delivered within 20-30 minutes. I was there when she ordered lunch on Saturday and it arrived in about 20 minutes and was fresh and hot (and pretty tasty, too). This way, patients don't get their meals delivered while they are out having some x-ray or test done only to come back to food that has been sitting out for an hour.

I also think the growth of hospitalists has greatly cut down on what you mentioned about doing tests at 5am to prepare for doctors making rounds at 7am. The hospitalist is at the hospital full time, all day long. They don't rush in to make rounds and then get to an office by 9am. The hospital is their office so they see patients throughout the day.

[zakity]

**snort** Not where I was...

They woke me up at 4 am every day to take me to tests or just to my blood pressure and temp. And, they had my butt wired up to some monitoring system. And, they always woke me up at least once during the night because one of their little pads from the monitoring system came off. And, one night, when I had insomnia, I got chewed out for not sleeping. I had a hospitalist too. He would just come by and tell me what everyone else was telling me. I felt sorry for him. It reminded me of that chick on Galaxy Quest whose job was to repeat the computer (sorry, apparently it is a movie flash back day for me).

[Scanner]

I know I would just use the expression, "I refuse" a lot in the hospital.

The word "refuse" carries a lot of legal weight. When someone comes down for a CAT scan and refuses. . .that's it. They go back up. I frankly don't want to hear it from the ordering doctor or nurse because it's my license on the line as it's considered assault if I force it on them. I only want consenting patients. The only exception are the intoxicated and/or demented.

"We need your blood pressure and temp. every 4 hours."

"I'll refuse that and elect for 8 hours of sleep. Thank you. I understand the risks. You can take it at 7 a.m."

Legally, as long as you are of sound mind, you don't have to have a logical reason as to why you refuse. Of course, if you have a bugger of a nurse, they can still keep asking you to get all the monitoring and testing in the middle of the night vs. letting you sleep.

3 AM: "Change your mind?"

"Nope."

LOL. Yeah, I plan to be a pip someday.

[Goldy1]

You could deplte your assets, stop working and go on Medicaid and not pay a dime in copays or premiums(I am being sarcastic but this is my reasoning for at least some form of universal care even at a cost to us not that I want us to discuss that topic again, it's too boring and controversial and never ending)

What scares me about cancer is healthy people getting it and the many kinds there are!

[disneysteve]

What scares me about cancer is healthy people getting it

That's kind of an awkward statement. One could say the same thing about any illness at all: diabetes, high blood pressure, appendicitis, Parkinson's, etc. People are healthy until they aren't. It is certainly true that people with no other known illness develop cancer, but people with no other known illness become diabetic or develop high blood pressure or get gallstones too.

Of course, I agree that the prevalence of cancer in general is a scary prospect.