Patients can’t escape reminders of U.S. health care’s brutal costs

debt-300x200Soaring medical costs crush the finances of far too many patients, as the public was reminded by the release of an annual report on the high toll of cancer-care spending and a surprising congressional reverse aimed at reining in runaway prescription drug prices — or at least attempting to.

Leading organizations dealing with cancer treatment — including the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries — found that patients in 2019 (the most recent year data were available) “shouldered a whopping $21.09 billion in costs,” the Washington Post reported.

Patients and their loved ones get hit with major costs in the first year of disease diagnosis, as well as the highest expenses at the ill individuals’ end of life, the report found.

The institutions, in their published  annual report on developments in a leading killer of Americans, also “found continued declines in deaths for 11 of the 19 most common cancers among men and 14 of the 20 most common for women. But women bear the highest out-of-pocket costs: Breast cancer patients paid an estimated $3.14 billion in 2019, compared to $2.26 billion for prostate cancer.”

The experts also aimed in their report to quantify patients’ out-of-pocket costs, as well as to provide an initial assessment of the price they paid for traveling for treatment, as well as waiting for and receiving it.

The experts reported this of “out of pocket costs,” charges that the newspaper explained can hit financially strapped cancer patients hard because these expenses typically come atop what they pay for health insurance premiums:

“Averaged across all cancer sites, out-of-pocket costs associated with cancer for medical services were highest in the initial ($2,200) and [end of life] ($3,823) phases and lowest in the continuing [treatment] phase ($466) … By cancer … out-of-pocket costs for medical services were highest in the initial and end-of life phases for acute myeloid leukemia ($6,093 and $7,039, respectively) and brain cancer ($5,751 and $5,901, respectively) and in the continuing phase for myeloma ($1,532), pancreatic cancer ($1,083), and acute myeloid leukemia ($1,056).

As for the too-often under-recognized cost of patients’ own time in dealing with their cancer care, the experts reported this:

“Cancer survivors in both age groups (18-64 years and ≥65 years) were more likely to have overnight hospitalizations, emergency room visits, ambulatory surgeries, provider office-based or hospital outpatient visits, chemotherapy, and radiation therapy than adults without a cancer history … Among adults with these services, cancer survivors in both age groups also had greater service frequency … and spent more time receiving care than their counterparts without a cancer history … Net annual mean time costs associated with cancer … were $304.3 … for adults aged 18-64 years, and $279.1 … for adults aged 65 years and older. In both age groups, hospitalizations and office visits were the services with the largest contribution to the overall time costs and accounted for the most of the net time costs.”

The Washington Post noted that the “total national cost of cancer care was an estimated $208.9 billion in 2020,” and the newspaper quoted Karen Hacker, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion, saying this in a statement:

“The cost of having cancer is enormous and an extreme burden on people and families, particularly for those who are uninsured or underinsured. Prevention is key to lowering out-of-pocket costs.”

The cancer experts, of course, zeroed in, too, on “out of pocket” drug spending as a major element of what experts in this field have described as the “financial toxicity” of cancer care.

Democrats’ surprise: an effort, at least, to rein in drug costs

Americans’ fury and frustration about relentless prescription drug prices may have finally registered with lawmakers, as Democrats in Congress struggled to pass a major social package, with many of its big elements dealing with health care costs.

The wish list from the Biden Administration and many congressional Democrats had included proposals to deal with drug costs, particularly for older patients and specifically by allowing federal officials to negotiate with Big Pharma over costly drugs covered by Medicare.

But it appeared that Big Pharma had strong-armed lawmakers, as always, sending armies of lobbyists and spending record sums to kill any effort to better control prescription drug costs, including for medications like insulin — a product basically unchanged but with prices spiking and becoming unaffordable for the desperate who rely on it.

But Democrats in the House and Senate suddenly returned to the issue and struck a compromise. It has a way to go before becoming law and is far smaller and less ambitious than what party leaders hoped for. It would be a start and could offer some relief to patients, particularly older individuals hit with huge prescription drug costs.

This also would be a sign of progress in regular folks making any headway against the political lock that Big Pharma has held on key lawmakers of both parties, preventing passage of laws that benefited patients and their well-being ahead of wealthy corporations.

Much can and will occur with and to the Build Back Better Plan if — or when — it passes the House and Senate, and President Biden puts his signature on it. The program, if it advances, will be a Democratic deal. It should be clear from this session of Congress that the GOP has not budged a micron in refusing to recognize that health care, in the wealthiest nation in the world, should be a right and not a privilege. Republicans have failed for more than a decade now to offer their own health care plan, while ripping at any others’ suggestions.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and even excellent health care. This has become an ordeal — notably with cancer — due to the skyrocketing cost, complexity, and uncertainty of treatments and prescription medications, too many of which prove to be dangerous drugs.

We have much work to do to deal with the relentless rise in bankrupting medical costs.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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