The Double Death for Those Diagnosed with Cancer

The Double Death for Those Diagnosed with Cancer

More Fallout from the Only Developed Nation on Earth without Universal Healthcare: The United States of America

The MAGA GOP is pledging to retain the massive 2017 Trump-era tax cuts, increasing them significantly from there. As we know, tax cuts generally favor most those who have the greatest taxable income, and we know who those are. Not most of us. The benefit cuts and cost of interest on our deficit we all pay are subsidies for the rich. Those 2017 set of tax cuts generated virtually none of the promised new, high-paying jobs, but have so far added at least $2 trillion to our deficit. This MAGA GOP promise of future extended and additional tax cuts will generate an estimated minimum add to the deficit of $4 trillion. A rising tide continues to float only all yachts, and the budget cuts in their crosshairs are heavily focused on their popular misuse of the word “entitlements.” And that generally means retirees and those needing medical care. A burden for the middle and the lower economic classes, not for well-heeled Americans.

God help you if you or your family members contract one of many of the most lethal forms of cancer… and you don’t have any or, as most of us do, only limited insurance coverage. And God help you even if you do have coverage but lose work or even a job over the related challenges of serious cancer. It’s bad whether it’s you… or a dependent child. Beyond the pain. Beyond the threat of death. A stab to the heart of so many families’ financial survival. The corollary of a medical system driven by profits, like ours, is that everything we use to treat cancer here is vastly more expensive than in countries with universal healthcare. And lots of treatments seem to fall outside the ambit of coverage in so many American insurance policies… assuming you have a policy that covers the treatment at all. Today, more than ever before.

If you have no real savings, your insurance or lack thereof has large co-pays and exclusions and caps, and you fall victim to a virulent form of cancer (or if that fate befalls a child or a spouse), there are challenges ahead. Assuming you even find a treatment path, can you work? Hold a job? Pay rent or maintain a mortgage? Will you losing insurance coverage for lack of an ability to pay premiums? Facing medical bankruptcy? Who takes care of your kids? If you have a car but cannot make car payments… Even if you have/had a good job, life changes with a major negative medical diagnosis and treatment reality. The so-called “rising out of pocket costs” for just about anyone so afflicted can be staggering, rising year after year. Brianna Abbott, writing for the May 28th Wall Street Journal, gathered the numbers, the costs, to bring this reality home to all of us:

“The economic burden of a cancer diagnosis is getting strikingly worse in the U.S., as drug and medical costs soar and more patients live longer with the disease. About 55% of cancer drugs introduced between 2019 and 2023 cost at least $200,000 a year, according to Iqvia’s Institute for Human Data Science. And an increasing number of patients are working-age, a group more likely to report financial hardship after diagnosis compared with older adults...

“Nearly 60% of working-age cancer survivors report facing some financial difficulty. Many patients struggle to afford care and end up taking on debt, with some getting payday loans or running up credit cards. Cancer alone accounts for some 40% of medical campaigns seeking financial help on GoFundMe, research shows… ‘Cutting back on meds. Cutting back on doctor visits. Losing your home. Cutting back on food—these are not things that we want to believe happen to people with cancer in this country,’ said Dr. Reshma Jagsi, a radiation oncologist at Emory University School of Medicine and the Winship Cancer Institute.

“Among common diseases, cancer creates a uniquely difficult financial strain known as financial toxicity. Treatments with expensive medicines start immediately and come with a string of nonmedical costs. Chemotherapy and other treatments can leave patients too weak to work for weeks or months. This can result in a twofold blow, with patients losing income and their employer-sponsored health insurance. The financial fallout can last for years… ‘It can cause this wealth shock that can ripple on,’ said Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York, whose husband died of cancer over a decade ago. Debt collectors still call her about his unpaid bills.

“The problem starts with costs for medical care and cancer drugs that have either risen above the rate of inflation or have high starting prices. Common cancer drugs have list prices that go well into the six figures: Imbruvica, which treats leukemia, has a list price of more than $213,000 for a full year. The average Medicare patient taking it paid $5,247 out-of-pocket in 2022, federal data show. AbbVie, one of the drug’s co-marketers, declined to comment. Tagrisso, a top-selling lung-cancer drug, has a list price of about $208,000 a year. Its maker, AstraZeneca, said the cost to an individual patient is rarely the list price, and the cost would vary based on a patient’s insurance coverage. The company said it has patient-assistance programs, and is committed to pricing responsibly and making its medicines affordable to patients.

“Many insurers have shifted rising healthcare costs to patients. Some employer-backed plans require patients to pay a percentage of a drug’s cost, which can add up to thousands of dollars. One report found a 15% increase in out-of-pocket costs for privately insured, working-age cancer patients from 2009 to 2016. Patients also foot the bill for transportation, lodging, child care and parking.

“The added costs are only part of the toll, with people’s livelihoods also put at risk. Many patients have to take time off—or actually stop working—after a cancer diagnosis. Patients who get chemotherapy are more likely to stop working within four years than those who don’t... The burden often affects entire families, with relatives pitching in financially or caring for their sick loved ones.” We see arguments from pharma and healthcare providers that the innovation that they claim “creates the finest medical system on earth” just requires expensive and expansive investment. But these staggering costs are accelerated by inane marketing costs and a strong priority for profitability that makes that same “finest system” too expensive to access for the most seriously in need of those most expensive treatments.

I’m Peter Dekom, and in the end, the United States may be the richest nation on Earth, but it has created a cruel healthcare system that subordinates the health and well-being of its residents to a yacht-supporting medical care system that absolutely prioritizes profits over all other values… and we remain the only developed nation with that reversed set of priorities.