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As Treatment Costs Rise, and Savings Dwindle, Mesothelioma Patients Need and Demand Timely Compensation

Mesothelioma is expensive. Not only does the cancer itself exact a heavy toll on the patient, it can also blow apart his or her savings.

To live longer, patients need to be prepared to pay more. Mesothelioma patients who are fortunate enough to be eligible for multi-modal therapies must fork over high deductibles, if they have insurance, or drain their life savings, if they don’t.

The younger the patient, the longer their survival. The longer the survival, the higher the medical costs. Mesothelioma patients naturally want more life, but the sad truth is only those who can afford cutting edge, life-time therapies have a shot to beat the odds.

We talk to many, many mesothelioma patients and their families about whether or not to pursue compensation. More and more patients, during these depressed economic times, are mightily concerned about the costs of health care. In the last few years especially, the majority of our living clients have cited the need to pay for medical care as a major reason for seeking compensation.

This makes sense. We recently evaluated the medical bills of our mesothelioma clients over the last two years. We looked at the bills from the date of diagnosis to treatment to beyond. We evaluated the age, the residence, and the overall costs. Our analysis did not include out of pocket expenses, the costs of travel, or lodging, or miscellaneous expenses. (See Chart Below: Medical Costs as a Function of Age).

Age

Residence

Medical Costs

age 73

Ventura, CA

$2,431,900.00

(dec’d at age 78)

Walnut, CA

$590,000.00

(dec’d at age 61)

Poulsbo, WA

$501,900.00

(dec’d at age 55)

Mission Viejo, CA

$360,000.00

(dec’d at age 57)

Graham, WA

$360,000.00

(dec’d at age 52)

Hermantown, MN

$350,000.00

(dec’d at age 61)

Las Vegas, NV

$250,000.00

(dec’d at age 54)

Tuscola, IL

$235,000.00

Medical Costs as a Function of Age

RGWPC Mesothelioma Clients, 2007-2008. Costs do not include travel, drugs, travel, incidental costs. Costs based on available medical bills; the numbers above likely underreport actual costs.

The numbers speak for themselves. Mesothelioma can be extraordinarily expensive. Those who pursue the most effective combination of treatments pay the most. One client, still alive today after 4 years, has a running bill of over $2,431,900.00 million. This patient, at the age of 73, has pursued surgery, chemotherapy, radiation and interferon. Without these ongoing costs, which have allowed him to treat his mesothelioma as a chronic disease, it is highly doubtful he would still be alive today.

It’s no secret that the age of the patient and his or her treatment ambitions are two major factors in assessing the potential medical bills of a mesothelioma patient. The Doctor Patient Medical Alliance in 2006 reported that it’s not uncommon for younger and relatively more robust mesothelioma patients who pursue a multitude of therapies to run up medical bills well north of $1 million.

It’s simple. Mesothelioma is tough to treat. The therapies are expensive. The longer a patient lives, the more therapies he’ll need. To get more life, the mesothelioma patient has to pay more money. This is one reason that the Law Offices of Roger Worthington, P.C., along with it’s associate counsel, move swiftly to work with the patients doctors to provide the paperwork the Courts require to specially set our meso client’s case for trial as soon as possible.

Meanwhile, as the costs of medical care rises, cancer patients nationwide are learning the hard way that unless they have good insurance and healthy savings, the best therapies may be out of reach.

Survey: Cancer Patients Decline Promising but Unaffordable Therapy

As reported in USA Today, a published survey among nationwide health care providers showed that 12% of late stage cancer patients chose not to seek treatment because they could not afford it. The decision to pursue or not pursue treatment was a reflection of personal wealth. Those earning between $40,000 to $80,000 were more than twice as likely to pursue treatments as compared to those making less than $40,000 per year. Only a fraction of the cancer patients opted out who where earning more than $80,000 per year.

Two-thirds of the patients reported distress over out of pocket costs related to treatments. Those on the lower income scale reported severe distress arising from steep co-payments and deductibles. Not only does cancer stress the body, it wreaks emotional havoc on patients who may be financially unable to afford treatment.

Between 1995 and 2004, the cost of treating cancer rose by 75%, according to a 2008 report from the Journal of the National Cancer Institute.

On the bright side, the increase stems in part from the fact that people undergoing new treatments are surviving longer. The downside is the costs of healthcare have increased more rapidly that incomes or the growth in the overall economy. Cancer patients well know that novel therapies won’t help if they can’t afford to pay for them. (See: "Care So Costly, Some Cancer Patients Choose to Opt Out," USA Today, October 14, 2008).

Hospitals Are Hurting Financially

The L.A. Times reported that California hospitals are hurting financially because of the recent economic downturn (Girion, January 14, 2009). Patients are putting off seeking treatment for a number of reasons, including unemployment, job insecurity, the lack of insurance, or underinsurance, or high out-of-pocket expenses.

Hospitals are seeing fewer paying patients. Profitable elective procedures are down. The number of uninsured patients is rising. Today there are 46 million Americans without health insurance.

Hospitals need to borrow money to operate. But the credit markets are stingy. Investment capital has all but vanished. Adding insult to injury, California’s budget crisis and low MediCal reimbursements for poor patients are further weakening the state’s health care network.

In the last decade, more than 70 hospitals have shuttered their doors. More are on life support. We are in the midst of a perfect storm of financial, economic and government crises, all hitting at once, at a time when cancer patients are already under siege physically and emotionally.

The safety net is not just worn and frayed, for many Californians, it’s gone. As hospitals close, or turn away the uninsured, employers are scaling back coverage, while the State is searching for new healthcare programs to cut.

California Hospitals Facing Lean Times

According to the L.A. Times:

  • At Cedars-Sinai Medical Center in Los Angeles, financial counselors are dealing with a surge in patients with high-deductible health insurance who are unable to pay their share of the bill.
  • In Oceanside, Tri-City Medical Center is struggling to plug a reported $400,000-a-month hole blown in its budget by the sudden escalation of the cost of its debt.
  • In Northern California, NorthBay Healthcare closed a $15-million projected shortfall by shuttering a pediatric hospital unit and an outpatient pediatric rehabilitation program with a waiting list of 100 children.* (Girion, L.A. Times).

Patients nationwide are delaying important diagnostic tests (such as colonoscopies), which tend to be hospital profit centers. The reasons are obvious: high deductibles, poor coverage, unemployment, and increased medical costs. Many of the uninsured are forced to wait for the crisis to hit before seeking care, which has pushed emergency rooms in many hospitals to the breaking point.

As hospitals close, patients reroute to other big county or state hospitals. At UCLA Medical Center, emergency room visits have increased 25% since July. Rumors have circulated in California that the state may start writing IOUs to hospitals, which would further drive hospitals towards bankruptcy.

Vicious Cycle: Patients Broke, Hospitals Breaking, Health Care Busted

It’s a vicious cycle. Employers are lowering health care coverage for their employees. Workers are faced with higher deductibles and reduced benefits. Many patients cannot afford their bills, even those with insurance. Hospitals are treating patients with little or no prospect for paying all of their bills, which in turns drives the hospitals to the brink of financial ruin. Hospitals are left with no choice but to reduce staff and eliminate important programs.

For those employees who do have health insurance, studies show that the share of spending for healthcare rose by double digits over the past two years, an increase per year of around 10%. (See: "Not so hidden cost of health insurance," L.A. Times, May 19, 2008). The employers’ share has gone up, as well, but not as much as their employees.

Health care costs fluctuate regionally. For example, to cover a family of four, Californians may pay 10% more than a family in Phoenix, but 15% less than a family in Miami, Florida.

Rising Costs Impact Wealthier Patients, Too

Another survey showed that rising health care costs were negatively impacting even middle to high income patients. Medical debt has been rising. More and more patients have been forced to limit expenditures on daily necessities. With debts piling up, over a third use up all their savings, another third rang up huge credit card debt, and the other third have simply been unable to afford to pay for basics such as food, rent, or heat. (See: " Rising medical costs pinch more Americans, study finds", The Washington Post, August 20, 2008).

Medicare Trust Fund Evaporating

Meanwhile, the Medicare trust fund is evaporating. Medicare is the federal government’s biggest healthcare program, serving some 44 million seniors and disabled people. In the past few decades, the federal government has subsidized private insurance companies to cover senior citizens. The "bonus" paid to the private insurers to assume coverage is substantially more than the cost of regular Medicare, and now the chickens have come to roost. (See: " Medicare Trend Raises Eyebrows," L.A. Times, February 11, 2008).

According to the L.A. Times article, the federal government payments to the private insurers average more per senior than the cost of care with regular Medicare. The bonus payments enable insurers to offer features that seniors in regular Medicare don’t get. Enrollment has increased, which has boosted insurance company profits. But the Medicare trust fund is fast depleting.

Because the federal trust fund is draining down, Medicare has raised monthly premiums for everyone. The "regular" Medicare seniors are forced to subsidize those who enroll in the privatized Medicare Advantage program.

Lawmakers have begun to question the Medicare Advantage program. "It’s a runaway train," said Senate Budget Committee Chairman Kent Conrad (D-N.D.). For more on the scope of the problem, and possible remedies.

For more information about the costs of mesothelioma medical treatment, and strategies for paying deductibles, out of pocket expenses, and other costs, please contact the Law Offices of Roger G. Worthington at 1-800-831-9399.

For an excellent review of options you can pursue to cut your health care costs without cutting care, please read the article by Francesca Kritz " Cut Health Costs, Not Your Care," L.A. Times, Dec. 29, 2008. The article surveys practical strategies for purchasing drugs, negotiating costs with medical providers, affording health insurance, researching treatments overseas, saving money on surgery and preventing disease and cancer in the first place.

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