Another parameter to add to our treatment-factors list

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zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/18/2009 6:12 AM (GMT -6)   
Insurance and or money to get any thing done. I don't want this thread to go off on our total system and very economic current status and scenarios. But, since insurance coverage and expenses are  relevant to our health and survival with this we need to have open eyes.
 
You may lose your job (sadly for anybody) and probably your insurance because of that ,or your insurance co-payments could rise to unreal levels you never saw before, or insurance by your company my be diminished in coverage/quality to save money to in effect cut costs and stay in business. Who knows where this ends and gets better with insurance costs, coverage, and denials of coverage issues. I never researched the costs of all the treatments I was looking at years ago because I had great insurance and all my opinions, treatments, expenses were covered, even when I fired docs and selected someone else. That exceeded my expectations, I was waiting to see a bill or have them tell me you cannot seek that many opinions etc. I got 8-opinions and very pleased it was all covered.
 
The more I know of some of these treatment costs, the more I cringe at huge expense. If you did not have insurance you might have to sell everything you own to get a protocol, how sad for our society. So, costs and insurances is another variable we have to add into this mix. If you have the luxury (and that is what it is), to have decent insurance you have less to fret about and can concentrate on fight the disease and not on how do I pay for it, also.
 
There are some PCa advocacy groups that have in the past and probably still do help people whom have little or no money to get some type of treatments. So, there is hope and some compassion out there for those folks who have no where to turn. You would have to seek them out and learn of such.
 
Some people may have to consider going outside the USA for certain tests or treatments or drugs. Hey, it is a choice....you may have to make that call. The positive news on tests and probably treatments is they are done around the world. I have heard through the grape vine that you can get scans, imaging etc. in countries like India (they have English speaking doctors), Thialand, Japan etc.  Costs savings can be as high as  60-90% less expense.
So ct scan and bone scan might only cost  $800-1000 even adding plane fare and overnight you could still be thousands ahead.  It is a choice....we need choices and options...  Naturally you have to do alot of internet digging or networking to find out whom or where is worthy to go see, they exist is the good news.
 
Because of economic conditions, perhaps some folks that were waiting for treatments might have to rethink, timing scenarios to make sure you are covered when you need it the most. Not saying rush per se, but another parameter for treatments is on your desk. You decide if it is trash bucket or bucket brigade. I am pointing it out even though it should be somewhat obvious.
 
Dx-2002  (7 yrs. survivor/warrior) Its a journey but it has literally been warfare.
Z-Bob  (aka-Neutrondbob)
 

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 1/18/2009 8:58 AM (GMT -6)   

Hi Zufus,

You have touched on something that is near and dear to me. I have footed the bill for my treatment completely out of pocket as I have no insurance. I have found both compassion and greed in my dealings with the local medical community.

When initially diagnosed I has an estimate in front of me that was from $125,000 to $165,000 not including the cost of pathologist or anesthesiologist. The estimate was based on the potential treatments that were being considered at the time. Surgery, radiation, and hormone sequentially and/or concurrently.

The final recommendation and path I chose was radiation and hormones concurrently. So far I am out of pocket $65,000. It could have been worse had it not been for my urologist and oncologist. Their practice has a radiation machine that is state of the art. They gave me a very good discount on the cost and the oncologist actually pegged his charge to the medicare reimbursement. You can not get lower than that. I recieved first class treatment both medically and personally. My urologist is administering the lupron and from what I can see is charging me one third of the going rate. I am very grateful to this group who have put my heath and welfare ahead of the pursuit of profit.

As for the groups that help with expenses they certainly provide a valuable service. Even the drug companies will furnish the drugs at cost under some circumstance. But what I found was they want to shake your pockets until they are empty and you have not one assest to your name in order to qualify. Destitute is the word that serves best.

The hospitals were the worst. No discount offerred. At least initially. I was only offerred a 10% discount after I said "well maybe I just won't pay and you can sue me". I had just read the annual reports of both of the "non profit" hospitals here. They both had a 20% "non profit" margin! Not bad. I do not know of many businesses that can retain 20% of their revenues after expense. I also had to pay cash and upfront before treatment. I know that the insurance company would have paid 33% to 50% of the cost. I have a friend who looked up the insurance reimbursement for the procedures. So much for the myth of the insurance companies carrying the uninsured.

The real problem is all of the hospitals as well as some private providers all have expensive technology for the treatment of disease. In the case of the radiation machines there are five in my local area. The population is relatively small to support all of these machines. You would think that supply and demand would drive price down. No way. All five charge roughly the same thing at least at list. This phenomenon has been documented that the cost increases as more of the facilities get technology because the number of patients per unit declines.

Well, I am revved up this morning after this. At least it got my blood flowing. :-)

Take care,

Don


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 1/18/2009 10:52 AM (GMT -6)   
Our health care in the US is tragic. It's an embarrassment the entire world laughs at. With the economy tanking it will only get worse. There's no rhyme or reason to it. I'm one of the very lucky ones whose treatment has cost about $100,000 as of now. My cost a little under $1000, so I personally have no complaints. But why was I so lucky and others not? Just because back 32 years ago I decided to leave private industry to work for the feds. Health insurance was never factored in as a reason. Hell back then in your 20s you think of yourself as immortal. Your health as you age shouldn't be at the risk of spinning a wheel which is what it's like now. I've been retired now near 5 years and while my PCa dx was a shock it was all I had to worry about. Not going bankrupt losing my house etc.. That's how it should be for everyone.
Diagnosed 11/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
Not unexpected bounce after
the 80% drop the quarter earlier.
Along with urine flow readings, and
acceptable amount left in bladder measured
by sonic. Results  warrant skipping third
quarter tests, and to return 
April, 2009 for
final biopsy scheduled to
complete clinical research study 
 
 
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 1/18/2009 11:01 AM (GMT -6)   
PC can be a bankrupter. My family has gone through RP, IMRT and now HT for another year. It has been extremely difficult financially. Most drug companies offer a patient assistance program, but you have to be pretty much below the poverty line to qualify. (This is before the cost of treatment....even though most cancer treatments will put pretty much anybody below the poverty line). One thing we did find with the hospitals, is that they would send a bill and if we paid a large chunk or the remainder of the bill, they would discount it. It did help a little and now going forward, I will always ask the hospital for a discount if paying the whole thing.
I couldn't find a way around the Lupron costs. Anybody have any luck or tips for that expense?
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25372
   Posted 1/18/2009 11:05 AM (GMT -6)   
Realziggy, that's the part of the equation that is unfair, and sometimes seems radomly distributed. In my case, I lost my job due to downsizing in July of last year, as part of my severance, I was lucky enough to have a boss that continued the BlueCross on my wife and I for 3 months at his expense. During that 3 months, I had 2 prostate biopsies and got the dx for PCa. Starting November 2007, I had to start paying the COBRA at my own expense, but had to drop my wife off and we gambled that nothing terrible would happen to her. So when I had my surgery Mid-November, I was under the COBRA and still am. My wife, will be covered again at her Employer first of Feb, since they just had open enrollment. My COBRA and her payment are still cheaper togther then both of us under COBRA. Great sense that makes.

When I had my 3rd bout of cancer previous to PCa, the year 2000, took 3 surgeries and 36 days of intense radiation, I was working for a firm that was "self insured". Over a 4 month period, I ran up close to $200k in medical bills. It wasn't long after I recovered that the employer "laid me off" for some strange reason. I am sure my bills alone affected their bottom line.

Then I wonder, what if I were out of work and had no insurance, how would my PCa have been handled? What kind of option and treatments would I have been given? Just scares me to think about it.

David in SC
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - Had operation St. Francis - removed blockage, put in Cath #5, suppose to be removed 1/19/9
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 1/18/2009 11:39 AM (GMT -6)   
My sister just went through Cobra with her husband who has terminal COPD too. It's a nightmare as they try to get health care. It's partly the dumb american public's fault too looking back at 1992 with Hillarycare. Remember that nonsense when the hmos and drug companies advertising against it? People believed it and let it be stillborn. Think how much better it would be if just the initial groundwork for national health care had been laid down then. Now it's 16 years worse and we've become more and more like a third world country with our health care. Soon it will be only the rich and the bureaucracy who will be able to afford it or have it covered adequately.
Diagnosed 11/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
Not unexpected bounce after
the 80% drop the quarter earlier.
Along with urine flow readings, and
acceptable amount left in bladder measured
by sonic. Results  warrant skipping third
quarter tests, and to return 
April, 2009 for
final biopsy scheduled to
complete clinical research study 
 
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/18/2009 1:04 PM (GMT -6)   
Wow, I am learning alot about parameters on health care, by your stories and lifes that got change by way of another fork in the road, that said a person like myself can understand only a little of how difficult that is to cope with and handle and I hope nobody goes off the deep end on this or postal (although it would be understandable) .

A new patient without insurance, it changes the whole angle of how to proceed, limited funds and mobility to get there and little or almost nil for choices on what to do. Maybe someone herein knows of choices for the uninsureds that might be possible. I remember seeing that Paactusa.org had some assistance for patients atleast in the past.

 
Don you did what you personally could do and negotiate and seek options, kind of a pricing brawl, and apparently worked, so that is something others can learn from right now.
 
David what a story for having coverage
 
RealZiggy- kudos to you
 
 Doting Daughter-that is another sad scenario of having medical issues
 


 

Post Edited (zufus) : 1/18/2009 12:17:13 PM (GMT-7)

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