Chemotherapy #7

And so it is that I find myself on the eve of chemotherapy session #8 having realized I never posted about session #7. It's become so normal and uneventful in most cases that this one just sort of scooted by. The real highlight of the session was having my mother, Anita, attend with Kim but even they fell under the spell of just-another-average-day and didn't even get a photo. Session #7 came and went and we probably didn't pay all that much attention to it because our eyes are on #8. Thursday November 17. 4 months later. Kim, I know is very excited. To celebrate we are off to see Hypnotic Brass Ensemble this evening at the Arlene Schnitzer Hall downtown; it's a family affair and somehow we are all excited. Should be a fun night.

So, what to say here? I've been thinking about what information might serve best for instructional purposes here and it's a touchy subject, bills. Money, of course, is of no concern when compared to someone's life but it is a reality we face. So here goes.

Every day our mailbox is filled with letters from the hospital or insurance company. There are letters to inform us of treatment services being considered for payment, letters confirming payment, and letters about the letters. Every letter has a privacy statement or some other insert, it's nuts how much paper they waste on telling us nothing. Some envelopes contain bills and, so far, they haven't been all that bad. We are fortunate to have insurance and we've been benefitting from the plan. The bills for all the early doctor's visits and procedures have been small though bills for CT scans and other big procedures stand out. The first chemotherapy bill arrived and the pre-insurance cost is $20k. That's for a single session out of 8 total. Insurance is picking up most of it though what's left is undetermined at present. I'll keep you posted but please know this is not an appeal for help, simply a heads-up on how much treatment costs. So much of this process is never spoken of and only discovered as it happens for those going through it. I'm hoping this blog helps demystify the process for anyone facing it in the future. 

I suspect the health care system is flawed though I won't go tin-foil hat conspiracy here on everyone. That said, why are the prices of cancer drugs so high and why have they gone up in price so much so quickly over the past few years? Drug companies refuse to discuss how they set prices and, under our current laws, they can charge whatever they want. Back in a previous post I wrote about a 22-year-old women in for her first chemotherapy treatment. Will she be forced to choose between a personal bankruptcy she can never emerge from or the best possible treatment to extend her life to its fullest? Hospitals and doctors are pushing back against pharmaceutical company pricing though I think we'll need stronger legislation to protect the people of this country. You should pay a premium for luxury items bought voluntarily, not life-saving medicine. I found this quote while doing some research:

"They are making prices unreasonable, unsustainable, and, in my opinion, immoral," said Hagop Kantarjian, MD, chair of the Department of Leukemia at the M.D. Anderson Cancer Center in Houston, referring to pharmaceutical companies and their cancer drugs.

Kim and I are also fortunate to have some guidance through this process and our most recent education was a very instructive meeting about insurance and bill paying. Very simply, don’t pay anything until it’s all said and done. The billing process is long and not perfectly connected so wait until all the facts are on the board before acting. The best advice I was given on the subject, “This is going suck.” And by “this” I mean the coordinating and tracking of bills and costs. With so much information bouncing back and forth between hospitals, doctors, and insurance offices there’s a lot of unconnected dots and it's my job to connect them.

Match explanation of benefits to services and costs, if there’s no match between numbers for the same visit/treatment, don’t pay the bill just yet. Sometimes it takes time for benefits to post properly between all offices so tracking everything is paramount. The concern here is paying something prior to the full cycle and discovering you paid too much. 

Again, money is a sensitive subject when it comes to someone's health, or life for that matter, but the expectation of a long life after treatment demands that attention be paid to ensuring our future best interests. The worst part of the money conversation is that the person under care often feels guilty for all the costs they are incurring. It's a normal reaction and one that shouldn't be dismissed without acknowledging that person's feelings. Kim will occasionally apologize for all this and I have to be gentle in reminding her there's nothing to apologize for. This is a fairly common relationship between the patient and the caregiver and especially, I believe, in the case where the patient is feeling good. So I am on the job of making certain it's all taken care of and that Kim does not feel any additional stress from the process. Still, there's a daily reminder in the mail for all of us that she has cancer and that there's $ associated with it. 

Kim will finish up chemotherapy tomorrow and then surgery in December. She'll need time to recover from surgery and to allow for the holidays so her radiation treatments will begin in January. For the insurance company that means a new billing year so we'll have to meet our deductible for an additional year. The insurance company is allowing us to change our plan to buy up to a lower deductible so that's a positive result of meeting with them and coordinating payment for care. Yeah, just writing about this seems unsavory, I trust it comes across as helpful. I'm looking forward to writing about session #8.

-Chris

The pink hair always attracts fans. We got to meet a few of the members of the band after the show at last night's Hypnotic Brass Ensemble show. Amazing, amazing performance. Such a great way to energize Kim for her final session. 

Kim's Halloween costume was so much easier this year because she could easily wear a wig. 

Comet continues his antics. How about a nap in the dryer?