Jay Lake (jaylake) wrote,
Jay Lake

[cancer] Following up on recent events, and more on costs

After a good night’s sleep for the first time in a week, I am happy to report that I saw my oncologist yesterday about the recent GI issues. As the day had gone by, my lower GI violence was abated in favor of a sullen ache, so we weren’t doing intervention so much as discussion. They did pull a full set of labs on me, and everything was, in her word’s, excellent. She commented on how healthy I was, beyond the obvious.

Among other things, this indicates that I was not suffering from a GI infection these past days.

I explained how things had gone since last Thursday night, and how desperate I was to have better control if they recurred. We discussed FOLFIRI, my recent diet, and medications. The oncologist was of the opinion that the basic problem is just life on FOLFIRI, but that I may have made it worse by consuming a lot of meat last week. (I was craving meat protein horrendously, so an unusually high percentage of my food intake had been meat.) I made a passing comment about loving cured meats and the link between nitrites and colon cancer. She pointed out that horse had left the barn a long time ago and I might as well enjoy bacon in moderation.

In the end, she prescribed a gas reducer, endorsed the use of kaopectate or other OTCs if I wished, and recommended papaya enzymes as a dietary supplement. She also asked me to eat more yogurt, bananas and pineapple, and to keep the meat content of my diet relatively low.

All to the better.

I was also forcibly reminded of the financial costs of this disease. Due to an unusual confluence of appointments, even with my fairly good insurance, my out of pocket costs for visit copays and pharmaceutical copays this week alone is over $200. That of course doesn’t count against my long-since-met annual out of pocket limitations on my insurance plan.

Think about that. I have done everything right. I have the privilege of being white, male and having a short English name. I have an excellent education, quite a good job, good insurance. And yet cancer is costing me as much as $200 per week in direct, hard costs. How would that hit your household budget?

This actually jibes with my overall estimate of cancer costing me about $10,000 per year. Most of that is healthcare direct, hard costs, a lot of which is front-loaded in the out-of-pocket limitations, but it’s also things like higher energy bills for keeping my house warmer than I would if I were not ill, extra transit costs for trips back and forth to medical appointments, and so on.

So who the hell can afford to be this sick? This eats up a significant percentage of my takehome pay. Even as someone relatively affluent who has done everything right by the American rules, cancer is slowly bankrupting me.

My friends in Europe and Australia and New Zealand aren’t forced to take unpaid leave or burn their vacation to be ill, and they aren’t forced to spend every spare dollar and more to meet the costs not covered by insurance. And their healthcare outcomes are as good or better than ours.

Tell me again why we don’t need a better system of healthcare finance?

Tell me again why ours is the best in the world?

This sucks in so many ways.

Originally published at jlake.com. You can comment here or there.

Tags: cancer, health, personal, politics

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