The “financial toxicity” of cancer

We’ve all heard the phrase “cancer kills.”

But guess what? So can the high cost of treatment.

I just read about a study that came out of the Fred Hutchison Cancer Research Center here in Seattle.

The results won’t surprise anyone familiar with how much cancer treatment costs (a lot!), but researchers found:

…cancer patients who go bankrupt are nearly 80 percent more likely to die than patients who don’t, and some cancers had significantly higher mortality rates. Prostate cancer patients who filed for bankruptcy were almost twice as likely to die; bankrupt colorectal cancer patients were 2.5 times more

Continue reading

Overuse of CT scans is dangerous and expensive

I read two articles yesterday that complemented each other:

In Kaiser Health News (KHN) Heavy Use Of CT Scans Raises Concerns About Patients’ Exposure To Radiation

And on KevinMD two radiologists posted The financial costs of treating CT-induced cancer

Each underscores the fact that CT scans are significantly overused in American healthcare.

Although CT scans are an essential diagnostic tool, the Food and Drug Administration reports that an estimated 30 to 50 percent of imaging tests are believed to be medically unnecessary.

Considering we spend tens of billions of dollars every year on diagnostic imaging, that’s a lot of wasted … Continue reading

Health insurance literacy – It’s not easy

Health insurance literacy is a term that has been used a lot in the media since the Affordable Care Act (ACA) rolled out a few years ago.

It basically means how fully a person understands how his or her health insurance works, as well as the lexicon of insurance-speak: words and acronyms like coinsurance, copay, deductible, premium, subsidy, provider, allowed amount, out-of-pocket maximum, balance billing, HSA, FSA, HMO, PPO, EPO, PCP, and so on.

If only people understood their health insurance, the experts moan, they would make better health choices and protect themselves financially.

I’m sure that’s true, but … Continue reading

Antibiotics still overprescribed

antibioticsThe overuse of antibiotics continues to be a big problem in this country, and do you know who doctors blame? The patients.

That’s right. Doctors know that antibiotics don’t work against the common viruses that cause colds, flu, coughs and sore throats, but many admit they prescribe them anyway when patients ask for them.

In a five or ten minute office visit, doctors don’t feel they have time to explain the difference between a virus and a bacteria, and how overuse of antibiotics causes the very real problem of antibiotic resistance. So they do what’s easiest, fastest, and results in … Continue reading

The high cost of dementia

November is Alzheimer’s Disease Awareness Month.

It’s hard to find anyone who isn’t aware of—and scared of—dementia**. Or who hasn’t had a family member or friend stricken by it.

Alzheimer’s is a horrible disease that damages not only the individual, but family and friends, as well, especially the primary care giver—most often the spouse.

Adding insult to injury is the incredible cost of getting help. A recent study published in the Annals of Internal Medicine confirms what many already know—Alzheimer’s disease and other forms of dementia cost families way more than almost any other disease.

Why? Cancer is one of Continue reading

Cost sharing and narrow networks

It’s that time of year—open enrollment for health insurance.

If, like me, you buy an individual health plan for yourself or your family, and you have been informed by your insurance company that your current plan will no longer be available, you are once again shopping for a plan that meets both your needs and budget.

The new plan I’ve been offered has both a higher premium and a higher deductible, but as far as I can tell our provider network will remain the same. That’s important, since my husband has a doctor he really likes. I had to change … Continue reading

Sad but true – CYA medicine works

A few months ago I posted about CYA—Cover Your Ass—medicine being one reason why too many diagnostic tests are ordered and health care costs are high.

CYA medicine is when the doctor or doctors are pretty sure what your problem is, but they order extra scans and x-rays and blood tests anyway because “failure to diagnose” is one of the leading causes of medical malpractice suits. They aren’t going to take any chances, and who can blame them?

Related story from KevinMD: This is why doctors practice cover your ass medicine

Besides, they don’t pay your resulting medical bill, so … Continue reading

Nursing shortage infographic

I was invited to share this very interesting infographic on the looming shortage of nurses in this country.

The last of the baby boomers will reach retirement age in 2029. Although baby boomers can expect to live well into their 80s and 90s thanks to healthier lifestyles and modern medicine, they won’t be without chronic health conditions like heart disease, high blood pressure, diabetes, arthritis, and early dementia.

That will put a strain on the health care system, as there is already a growing shortage of doctors and nurses. And as more highly-trained nurses take on the role of primary … Continue reading

Confused by mammogram guidelines?

October is Breast Cancer Awareness Month, so I can’t let it pass without commenting on the American Cancer Society’s (ACS) recently updated screening mammogram guidelines.

Before, the ACS recommended annual mammograms starting at age 40.

Now they recommend annual mammograms for ages 45 to 54, with screening mammograms done every other year after age 55.

But, they add, women should still have the choice to start screening at age 40 and have yearly mammograms thereafter.

The confusion arises not only because the ACS is a bit wishy washy on its guidelines, but because the American College of Obstetricians and Gynecologists … Continue reading

The overuse of antidepressants

I know so many people taking antidepressants. And they talk about it quite openly, with me and with each other.

“What are you taking? Zoloft? Oh, I tried that but didn’t like it. Celexa works better for me.”

I’m sure none of these people went to his or her (mostly her) doctor and got a prescription for no reason whatsoever. But it’s pretty hard to deny that antidepressant use in this country has skyrocketed over the last two decades, which begs the question: Is everyone really that depressed?

No. A recent study in The Journal of Clinical Psychology looked at Continue reading

What if Your Hotel Bill Was Like a Hospital Bill?

I couldn’t help but laugh when I ran across this video from Costs of Care: What if Your Hotel Bill Was Like a Hospital Bill?

I swear I recently had a very similar conversation with a health insurance company regarding the cost of a new wheelchair for my elderly aunt!

Although insurance covered the bulk of the cost (well over $5,000) my aunt still owed close to $2,000. The bill had a list of about 20 items related to the wheelchair, but neither side admitted to knowing anything about exactly what each charge was … Continue reading

The shingles (herpes zoster) vaccine

shingles herpes zosterA painful but common condition in older adults is shingles or herpes zoster. I’ve known several elderly people afflicted with this, and I will absolutely get the vaccine as soon as I turn 60!

The vaccine, Zostavax, is FDA-approved for ages 50 and up, but the Cleveland Clinic recently advised that it’s not cost effective for anyone under 60 to get immunized.

Why? Because Zostavax is too expensive. On average, it costs about $200, and that doesn’t include the cost for the office visit or vaccine administration that some clinics charge.

The vaccine is effective for 10-12 years, so … Continue reading

Another drug skyrockets in price

A year ago I posted about the worrying trend of generic medications—a mainstay of affordable health care—rising in price by 100%, 200%, 1000% or more. My husband’s levothyroxine, for example, has increased in price by over 600% since 2013.

The common and used-to-be-dirt-cheap antibiotic, doxycycline, has gone up a whopping 6,000%!

Unfortunately, this trend has not stopped.

The latest old-drug, new-price story is that of Daraprim (pyrimethamine). Last month Turing Pharmaceuticals bought this drug and immediately jacked up the price from $13.50 per tablet to $750, an increase of over 5,000%.

The New York Times, I think, had the … Continue reading

A less expensive option for Diclegis

January 2017: Important update on Diclegis! A medical journal recently published a paper questioning the safety of Diclegis, or at least raising concerns about the quality of the research behind its FDA approval.

Although the components of Diclegis can be easily purchased over the counter, as my post shows, it’s very important that ANY drugs taken during pregnancy be OK’ed by your obstetrician first. FN

I don’t usually pay much attention to media’s almost 24/7 coverage of all things Kardashian, but it’s been hard to miss the news tidbits about Kim Kardashian’s second pregnancy.

And to those that follow her … Continue reading

Is it wise to remove wisdom teeth?

I participate in a world-wide group of health care providers that exchanges information about the high costs of health care and overtreatment in our respective countries. (It’s not just an American problem!)

One provider recently shared for our consideration a paper that stated too many third molars (aka wisdom teeth) were being unnecessarily removed in the US.

Ten million third molars (wisdom teeth) are extracted from approximately 5 million people in the United States each year at an annual cost of over $3 billion.

In addition, more than 11 million patient days of “standard discomfort or disability”—pain, swelling, bruising, and

Continue reading