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Medical costs can ruin a family's finances

Posted at 2:07 PM, Sep 26, 2015
and last updated 2015-09-26 14:07:24-04

Nearly  and most of those cases are tied to cancer.

With one in three Americans diagnosed with cancer in their lifetimes, someone you know will likely have to make some of these tough financial decisions.

The hospital room is familiar territory for Hunter Swain.

“It started three years ago, I was diagnosed with a different strain of leukemia,” Hunter said.

Months of her 13-year-life, she's been in the hospital, battling two types of cancer, overcoming blood clots and attached to tubes.

“They were all connected to an IV pump and I had around 11 medicines going at the same time,” Hunter said.

Each of those medications has an expensive price tag.

“The financial part never crossed my mind until I received that first bill in the mail and I saw just how expensive it really is,” Gary Swain said.

Hunter's dad took 18 weeks off work to support her through treatment.  They drive more than one hundred miles from Avon Park for her care at All Children's Hospital in St. Petersburg. Her siblings are staying with grandparents at home. Gary is paying for regular life expenses, along with medical bills.

“Then you're flooded with, oh boy, you know I'm going to have to pay 20% of this, this is going to take years and years and years and years to try to pay this off,” Gary said.

Many experts said, this cost of cancer treatment is a scary reality, including one of Hunter's doctors, Dr. Gregory Hale.

“Really their whole life is already consumed with their child's medical care and then when you add the stress of the finances of the family on top of that it can almost become unbearable for families,” Dr. Hale said.

Dr. Hale said chemotherapy drugs can be given different ways and that could affect how much you pay for them. Historically, intravenous drugs would be covered.

“In those cases insurance companies typically pay the vast majority of the cost however many of the newer targeted therapies are actually oral and can be taken as pills or liquids, those typically require a higher co-pay which is typically as much as 20-40% depending on the patient's insurance program,” Dr. Hale said.

The new medicines can be more efficient, but pricey.

“Some of these new medications, can cost $10,000 a month, then 20% of $10,000 is a substantial amount, especially when it can go on for months,” Dr. Hale said.

Some patients avoid treatment if they know they can't afford it.

“The head and neck patients who will come in with just very large cancers, rather than going to see their doctor as soon as they have a sore throat, they'll come in when they can't swallow anymore,” Dr. Lawrence Berk, the medical director of radiation oncology at Tampa General Hospital, said.

Dr. Berk said the biggest problem he sees is the difference between how much the drug costs to make and the price tag of the treatment.

“I think there's going to have to be some sort of rationalization, some sort of coming to grips with, you can't charge an infinite amount of money when people are desperate for survival,” Dr. Berk said.

Drug companies would argue they often spend more than a decade and over a billion dollars to develop each of these cancer drugs.

Social workers do help families find some coverage for the piece they'll owe.

As they wait for Hunter's bone marrow transplant, the Swains need any financial assistance available.

“Her bills overall have been well over a million dollars and no I could not imagine having to pay the whole million dollars, I mean that's no way, no way,” Gary said.

“I just know everything's going to be okay, it's just a feeling,” Hunter said.

Doctors say the best thing you can do if you or a family member is diagnosed with cancer is to talk to your healthcare team about your finances up front. They said there may be more than one way to treat the disease and they could each be covered differently by your insurance plan.