Posts Tagged - ‘cancer’

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Your Health Coverage Can Be Canceled for One Penny

Friday, July 9th, 2010


Image: stevendepolo under CC 3.0

In order for your coverage to remain secure, it is essential to pay every single penny of your health insurance premium–literally.

A woman with cancer lost her job, but got COBRA to continue her group health insurance benefits. Last year’s stimulus package gave her a 35% subsidy to help cover the cost. However, her insurance company never sent her the reduced bill.

Therefore, she calculated the smaller amount herself and sent in the premium. Unfortunately, the insurer’s calculations didn’t agree: they said her payment should be one cent higher. As a result, they canceled her plan entirely for nonpayment! She was unable to send a check for $0.01 because she was in the hospital undergoing chemotherapy at the time.

The good news is that they eventually overturned their decision and reinstated her coverage.

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When Health Insurers Pay For Overtreatment

Monday, June 7th, 2010

Image: Photos8.com

Overtreatment is commonly considered as health care services that are provided when they aren’t necessary. It has been criticized as one of the factors that made healthcare reform a serious priority.

For example, MRI scans are often performed on people with low risk. Since such tests aren’t completely accurate, some people have back surgeries that could’ve been avoided. Those individuals, whose conditions may have improved through other means, may then require more surgery in a decade.

Other examples abound, including the cumulative levels of radiation absorbed through a high number of CT scans–which is linked to increased risk of cancer. Affordable health insurance becomes harder to find due to this overspending. The worst part is that there have been few studies that determine which common procedures are needed and which ones could be scaled back without hurting health outcomes or creating fears of rationed care.

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Connecticut Health Insurance Reform Continues

Tuesday, May 25th, 2010

Image: State Symbols USA

It may not receive the publicity of other early reform adopters like Massachusetts, but Connecticut health insurance companies–as well as the government–have been ahead of the nation in enacting strategies to increase access while cutting costs.

Recently, they created the Connecticut Clearinghouse as an online health insurance market that allows consumers to better compare their options. The state also enacted healthcare reform (similar to the federal bill) that forces insurers to offer more transparency to consumers when buying. Small businesses are also now allowed to buy prescription drugs for their employees through the discounted plan for public employees.

In addition, Connecticut now requires coverage parity for cancer medications: oral medications will be covered as fully as those administered through IVs. The former are more convenient, but often more expensive. If coverage is denied, patients have access to health care advocates to help them through the appeals process.

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Some Health Insurers Don’t Cover Oral Cancer Drugs

Friday, April 30th, 2010

Image: CarbonNYC under CC 3.0

Battling cancer is hard enough, but when your health insurance plan refuses to pay for a more convenient and less daunting treatment, it’s even worse. Although “chemo parity” laws are pending in several states as well as Congress, there is still a lot to be done.

Many health insurance companies will not cover oral chemotherapy drugs that may cost up to $4,000 per pill, since less expensive IV treatments are available. The latter require more of the patient’s time, transportation, and have more side effects. They are also susceptible to leaks and other problems that cause emergency room visits!

Why does this happen? Oral cancer drugs are often classified as prescription medication benefits, which tend to be far less generous than medical benefits (such as intravenous surgery). For their part, health insurance providers blame Big Pharma for putting such a high price tag on the pills to begin with. Pharmaceutical companies, on the other hand, claim that the high prices are necessary to recoup their research and development costs.

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More Medical Care Isn’t Always Better

Monday, April 12th, 2010

Image: Laughing Squid under CC 3.0

When it comes to holding down health insurance plan costs, it is generally agreed on that a main factor is the sheer amount of utilization of medical care. Innovations in technology have resulted in significant improvements in life expectancy, but many believe that there are times when health care services are overused.

Obviously, nobody wants to forgo screenings or treatment when it’s necessary. However, there are some times when they can do more harm than good. For example, the risk of radiation from repeated colonoscopies, mammograms and CT scans can add up, while doing relatively little to catch cancer early in most patients under a certain age. Some believe that lifetime exposure can even increase a person’s risk of cancer!

Why is medical care often overused? Patients often demand it, and doctors may take the path of least resistance. Physicians may also be worried about being sued for medical malpractice in the worst-case scenario; doctors are more likely to be sued if they are perceived to not have done enough. Also, doctors tend to be paid on a per-procedure basis, giving them an incentive to perform more tests and procedures. No matter what, the cost is paid for by your health insurer, and passed onto you through more expensive health insurance premiums.

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Poorer Girls Dying of Preventable Cancer

Friday, March 19th, 2010

(Image: Zef Delgadillo under CC 3.0)

Poorer girls are not getting a vaccine that would save their lives because they can’t afford it.

Mississippi and Arkansas, two of the nation’s poorest states, also have the highest death rates from cervical cancer. The reason is many girls who live in both states don’t have affordable medical insurance, and as a result don’t receive health screenings, and basic care.

The cancer prevention vaccine, Gardasil, is administered a lot more frequently in wealthier states, and the impact is quite evident. In the wealthier state of Rhode Island, cervical cancer mortality is half as high as in Mississippi and Arkansas, 55% of girls received Gardasil.

The only hope for improving such inequalities is in the government. Congressional leaders are slated to vote on a health bill this weekend. If passed, the government will cover the cost of insurance for millions of people without good health coverage.

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