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The Financial Devastation of Cancer Treatment

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This is an important issue of concern for all Americans, when dealing with the often overlooked problem of surviving financially, as well as physically, when going through cancer treatment. This article was published in the San Francisco Chronicle. At the end of the article, I share my personal experience. Sarah Dees


by Victoria Colliver

Chronicle Staff Writer

San Francisco Chronicle, 2/6/09

“A cancer diagnosis can threaten anyone with bankruptcy and financial ruin, no matter what your earning power is ….There are many paths you take, but they lead to the same destination: loss of all resources.”

When Christine Franklin was diagnosed with breast cancer, she spent at least $7,000 in out-of-pocket medical expenses, but was able to continue working as a busy sales executive.

But when the disease recurred last year, she had to quit her job because of the debilitating side effects of her new medications. With her income greatly reduced, she was forced to sell her Vacaville home. Franklin, who pays the monthly premium for her former employer’s health coverage along with high co-payments for drugs and care, has stopped adding up the costs.

“When you have cancer, you not only lose who you were-your body no longer looks the same- but you can lose your job, and before you know it, it’s a slow spiral.” said Frankin, 57, who is divorced and lives on disability payments. “You feel yourself going down, like you’re sliding down a hillside and the earth gives way and you’re just grasping to hold on.”

A report released Thursday by the American Cancer Society and the Kaiser Family Foundation found that even those cancer patients fortunate enough to have private health insurance face severe challenges paying for life-saving treatments.

Hefty out-of-pocket expenses, high cost-sharing requirements, caps on benefits and lifetime maximums on some policies are among the factors that can contribute to financial problems and lead many people to resort to bankruptcy, the study found.

“You would at least think the health care system would work for the people who are sick,” said Drew Altman, president and chief executive officer of the Kaiser Family Foundation. “What this study shows is there are lots of gaps and holes and problems for the people who are the sickest in our society. That’s the opposite of how health care should work.”

In 2008, about 684,850 people under 65 were diagnosed with cancer, according to the American Cancer Society. The majority-estimated as high as 70 percent by at least one study-had private health insurance.


Rather than compiling statistics, the study profiled 20 patients whose experiences were representative of the types of problems reported to the American Cancer Society’s Health Insurance Assistance Center.

Of those profiled, nine had coverage through an employer, one paid for employer coverage, seven had individual insurance, two received coverage through a state high-risk pool, and one became uninsured.

The problems they experienced included delays in treatment as well as debt and stress. People who became too sick to work usually can continue their employer’s coverage for up to 18 months by paying the full premium, but the added expense of that coverage can pose a hardship because patients often are living on a reduced income.

Getting alternative coverage, even years after the diagnosis with no recurrence, can be a nonstarter. Insurers in the individual market routinely restrict applicants with a history of cancer. Public programs such as state high-risk pools or Medicare, which is available to those under 65 who are disabled, often have high costs and long waiting periods.


A 58-year-old Florida woman profiled in the study reached the $100,000 annual limit on her policy in 2007 after her breast cancer diagnosis. Jamie Drzewicki wound up amassing $75,000 in uncovered medical costs, a sum that was reduced to $30,000 after her hospital forgave some of the debt.

“I am a hard worker, and now I am making decisions between paying for my groceries and paying off some of my bills,” Drzewicki told the study’s researchers.

Tammy Witt, a 40-year-old mother of two from Ohio, initially was covered for her breast-cancer treatments with her employer’s insurance, but the company changed ownership and switched to a policy that had a meager $2,500 annual benefits limit. The strain contributed to her separating from her husband and eventually forced her into bankruptcy.

Another patient, 62-year-old Thomas Olszewski from Texas, has been cancer free for nearly ten years after his 1999 prostate cancer diagnosis, but is grappling with high premiums.

Now retired, Olszewski said he has a tough time affording his individual policy, which costs $437 a month and comes with a $3,750 annual deductible. He said he often delays lab work and follow-up care due to costs.

“A cancer diagnosis can threaten anyone with bankruptcy and financial ruin, no matter what your earning power is,” Peggy McGuire, executive director of the Women’s Cancer Resource Center in Oakland stated. “There are many paths you take, but they lead to the same destination: loss of all resources.”

Sometimes patients who lose their jobs eventually qualify for Medi-Cal, McGuire said. Others may be able to get help through resources like pharmaceutical patient assistance programs, which cover the cost of certain drugs.


Franklin, who was not part of the study, pays $450 a month to remain on her former employer’s plan while she waits to qualify for Medicare due to disability rather than her age.

She is relieved to have insurance, but struggles to pay $658.73 each month for a cancer drug that does not have a generic equivalent and $600 every three months for follow-up scans. She now has a $100 co-payment each time she sees her oncologist because her employer switched coverage and the doctor is not in the new physician network.

Franklin, a mother of two and grandmother of three, feels fortunate to be cancer free after a clear scan in December, but always has to steel herself for the possibility of bad news in her next round of tests.

Still, she manages to keep her sense of humor. Franklin considered the cost of all the treatments she’s had and compared herself to the Bionic Woman: “Sometimes you sit there and think: Am I really worth this?”

Email Victoria Colliver at Permission to reprint article has been requested. Article posted now for approval of author.

More information: the full study can be found on the Kaiser Foundation’s web site at

This article was published in the San Francisco Chronicle, on February 6, 2009. I share it here because I found myself in a similar situation.

Although I had full health insurance coverage through my former husband’s employer when I was hurt in an auto accident in 2002, and when I was diagnosed with colorectal cancer, the auto insurance and health insurance only paid the doctors and hospitals for medical bills. I was unprepared to face the financial costs that still had to be paid even though I was hurt or sick, such as medical bill co-pays, prescriptions, living expenses, and mortgage payments. I became a statistic, one of many who face financial devastation because they are simply unprepared to deal with those expenses. Like so many others, I found myself deeply in debt and nearly losing my home, which I had to mortgage to support myself and my daughter.

I am a professional artist, and I owned a successful wholesale art and picture framing manufacturing business for twenty years. Due to my injury from the auto wreck, I had to close my business, and in doing so, lost my income.

I went through a divorce, and bought a house by paying in full with cash from my lump sum divorce settlement. I worked for a year to renovate the house, to start over and create a comfortable new home for my daughter and me. Just when I thought I was about to get back on my feet again, a tumor was discovered, and I began my new full time job of being a cancer patient. Radiation treatments five days per week, and chemo drugs pumping into my heart 24 hours a day through a chest port, operated by a fanny pack pump worn around my waist, kept me in pain and too sick to work in any capacity.

After a year of cancer treatment and then a long period of recovery from the side effects of chemo and radiation, I hit the wall financially. I had borrowed all the money I could, and there was just nowhere else to go. I still had no income or means to begin repaying the debt. Although I had survived cancer, the stress and anxiety of all the financial struggles made recovery much more difficult, and the thought of returning to life completely overwhelming. I didn’t have a clue about how to “come back” from the financial devastation of cancer treatment. Financial survival seemed even more out of reach than surviving the disease.

When I began to regain my health, I was searching for new employment. It seemed too difficult to start over again and rebuild my art business from scratch, with no financial backing, and still struggling with chronic pain and chronic fatigue.

I’ve worked hard all of my life, and I always thought that I could work my way out of any problem. That had always been my method of handling any situation. It just never occurred to me that something would happen to me that could prevent me from being able to work.

Since fine art is a “luxury item” people can live without, I thought I would try making a living at something more suited to our “challenged economy”. So I studied and got my life insurance license and tried selling life insurance from January 2009 until May. My personality wasn’t really suited to that, tough, and it was a real joy when Michael Brittingham offered me a job working as an artist full time again, in the “Artist in Residence” program he said he was establishing. I’ve worked for wealthy people in the past, and it didn’t seem unlikely to me that I could be hired to work in my true profession again.

Brittingham told me that I needed to stop working in life insurance and devote all of my time to selling  off our furniture, packing up the rest of our things to put into storage, and getting ready to go with him to work in his new project. When he arrived, he said, we would take care of my financial arrangements, settle my debts with my creditors, rent my house to someone, and my daughter and I would be flying off with him to work in another location. From the end of May until he arrived at my house, that’s exactly what I did. I believed the persona he had created of being a wealthy, spiritually aware artist and businessman. I had no money anyone could take, and I just couldn’t imagine why a successful man like him would bother jerking around a person in my condition. It just didn’t make any sense. That’s why I didn’t suspect him of being dishonest.

My health insurance problems continue. After 36 months my Cobra insurance ran out. I was then  underinsured by the only minimal coverage I could afford. It provides for five doctors visits per year. That means quarterly visits for pain management meds I must have to function and one visit with my endocrinologist for my thyroid prescription. No doctor appointments left for cancer checkups. I haven’t been able to go for a checkup in a year and a half and I’m supposed to go every three months. I still owe Moffitt Cancer Center money. They’ve been kind about waiting to be paid, but how can I make another appointment I can’t pay for?

Thanks to Michael Brittingham I now have no health insurance at all. I had been scratching up $236.00  a month for the cheapest self-insurance I could buy. That was one of the urgent bills on the list I told him I needed to pay. Since he split the country without paying me the money he scammed me out of, I haven’t paid it and my insurance has been canceled.

All I have tried to do since I completed cancer treatment is find a way to get back to work, earn a living, and provide for my daughter and me.

Brittingham has written letters full of lies about my character. He wrote that I was irresponsible with money and had not paid my bills in seven years. He published these lies in his private groups.

Quite the opposite is true. I was seeking financial assistance in order to take responsibility for my debts, pay them off, and work for him to repay him. That was our agreement. Even when I had to close my business in 2002 after I was hurt badly in an auto wreck and I lost $50,000 out-of-pocket, I made sure every job was completed, every bill paid, and all accounts were handed over to a responsible associate. In twenty years of owning a business, I never had any complaints made against me, never went bankrupt, and I had good credit. I have a long list of people who were satisfied with my work, who would hire me again if they need art services.

Now I am seeking work again. I continue to strive for financial healing.

I have always put my heart into my work; it was easy to love creating art, and my heart went into each and every project. I’ve got my heart invested in making a positive contribution toward helping people too. Nothing is new about that. The list of community service projects I have done volunteer work for is as long as my list of paid professional projects.

I have learned a lot from this experience. I now work hard to raise awareness of the need to get tested early to detect possible colon-related cancers. A colonoscopy test done in time can save your life by preventing colon-related cancers from advancing to the point where they can become incurable. Don’t count on your doctor to tell you when to get the test done. Ask for it. Be proactive in taking good care of your health.

It’s also truly necessary to prepare yourself financially for the possibility of cancer or a long term critical illness. With statistics illustrating that one in three people will be stricken with cancer, and one in eight people will become seriously disabled during their prime earning years, it is clear that some kind of backup financial insurance is really necessary, not something that can be put off or overlooked. Don’t count on your basic group health insurance to meet your needs. It just won’t be enough. Invest in some additional insurance that provides cash payments to you directly. You’ll be so glad it’s there when you need it.

Thank you for allowing me to educate you about this very serious, often overlooked aspect of dealing with the dread disease of cancer.

Sarah Dees

I posted this story as a Discussion on a social – business networking site, and this comment was posted in response:

Sarah, thank you so much for sharing this story, and it is so very true. As a Senior Debt Consultant, I have been able to help people like this who have faced impossible medical expenses, by placing them into a “debt negotiation” program. One couple was facing over $2,000 monthly payments on debt from helping their daughter who had cancer. They both worked and faced the possibility of “never being able to retire.” In their “debt negotiation” program, they are now making payments of about $1,300 per month for 39 months, and then they will be done with the problem. These programs (2 different ones I represent based on state) are both lawyer-coordinated which is very important.

Thanks again!

Roger Foulks


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