Re: More Cancer Patients Can't Afford Care

Thumper wrote:
On Fri, 6 Feb 2009 07:34:39 -0800 (PST), "rick++"
<rick303@xxxxxxxxxxx> wrote:

Chemo is like $2,500 a dose including medicine and clinic visit.
A full round of 6 - 10 treatments is pricy. Worse when drugs
were limited under insurance.


This afternoon I go in for my monthly infusion for Rheumatoid
Arthritis. I get to sit there with the Cancer patients that are
taking chemo. My infusion only lasts an hour and costs $2700 for 1
bag. Most of them are doing 4-8 bags of meds that takes several
hours. I deem to remember a figure more like $5000 and upward but I
don't know how many treatments or the time frame they were talking
about. I feel guilty after every infusion as I get up to leave while
they still have hours to go. I'm sure there are more than a few
people here that have a more intimate knowledge of this.

Thumper

Here is a post on cancer care in France that I posted on 07/09/08:


France At Forefront Of Free, Innovative Cancer Care
http://www.npr.org/templates/story/story.php?storyId=92362918

All Things Considered, July 9, 2008 · Annie Hubert has lived with cancer
for 14 years. She was first diagnosed at age 53, received treatment and
was declared cancer free. Then, four years ago, it came back, creeping
into her bones, liver and lungs.

Hubert goes to the Bergonie Institute, a cancer clinic in Bordeaux, for
her chemotherapy and other treatment. On the day we visited her, she
came to the clinic for a regular scan to check the size of her tumors.

"For four years, you know, these very regular checkups. I'm used to it,"
says Hubert. "It's just part of life. If I were 30, I suppose I would
see things differently. But I'm 67. So everybody has to die one day.
I'll probably die from this disease. I don't know when. I live with it."

Live with it she has, and as normally as possible.

Hubert is an anthropologist. She did her field work in Southeast Asia.
But after her cancer, she got a grant from the French government to
study how doctors communicate with patients.

"I am a good anthropologist because I am doing what the French call
'observation participant,'" she says with a laugh. "Nothing equals
experience to understand things."

Maybe it's Hubert's upbeat attitude that allows her to keep doing the
work she loves. But it's also, in no small part, thanks to France's
health care system.

Comprehensive Care

Everyone in France gets health insurance. When someone has a difficult
disease, such as cancer, the national health system steps in and pays
for 100 percent of the care.

Unlike in the United States, insurance in France is not linked to
employment, nor is there a lifetime limit on how much treatment a
long-term survivor like Hubert can get.

The guarantee of health insurance is the first reason why cancer experts
around the world look to France as a model for cancer treatment and
care. Another is that cancer care is well organized at the national and
hospital levels. To treat patients, a hospital or clinic has to prove it
meets national standards for high-level care. It must treat a minimum
number of patients a year, and it must use a team of doctors, nurses and
others to provide coordinated care.

These standards are found at the best cancer centers in the United
States, but they are set in national standards and required of all
hospitals and clinics in France.

In Bordeaux, Hubert has one doctor, oncologist Marc Dublet, who has been
in charge of all her care since her surgery. She can call Dublet anytime
with any question or concern.

French doctors traditionally have simply told patients what to do, but
that's changing.

"Now we discuss more and more with (the) patient and we decide together
what treatment to do," says Dublet.

Hubert says she appreciates that she's not treated like "an illiterate
something" and that her doctors listen to her.

Nor has Hubert had to fight with insurance companies or worry about
getting access to her expensive therapies, a third reason why French
health care stands out.

"Never ever. For any. Which is incredible," says Hubert. She knows the
value of such care because friends in America with cancer have noted the
difference. Hubert also has an American son-in-law in California who has
multiple sclerosis. He and her daughter have good insurance, Hubert
notes. Nonetheless, they spend several hundred dollars a month for his
treatment.

France guarantees that every cancer patient can get any drug, including
the most expensive and even experimental ones, says Dr. Fabian Calvo,
deputy director at the relatively new National Cancer Institute.

"As soon as there is a breakthrough," he says, referring to signs that
the drug is safe and effective, "even if the drug has not obtained
(government) approval, you can get access for that."

The national health insurance system pays for even the most expensive
drugs. Access to any medication is one reason a study this year rated
France the best among industrialized nations at preventing avoidable deaths.

The United States came in last.

Room To Improve

Until recently, France lagged in some preventive care. However, four
years after the cancer institute started a campaign to increase free
screening, the number of women over 40 who get free mammograms has
doubled to 60 percent.

The newest government campaign, started this year, urges people 50 and
older to get colonoscopies. Calvo, who runs research programs at the
institute, estimates that for every million people who get a
colonoscopy, doctors will detect about 6,000 tumors.

"As it is early tumors, we could cure the major part of these patients,"
he says.

Still, that new emphasis on screening came too late for some, such as
Brian Coote. Three years ago, Coote and his wife, Julie, retired early
and moved from outside London to southwest France. From their old stone
farmhouse on a hill, Coote looks across the farms of the gently rolling
Dordogne Valley.

He's 57, athletic and an avid hiker. In spring 2007, he started having
stomach problems. At first, his rural general practitioner dismissed it
as nothing serious.

"The end of June, I'm doing a big walk in the Pyrenees Mountains," he
recalls. "And I had to stop after three days and come home. And that
sort of said, well, there's something here that's not normal for me. "

It took until mid-September to get the diagnosis that should have come
months earlier: He had colon cancer. Coote faults his first doctor. But
he says once he got to a surgeon, he has received excellent care.

Now, there's even a nurse who makes home visits. She drives all the way
to the farmhouse.

"She knows me well," says Brian. "When I came out of hospital after the
operation, she was here every day to check the dressing."

"She also comes to do a blood test just before the chemo," Julie says.
"If chemo is on a Monday, she comes on a Saturday to take the blood test."

Coote's care is designed to keep his life as normal as possible. Earlier
in the week, Julie drove him to the hospital for his chemotherapy. Some
of it is delivered over several days through a small pump — about the
size of a lemon — connected through a catheter to his chest. Back home,
a few days later, he took a long hike on country roads with the pump in
his pocket. When the chemo was over, the nurse arrived to disconnect the
pump.

The Cost of Care

In a country that's so generous, it's hard to control rising health care
costs. Last year, the National Health Insurance fund ran a deficit of
nearly $9 billion. President Nicolas Sarkozy's government looked for
ways to cut costs.

Last fall, just as Coote began his treatment, the government announced
it no longer would pay for foreign retirees' health care. They would
have to buy their own private insurance. But Coote knew that with
cancer, he wouldn't find anyone to insure him.

"I didn't want to think about it too much, especially during that
October through November period (when) I was doing chemo and radio at
the same time," he says. "I did in the back of my head kind of think
this is ludicrous. They cannot possibly do it. It means that people are
going to die."

Some 200,000 British expatriates live in France, according to the
British Embassy there. Their numbers give them power. They petitioned
and protested.

In January, the government reversed itself.

Many British expatriates say they live in France, in part, because they
don't trust the British health care system. Coote isn't one of them, but
he does appreciate the health care he has received since his surgery in
France. It allows him to continue to live the life of his choice in this
stunning corner of the world — even as he battles a difficult cancer.

Related NPR Stories

*
July 2, 2008
Taking The Measure Of Health Care In America
http://www.npr.org/templates/story/story.php?storyId=92136549

*
July 2, 2008
France's Model Health Care For New Mothers
http://www.npr.org/templates/story/story.php?storyId=92116914


The United States spends an average $6,402 per person annually on
medical care. France spends about half that — while providing better
maternity benefits and complete coverage for people with conditions such
as diabetes and cancer. Compare the systems.
http://www.npr.org/news/specials/healthcare/healthcare_profiles.html


--
Civis Romanus Sum
.

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