Financial Toxicity Article on WSJ

[Gfunk6]

https://www.wsj.com/health/healthcare/cancer-cost-patient-debt-dd7c540c?mod=hp_lead_pos7

“It can cause this wealth shock that can ripple on,” said Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York, whose husband died of cancer over a decade ago. Debt collectors still call her about his unpaid bills.

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[Radadabbadoo]

Her employer isn't exactly running a charity either

 

[sloh]

47% had medical debt related to their cancer. 49% of debtors owed more than 5k. 98% were **insured** at the time debt was incurred. And just to throw salt on the wound, “Chemotherapy and other treatments can leave patients too weak to work for weeks or months. This can result in a twofold blow, with patients losing income and their employer-sponsored health insurance. The financial fallout can last for years.”

 

[OTN]

Financial toxicity is very real, and as a result ASTRO should encourage patients to see low-cost centers as opposed to NCI-designated cancer centers, which charge multiples of many other options available in the market. This will especially be important if ROCR is passed.

 

[deleted1180461]

People having to pay debts for services rendered. The horror. The government will take care of that for you if you vote for <insert name indirectly financed by billionaire xyz lender>

Her employer isn't exactly running a charity

Useful idiot - Wikipedia

en.m.wikipedia.org

 

[RickyScott]

the real financial toxicity is not the medical debt but the unseen global finanical impact. Take a New york City teacher with Cadillac insurance through the union. She may not owe a cent after undergoing treatment at mskcc with Dr. chino, but the union/city of New York pays 150 -200 k for the partial breast imrt and probably 5k for the ekg. That gets distributed to all of us.

I am not being facetious opining that the social harm from price gouging by the mskcc s and Mdacc s at, some price point, outweighs the good.

Mskcc apparently had their prices listed in (machine readable file format ? ) and they are consistently 10x cms.

 

[ramsesthenice]

the real financial toxicity is not the medical debt but the unseen global finanical hit. Take a New york City teacher with Cadillac insurance through the union. She may not owe a cent after undergoing treatment at mskcc with Dr. chino, but the union/city of New York pays 150 k for the partial breast imrt and probably 5k for the ekg. That gets distributed to all of us.

I am not being facetious when poining out that the social harm due to price gouging by the mskcc and Mdacc at some price point outweighs the good.

This is largely my thought as well. For people with reasonable insurance, even going to a less expensive community center will likely still mean maxing out their out of pocket expenses for the year(s). So they may not personally “feel” any difference. But like you said, it gets passed off rather than magically disappearing.

 

[RickyScott]

Financial toxicity is very real, and as a result ASTRO should encourage patients to see low-cost centers as opposed to NCI-designated cancer centers, which charge multiples of many other options available in the market. This will especially be important if ROCR is passed.

Rocr will have 0 impact on price negotiation. With 100% certainty, hospitals, if leverage permits, will charge multiples of the rocr price! Rocr does not stipulate that everyone will negotiate the same rate with private payors.

 

[medgator]

Rocr will have 0 impact on price negotiation. With 100% certainty, hospitals, if leverage permits, will charge multiples of the rocr price! Rocr does not stipulate that everyone will negotiate the same rate with private payors.

With enough local and overseas VIP cash pay business, why would the premier PPS-exempt centers ever stoop to taking Medicaid or MA plans? They don't need to be cheap for the average patient

 

[NotMattSpraker]

Financial toxicity is very real, and as a result ASTRO should encourage patients to see low-cost centers as opposed to NCI-designated cancer centers, which charge multiples of many other options available in the market. This will especially be important if ROCR is passed.

"Financial toxicity research" like "decarbonization research" is a tool that ASTRO abuses in the US to push more and more patients into self-proclaimed reference centers.

This might have been my recent favorite, what a joke (posting the rebuttal by Mark Storey, the only piece worth reading on this topic)

Market trends: A Rebuttal

A recent article made my blood boil. We'll look deeper and see if my gut was right or wrong.

protons101.substack.com

 

[RickyScott]

"Financial toxicity research" like "decarbonization research" is a tool that ASTRO abuses in the US to push more and more patients into self-proclaimed reference centers.

This might have been my recent favorite, what a joke (posting the rebuttal by Mark Storey, the only piece worth reading on this topic)

Market trends: A Rebuttal

A recent article made my blood boil. We'll look deeper and see if my gut was right or wrong.

protons101.substack.com

They redefine financial toxicity as the direct personal expense incurred by the patient. So if the insurance covers everything, there is no financial toxicity?

 

[NotMattSpraker]

They redefine financial toxicity as the direct personal expense incurred by the patient. So if the insurance covers everything, there is no financial toxicity?

Haha right. Its like how there is "no price" for proton therapy.

Patient's financial complaints about our health system are valid. If someone gives me an actionable way to make that better for patients (or my own family), I will start paying attention to "financial toxicity research" again.

Until then, I can sleep soundly knowing I dont publish propaganda, don't work for a PPS center, and work in a field that has a collective kink about being consistently under funded.

Does this make me eligible for one of those social media oncology awards?

 

[RadOncMegatron]

As I have said on here before, if Fumiko doesn’t make real change at MSKCC who I am sure is guilty of financial toxicity than she cannot be effective. I really hope she does promote change but it has to be done unfortunately at MSKCC first or else she will only be someone who uses financial toxicity to merely publish articles. Best of luck to her.

 

[RickyScott]

plenty of uninsured/badly insured patients/illegal immingtants receive keytruda for free or with no copayment. The patient assist programs work really well and pts are rarely saddled with any costs from the actual drug. Does this mean that the prices of IO are not financially toxic? Such an absurd line of thinking.

 

[NotMattSpraker]

As I have said on here before, if Fumiko doesn’t make real change at MSKCC who I am sure is guilty of financial toxicity than she cannot be effective. I really hope she does promote change but it has to be done unfortunately at MSKCC first or else she will only be someone who uses financial toxicity to merely publish articles. Best of luck to her.

I not sure why she is singled out. That paper has a number of people that I was surprised to see them on it. Id expect far better. This same logic can be applied to so many things in this field, including some of our clinical trials.

"Effective" is to publish research and get funding and get promoted. She is elite level effective. I bet lowering MSKCC revenue would be viewed as highly ineffective, maybe fireable.

I am not being facetious opining that the social harm from price gouging by the mskcc s and Mdacc s at, some price point, outweighs the good.

This is it. I stopped listening to researchers/teams that are being willfully ignorant about the reality of serious problems so that they can advance their own career.

I do not think it will get better until we change the definition of "effective".

 

[RadOncMegatron]

I not sure why she is singled out. That paper has a number of people that I was surprised to see them on it. Id expect far better. This same logic can be applied to so many things in this field, including some of our clinical trials.

"Effective" is to publish research and get funding and get promoted. She is elite level effective. I bet lowering MSKCC revenue would be viewed as highly ineffective, maybe fireable.



This is it. I stopped listening to researchers/teams that are being willfully ignorant about the reality of serious problems so that they can advance their own career.

I do not think it will get better until we change the definition of "effective".

Last time I checked she is very vocal and has built an academic career on this topic. I believe she is one of the main if not the main rad onc on this topic. We all know it’s a tough spot she is in because the financial toxicity work is good, but her own institution maybe one of the most financially toxic places.

 

[NotMattSpraker]

Last time I checked she is very vocal and has built an academic career on this topic. I believe she is one of the main if not the main rad onc on this topic. We all know it’s a tough spot she is in because the financial toxicity work is good, but her own institution maybe one of the most financially toxic places.

Probably the main oncologist on the topic.

This is what I’m saying though. To clarify, I was being a bit facetious before, this is not some moral thing keeping anyone up at night.

I don’t think she is in a tough spot, and that’s the problem… in my opinion… that many do not share 😂

It should be harder to sit at MSKCC and “advocate” against high costs, but instead it is rewarded.

 

[Chartreuse Wombat]

As I have said on here before, if Fumiko doesn’t make real change at MSKCC who I am sure is guilty of financial toxicity than she cannot be effective. I really hope she does promote change but it has to be done unfortunately at MSKCC first or else she will only be someone who uses financial toxicity to merely publish articles. Best of luck to her.

Dr Chino is moving to MD Anderson in the summer

 

[Mandelin Rain]

Dr Chino is moving to MD Anderson in the summer

 

[Radadabbadoo]

I'd rather work for Koong than Powell too.

 

[RickyScott]

shes probably sick of renting and having no savings.

 

[radoncftw]

shes probably sick of renting and having no savings.

financial toxicity of NYC

 

[seper]

By agreeing to comment at WSJ, Dr. Chino is giving her a soon former employer a farewell kick in the butt