Wednesday, June 10, 2009

Cancer Causes Personal Bankruptcy

From the Today show both financial expert Jean Chatzky and chief medical correspondent Dr. Nancy Snyderman discuss the disturbing truth about the healthcare crisis that those with insurance are going bankrupt, particularly with cancer diagnoses.

I particularly thought that Ms. Chatzky should be commended for calling attention to that fact that people do spend more time researching vacation rather than understanding their health insurance benefits! They neglect their health not understanding that having good health is the most powerful financial asset they own.

If you are healthy you can always earn more money. If you are ill, you can have all the money in the world and never get back good health. The public doesn't get the right preventive care 1/2 the time in this country. Cancer caught early can be less costly with better survival.

The complex relationship between the ability to pay and the ability to get well is only going to get worse. That's why I wrote my book Stay Healthy, Live Longer, Spend Wisely - Making Intelligent Choices in America's Healthcare System.

Medical costs are the leading cause of personal bankruptcy in this country. There is a financial reason that healthcare reform must occur. It is highly likely that President Obama will make it happen.

What it will look like is another story.


Liz B. said...

Dr. Liu,

A person with brain cancer, the post I see most often on the American Cancer Society message boards is "Why aren't full body CT scans part of an annual screening?"

My answer was that it was an expensive procedure that is probably useless in most cases.

But if insurance companies are balking at the cost of continually covering a patient's expenses, wouldn't they save money in the long run by providing these scans or tests in advance?

Davis Liu, MD said...

Great question. The answer is quite simple. There is no evidence that body scans save lives. For example, in the 1970s it was thought that doing annual chest xrays on smokers would improve lung cancer survival. So a study was done. It took a group of VA veterans all who were smoking and 1/2 the group got annual chest xrays and the other 1/2 no xrays.

The group that received xrays annually did find lung cancer growths in otherwise asymptomatic people. Although we patted ourselves on the back, did surgery, and gave them chemotherapy, the shocking part of the story came later.

This group did NO better in survival that the group that didn't get chest xrays. In other words smokers with symptoms of shortness of breath, weight loss, coughing up of blood, survived just as long as the group that was getting annual chest xrays.

Therefore this "screening test" of annual chest xrays did nothing. A good screening test identifies problems early and doctors and patients when aware of the problem earlier can do something about it and improve survival. Otherwise if it finds illness earlier but does not better than no screening test, it isn't helpful.

Body scans don't have any evidence of improving lives. An ongoing trial is underway to see if lung CT scans in smokers is better than chest xrays, results will be out in the next few years.

Also, body scans have radiation. A body scan could have radiation exposure equivalent to 200 chest xrays. Radiation, unnecessarily, is a risk factor for cancer as well.


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