$132,000/year cancer drug. Guess who’s paying for it?

Retired business journalist tells his story in the New York Times.

Former Money Magazine editor Frank Lalli

Former Money Magazine editor Frank Lalli

On 12-1-12, I noticed a story by Frank Lalli, entitled A Health Insurance Detective Story. He was writing about the nightmare endured while trying to figure out how he was going to pay for his cancer medication after the coverage by his former employer (Time Warner) finally ended.

His story was all about the incredible hassle one must face in dealing with an extremely complicated and bureaucratic system. As he said:

If a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

As he told his story of detail, hassle and endless red tape and paperwork—I was hearing a different story. The one about who actually pays for our medical bills in this country. Frank documents his ordeal very well—over 70 phone calls to 16 organizations in just a few weeks.

Would you believe $524 per pill?

Would you believe $524 per pill?

In Mr. Lalli’s case, the annual cost of his cancer drug had been running $132,000 a year ($524/pill)—but his out-of-pocket exposure had been $1,000—less than one percent of actual cost of the drug. Time Warner was picking up the balance. Now, he was being told that his $1,000 out-of-pocket deal had been eliminated.

Ultimately, after all those phone calls and endless stress, he ended up with an even sweeter deal than he had before—he would now be paying just $60/month for his cancer drug—Leaving $131,280 to be paid by the rest of the system.

My concern is about who pays for the other 99.5% of the cost of his drug.

The rest of the system includes individuals, employers, U.S. government and state governments. But regardless of which one of those four actually cuts the final check, the cost is eventually felt by all of us individuals in the system. In total, our cost of health care is now $2.8 trillion or almost $9,000 for every man, woman or child in the United States.

This pile of $100 bills wouldn't pay half of the annual cost of Mr. Lalli's cancer drug.

This $50,000 pile of $100 bills wouldn’t pay half of the annual cost of Mr. Lalli’s cancer drug.

The real issue here is that our entire system is one big money game. We put the cancer industry on a pedestal as the great savior who is out there searching for the cure. But, they’re really an industry bent on making money—like any other industry that sells a product.

In Mr. Lalli’s case, he was probably never told about the lifestyle issues that probably caused his cancer in the first place. There is no money to be made in that kind of business.

He probably never realized that up to 80% of our health care dollars are driven by what we choose to eat. Although he was lucky in finding a $60 a month solution to his cancer drug dilemma—his good luck resulted in the rest of us sharing the remaining $10,106 per month.

I attended an Advanced Study Weekend at Dr. McDougall's California facility in 2007---the same site where Whole Foods CEO John Mackey brought a large group of his associates.

Check out the link below for Dr. McDougall’s explanation of his innovative insurance idea.

This is the reason why our cost of health care is so high—and this is simply not fair to the portion of the population that has chosen to take charge of their own health. We shouldn’t have to pay the medical bills for those who have not made that step.

Like Dr. John McDougall says, we need our own health insurance formula—one that does not offer many of the medical services that have been deemed unnecessary for people who choose to eat an optimal diet.

Consecutive daily blogs

Consecutive daily blogs

The second link below contains my blog about Dr. John McDougall’s innovative insurance idea. It also contains a one-hour video, in which Dr. McDougall shares all of his thinking.

Handy 4-piece take-charge-of-your-health kit—from Amazon.com

Want to find out how healthy your family is eating? Take our free 4Leaf Diagnostic Survey. It takes less than five minutes and you can score it yourself. After taking the survey, please give me your feedback as it will be helpful in the development of our future 4Leaf app for smartphones. Send feedback to jmorrishicks@me.com

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J. Morris Hicks, working daily to promote health, hope and harmony on planet Earth.

For help in your own quest to take charge of your health, you might find some useful information at our 4Leaf page or some great recipes at Lisa’s 4Leaf Kitchen.

Got a question? Let me hear from you at jmorrishicks@me.com. Or give me a call on my cell at 917-399-9700.

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Blogging daily at hpjmh.com…from the seaside village of Stonington, Connecticut – Be well and have a great day.

—J. Morris Hicks, board member, T. Colin Campbell Foundation

About J. Morris Hicks

A former strategic management consultant and senior corporate executive with Ralph Lauren in New York, J. Morris Hicks has always focused on the "big picture" when analyzing any issue. In 2002, after becoming curious about our "optimal diet," he began a study of what we eat from a global perspective ---- discovering many startling issues and opportunities along the way. In addition to an MBA and a BS in Industrial Engineering, he holds a certificate in plant-based nutrition from the T. Colin Campbell Center for Nutrition Studies, where he has also been a member of the board of directors since 2012. Having concluded that our food choices hold the key to the sustainability of our civilization, he has made this his #1 priority---exploring all avenues for influencing humans everywhere to move back to the natural plant-based diet for our species.
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1 Response to $132,000/year cancer drug. Guess who’s paying for it?

  1. CJ says:

    Jim, thanks for bringing up this question. The showering of our country’s resources, our tax dollars, to Big Pharma is nothing short of insanity. How much better these funds could be spent on true health-*producing* programs, quality healthcare for all, infrastructure, etc., which are critically needed. Congress only talks about how we need to cut essential senior and safety-net programs like social security and medicare… there is never even a mention of a reduction in our insane military budget, which sadly remains untouchable. So much good could be done with just a miniscule percentage of that. Let there be peace on earth… hope you have a Merry Christmas.

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