Anne Koller was diagnosed with late-stage colon cancer in 2011 and has been fighting it since.
But it鈥檚 not just the cancer she鈥檚 fighting. It鈥檚 the bills.
鈥淭hink of those old horror flicks,鈥� she says. 鈥淭he swamp creature 鈥� comes out and is kind of oozy, and it oozes over everything.鈥�
Anne Koller closes her eyes as an oncology nurse attaches an IV line of chemotherapy to a permanent port in her chest. Koller will spend 3 to 6 hours undergoing therapy (Photo by Sarah Jane Tribble/WCPN).
Koller, who lives in the Cleveland suburb of Strongsville, just turned 65 years old. She is petite and sports a stylish auburn wig. When she was able to work, Koller was in the corporate world and safely middle-class, with health insurance and plenty of savings.
But when she got sick, her high deductible health plan soon became a burden. And her monthly premiums kept increasing, reaching nearly double her mortgage payment. She soon found herself unable to keep up with the bills. They piled up.
鈥淵ou start looking at these bills,鈥� Koller says, 鈥渁nd, as much as you know it鈥檚 expensive, the shock itself is like, 鈥榃hat?鈥欌��
Her response was to begin asking her doctors about the cost of the treatments they recommended and whether there was a less expensive alternative.
Middle-income patients are 鈥� more than ever 鈥� feeling the pressure of that financial burden, , an oncologist at University Hospitals in Cleveland. He took over Koller鈥檚 care a couple of years ago.
鈥淧atients are weighing this in their calculus now,鈥� Meropol says.
high-deductible health plans and soaring prices for a new generation of drug therapies that came onto the market in the late 1990s.
Anne Koller was diagnosed with Stage 3c colon cancer in 2011. She has been fighting cancer and the medical bills ever since (Photo by Sarah Jane Tribble/WCPN).
鈥淲e went from drugs that cost a few hundred dollars for a course of therapy that might be a month or six months or a year, to drugs that were costing $10,000 a month,鈥� Meropol says.
Total cost of cancer care in the United States is projected to reach more than , according to the National Cancer Institute. The U.S. Centers for Disease Control and Prevention released a last year that found that, compared to people without a cancer diagnosis, cancer survivors are less likely to work and more likely to struggle financially. Another study, out of Washington state, found that the longer a cancer patient survived, the .
University of Chicago鈥檚 argues that it鈥檚 time for oncologists to begin considering the financial consequences as to cancer care.
鈥淲e talk about hair loss,鈥� de Souza says. 鈥淲e talk about numbness and tingling in the hands and feet. We talk about, 鈥楾his chemotherapy will cause low blood counts.鈥� Right. Should we also be talking about, 鈥榃ell, this chemotherapy is expensive?鈥� 鈥�
He and Meropol are part of a growing field of researchers studying the for cancer patients.
Anne Koller will tell you cancer does cause financial stress.
鈥淗ere鈥檚 what happens,鈥� Koller says. 鈥淚 was talking about that swamp thing 鈥� but you know, OK, you go to collections. You end up with a court thing. I had been talking to the hospital, asking for help 鈥� nothing, nothing. Finally, they went to a sliding payment scale.鈥�
Her credit is ruined. So she continues to drive an old car. Small expenses, like an Internet connection, are out of the question. And there are other challenges.
鈥淪ocially, things change a lot,鈥� she says. 鈥淵ou talk to people and, if you dare, say, 鈥楪od, you know, I can鈥檛 afford this,鈥� for instance.鈥� And there is little money for niceties, she said. If someone suggests, 鈥溾�楲et鈥檚 go out to lunch,鈥� on the day you can eat. You 鈥� think twice about it.鈥�
Koller says she wishes more financial information had been given earlier in her treatments. She is now using the very last of her savings to pay bills 鈥� and, still, some are going unpaid.
This story is part of a reporting partnership that includes , and Kaiser Health News.