50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
billy269
Posts: 82
Joined: Mon Nov 18, 2013 2:50 pm

50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by billy269 » Mon Oct 22, 2018 11:34 am

I happened to see this terrifying headline today. Bills average $92,000/yr. Goes to show the importance of not just having health insurance, but quality health insurance without caps or exclusions.

https://www.dailymail.co.uk/health/arti ... years.html

Nate79
Posts: 3604
Joined: Thu Aug 11, 2016 6:24 pm
Location: Delaware

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Nate79 » Mon Oct 22, 2018 11:57 am

I don't know, the numbers seem a little sensational. According to this site:
According to a 2013 study in the American Journal of Clinical Oncology, for Americans newly diagnosed with cancer, the annual economic burden was $16,000 per person. Cancer bills have been a leading cause of personal bankruptcy in the U.S and a third of survivors report ongoing financial burdens after cancer. Often this is a result of stopping work, which 85 percent of cancer patients report.
https://www.curetoday.com/community/kat ... ith-cancer

To keep this actionable how does one protect themselves from this financial threat?

Rupert
Posts: 3740
Joined: Fri Aug 17, 2012 12:01 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Rupert » Mon Oct 22, 2018 12:01 pm

Nate79 wrote:
Mon Oct 22, 2018 11:57 am
I don't know, the numbers seem a little sensational. According to this site:
According to a 2013 study in the American Journal of Clinical Oncology, for Americans newly diagnosed with cancer, the annual economic burden was $16,000 per person. Cancer bills have been a leading cause of personal bankruptcy in the U.S and a third of survivors report ongoing financial burdens after cancer. Often this is a result of stopping work, which 85 percent of cancer patients report.
https://www.curetoday.com/community/kat ... ith-cancer

To keep this actionable how does one protect themselves from this financial threat?
The difference between the two figures may be one just counting medical expenses during the crisis and the other counting all the extras, e.g., home care, lost wages, etc. Anyway, to answer your question, one way is to purchase adequate disability insurance.

billy269
Posts: 82
Joined: Mon Nov 18, 2013 2:50 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by billy269 » Mon Oct 22, 2018 12:13 pm

Rupert wrote:
Mon Oct 22, 2018 12:01 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
I don't know, the numbers seem a little sensational. According to this site:
According to a 2013 study in the American Journal of Clinical Oncology, for Americans newly diagnosed with cancer, the annual economic burden was $16,000 per person. Cancer bills have been a leading cause of personal bankruptcy in the U.S and a third of survivors report ongoing financial burdens after cancer. Often this is a result of stopping work, which 85 percent of cancer patients report.
https://www.curetoday.com/community/kat ... ith-cancer

To keep this actionable how does one protect themselves from this financial threat?
The difference between the two figures may be one just counting medical expenses during the crisis and the other counting all the extras, e.g., home care, lost wages, etc. Anyway, to answer your question, one way is to purchase adequate disability insurance.
I currently have (I think) decent insurance through my employer. But obviously, if I get cancer and lost my job, I will not have insurance. Is there where disability insurance comes in? How much does that usually run?

User avatar
bottlecap
Posts: 5857
Joined: Tue Mar 06, 2007 11:21 pm
Location: Tennessee

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by bottlecap » Mon Oct 22, 2018 12:19 pm

Don't be terrified. It's a very misleading headline and an only slightly less misleading study.

JT

Nate79
Posts: 3604
Joined: Thu Aug 11, 2016 6:24 pm
Location: Delaware

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Nate79 » Mon Oct 22, 2018 12:21 pm

A quick search on LTD and cancer brought up this article from NOLO:
https://www.nolo.com/legal-encyclopedia ... efits.html

Getting LTD to cover cancer seems to depend on the terms of the LTD and the severity of the condition - basically whether you can work in your own occupation or any occupation depending on terms.

Another article on options for disability:
https://www.breastcancer.org/tips/your_job/time_off

So, short term and long term disability. Possibly FMLA. Health insurance and emergency fund.

What is not clear to me is are there out of pocket medical costs that insurance doesn't cover that is driving up these costs reported in the original article?

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 12:22 pm

bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.
JT
Seems that way to me as well.

It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.

texasdiver
Posts: 2719
Joined: Thu Jun 25, 2009 12:50 am
Location: Vancouver WA

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by texasdiver » Mon Oct 22, 2018 12:26 pm

Well.....kind of depends on what constitutes "life savings" doesn't it?

The median "life savings" for US households is currently $11,700 and 29% of US households have less than $1,000 saved. So nearly 30% of American households will "burn through" their life savings just to buy a new appliance or put new tires on their car.

https://www.magnifymoney.com/blog/news/ ... n-savings/
Last edited by texasdiver on Mon Oct 22, 2018 12:43 pm, edited 2 times in total.

doss
Posts: 194
Joined: Tue Nov 01, 2011 9:52 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by doss » Mon Oct 22, 2018 12:28 pm

bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.

JT
As someone that had cancer in the recent years, the headling was terrifying because I am trying to save for early retirement. I have a constant internal battle with myself as to whether I will get to retire early...and if not, what's the point of trying working hard and trying to save all this money? I am in my late 30s and still have a long time to go where anything can happen. Every little ache or back pain these days worries me because I am wondering if that's the cancer that may be coming back.

Your simple words gave me comfort.

Dottie57
Posts: 4671
Joined: Thu May 19, 2016 5:43 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Dottie57 » Mon Oct 22, 2018 12:28 pm

No, this is misleading.

I had a co-worker with stage4 cancer. Disability kicked in for about 5 months while drs were working on the diagnosis and coming up with a treatment plan. After chemo was started and he knew how it would go, he returned to work 4 days a week.
So people can work while being treated for cancer. He had no complaints on healthcare coverage.

So you need a good emergency fund, disability, healthcare insurance, loving family and friends.

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 12:38 pm

There are large numbers of folks who have had cancer where the costs are fully covered by health insurance and fully dealt with using sick leave from work. While there is no "good" kind of cancer, the type I had 30+ years ago was dealt with by surgery and regular followup. I only missed about a week and a half of work for the surgery - all within my annual sick leave at the time.

Rupert
Posts: 3740
Joined: Fri Aug 17, 2012 12:01 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Rupert » Mon Oct 22, 2018 12:43 pm

billy269 wrote:
Mon Oct 22, 2018 12:13 pm
Rupert wrote:
Mon Oct 22, 2018 12:01 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
I don't know, the numbers seem a little sensational. According to this site:
According to a 2013 study in the American Journal of Clinical Oncology, for Americans newly diagnosed with cancer, the annual economic burden was $16,000 per person. Cancer bills have been a leading cause of personal bankruptcy in the U.S and a third of survivors report ongoing financial burdens after cancer. Often this is a result of stopping work, which 85 percent of cancer patients report.
https://www.curetoday.com/community/kat ... ith-cancer

To keep this actionable how does one protect themselves from this financial threat?
The difference between the two figures may be one just counting medical expenses during the crisis and the other counting all the extras, e.g., home care, lost wages, etc. Anyway, to answer your question, one way is to purchase adequate disability insurance.
I currently have (I think) decent insurance through my employer. But obviously, if I get cancer and lost my job, I will not have insurance. Is there where disability insurance comes in? How much does that usually run?
The disability insurance may replace all or part of your salary if you could not work during or after your treatment. The cost varies depending on coverage and underwriting. Many employers offer a group plan. Most Bogleheads recommend skipping that in favor of individual DI or at least supplementing the employer coverage with individual DI. There are many prior threads on the topic. "True own occupation" coverage is, ideally, what you want. Note that most (all?) DI policies require you to also apply for Social Security disability benefits (SSDI). If Social Security decides you are disabled, you become eligible for Medicare coverage at an earlier age (it's either two years after you become disabled or two years after Social Security determines you are disabled, I can't remember which), which helps with the health insurance problem. DI insurance would not provide you with health coverage. You'd have to try to somehow stay on your employer's policy, pay for COBRA coverage (if your employer is large enough to be eligible), or purchase individual insurance for coverage during the two years before you become eligible for Medicare.

Ragnoth
Posts: 167
Joined: Sat Sep 17, 2016 8:10 am
Location: New York

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Ragnoth » Mon Oct 22, 2018 12:48 pm

The headline is sensational, but the costs of health care at end of life are no joking matter.

Between medical bills, extra costs of home care, and lost earnings (if you are still working), it can put an incredible dent into any amount of savings.

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 12:50 pm

Ragnoth wrote:
Mon Oct 22, 2018 12:48 pm
The headline is sensational, but the costs of health care at end of life are no joking matter.
Between medical bills, extra costs of home care, and lost earnings (if you are still working), it can put an incredible dent into any amount of savings.
Yes - very true.

fulltilt
Posts: 181
Joined: Thu Dec 01, 2011 2:23 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by fulltilt » Mon Oct 22, 2018 12:52 pm

Dottie57 wrote:
Mon Oct 22, 2018 12:28 pm
No, this is misleading.

I had a co-worker with stage4 cancer. Disability kicked in for about 5 months while drs were working on the diagnosis and coming up with a treatment plan. After chemo was started and he knew how it would go, he returned to work 4 days a week.
So people can work while being treated for cancer. He had no complaints on healthcare coverage.

So you need a good emergency fund, disability, healthcare insurance, loving family and friends.
You forgot to have good life insurance on your list of needs.

User avatar
JoMoney
Posts: 6153
Joined: Tue Jul 23, 2013 5:31 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by JoMoney » Mon Oct 22, 2018 12:57 pm

Nate79 wrote:
Mon Oct 22, 2018 11:57 am
...
To keep this actionable how does one protect themselves from this financial threat?
Insurance.
Having assets that might be shielded in bankruptcy.
For early retirees it's a four letter word, but I would suggest they "WORK" at least a little bit, to maintain coverage by social security disability and the possibility of medicare (they'll have problems getting and keeping insurance if they get cancer).
"To achieve satisfactory investment results is easier than most people realize; to achieve superior results is harder than it looks." - Benjamin Graham

Dottie57
Posts: 4671
Joined: Thu May 19, 2016 5:43 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Dottie57 » Mon Oct 22, 2018 12:58 pm

fulltilt wrote:
Mon Oct 22, 2018 12:52 pm
Dottie57 wrote:
Mon Oct 22, 2018 12:28 pm
No, this is misleading.

I had a co-worker with stage4 cancer. Disability kicked in for about 5 months while drs were working on the diagnosis and coming up with a treatment plan. After chemo was started and he knew how it would go, he returned to work 4 days a week.
So people can work while being treated for cancer. He had no complaints on healthcare coverage.

So you need a good emergency fund, disability, healthcare insurance, loving family and friends.
You forgot to have good life insurance on your list of needs.
You are right. But you should have it before the diagnosis.

I am single and carry no life insurance as no one needs income from me.

User avatar
JPH
Posts: 810
Joined: Mon Jun 27, 2011 8:56 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by JPH » Mon Oct 22, 2018 1:01 pm

bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.

JT
It's the same study I posted about here, including a link to the original peer-reviewed article. The headline may be sensational, but why do you think the study is "misleading?" It seems like a pretty well done study to me. Would you like to defend your opinion with a review of the actual study?
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

mariezzz
Posts: 269
Joined: Mon Oct 02, 2017 11:02 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by mariezzz » Mon Oct 22, 2018 1:13 pm

dm200 wrote:
Mon Oct 22, 2018 12:22 pm
Seems that way to me as well.
It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
It's also important to note that bad luck plays a bigger role overall. See https://www.scientificamerican.com/arti ... -bad-luck/ (and other sources). Not surprisingly, it's complicated; the quote below is an attempt to convey the complexity.
using health records from 69 countries, they conclude that 66 percent of cancer-causing genetic mutations arise from the “bad luck” of a healthy, dividing cell making a random mistake when it copies its DNA. ... After a roundabout calculation, the researchers concluded that DNA-copying mistakes are responsible for 66 percent of the mutations, while 29 percent are due to environmental factors and 5 percent to heredity. Different cancers differ significantly.
Screening can help with some kinds of cancers (HPV screening and pap smears combined for cervical cancer). However, for other types of screening (PSA, mammogram), the benefits of screening have been overstated and the risks of screening (stress, invasive procedures, radiation, and others) have been understated . There have been large scale studies showing this problem, esp. with screening for breast cancer, in recent years, but more often than not, what physicians and health care organizations recommend is more screening that was recommended by some of the large task forces that reviewed all the literature. https://www.nytimes.com/2017/07/17/well ... sorry.html )

Overscreening has financial costs, as well as health costs (which can have financial impacts) - due to the stress, potential infection from invasive procedures, immediate and long-term health impacts of chemo/radiation; and cost of time lost due to screening & follow-up procedures.

Cancer research gets massive amounts of money from the government and various private foundations. The state of our knowledge is constantly improving; new screening tests may be developed, and so on. What is true at the current moment may be rethought in 5-10 years, so it's important to be informed (and be aware, physicians are often not as informed as they should be).

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 1:24 pm

mariezzz wrote:
Mon Oct 22, 2018 1:13 pm
dm200 wrote:
Mon Oct 22, 2018 12:22 pm
Seems that way to me as well.
It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
It's also important to note that bad luck plays a bigger role overall. See https://www.scientificamerican.com/arti ... -bad-luck/ (and other sources). Not surprisingly, it's complicated; the quote below is an attempt to convey the complexity.
using health records from 69 countries, they conclude that 66 percent of cancer-causing genetic mutations arise from the “bad luck” of a healthy, dividing cell making a random mistake when it copies its DNA. ... After a roundabout calculation, the researchers concluded that DNA-copying mistakes are responsible for 66 percent of the mutations, while 29 percent are due to environmental factors and 5 percent to heredity. Different cancers differ significantly.
Screening can help with some kinds of cancers (HPV screening and pap smears combined for cervical cancer). However, for other types of screening (PSA, mammogram), the benefits of screening have been overstated and the risks of screening (stress, invasive procedures, radiation, and others) have been understated . There have been large scale studies showing this problem, esp. with screening for breast cancer, in recent years, but more often than not, what physicians and health care organizations recommend is more screening that was recommended by some of the large task forces that reviewed all the literature. https://www.nytimes.com/2017/07/17/well ... sorry.html )
Overscreening has financial costs, as well as health costs (which can have financial impacts) - due to the stress, potential infection from invasive procedures, immediate and long-term health impacts of chemo/radiation; and cost of time lost due to screening & follow-up procedures.
Cancer research gets massive amounts of money from the government and various private foundations. The state of our knowledge is constantly improving; new screening tests may be developed, and so on. What is true at the current moment may be rethought in 5-10 years, so it's important to be informed (and be aware, physicians are often not as informed as they should be).
The issue is complex, and there are so many groups, organizations and companies with huge financial interests - often on different sides - sponsoring studies, etc. I have no medical credentials, but one disparity I look at is the often vast differences between cited "cure rates" for different types of cancer and death rates from the same cancer. I lean towards the death rates as being more reflective of the value of screening, lifestyle choices and treatment options.

visualguy
Posts: 859
Joined: Thu Jan 30, 2014 1:32 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by visualguy » Mon Oct 22, 2018 1:27 pm

Rupert wrote:
Mon Oct 22, 2018 12:43 pm
The disability insurance may replace all or part of your salary if you could not work during or after your treatment. The cost varies depending on coverage and underwriting. Many employers offer a group plan. Most Bogleheads recommend skipping that in favor of individual DI or at least supplementing the employer coverage with individual DI. There are many prior threads on the topic. "True own occupation" coverage is, ideally, what you want. Note that most (all?) DI policies require you to also apply for Social Security disability benefits (SSDI). If Social Security decides you are disabled, you become eligible for Medicare coverage at an earlier age (it's either two years after you become disabled or two years after Social Security determines you are disabled, I can't remember which), which helps with the health insurance problem. DI insurance would not provide you with health coverage. You'd have to try to somehow stay on your employer's policy, pay for COBRA coverage (if your employer is large enough to be eligible), or purchase individual insurance for coverage during the two years before you become eligible for Medicare.
I would find it daunting to deal effectively with all these bureaucracies even when healthy. What a nightmare it would be when seriously ill... Frankly, there's no substitute for having enough money to avoid being totally at their mercy.

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 1:30 pm

visualguy wrote:
Mon Oct 22, 2018 1:27 pm
Rupert wrote:
Mon Oct 22, 2018 12:43 pm
The disability insurance may replace all or part of your salary if you could not work during or after your treatment. The cost varies depending on coverage and underwriting. Many employers offer a group plan. Most Bogleheads recommend skipping that in favor of individual DI or at least supplementing the employer coverage with individual DI. There are many prior threads on the topic. "True own occupation" coverage is, ideally, what you want. Note that most (all?) DI policies require you to also apply for Social Security disability benefits (SSDI). If Social Security decides you are disabled, you become eligible for Medicare coverage at an earlier age (it's either two years after you become disabled or two years after Social Security determines you are disabled, I can't remember which), which helps with the health insurance problem. DI insurance would not provide you with health coverage. You'd have to try to somehow stay on your employer's policy, pay for COBRA coverage (if your employer is large enough to be eligible), or purchase individual insurance for coverage during the two years before you become eligible for Medicare.
I would find it daunting to deal effectively with all these bureaucracies even when healthy. What a nightmare it would be when seriously ill... Frankly, there's no substitute for having enough money to avoid being totally at their mercy.
Yes - a real challenge ... Sometimes, even if you are successful, it can be exhausting..

User avatar
JPH
Posts: 810
Joined: Mon Jun 27, 2011 8:56 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by JPH » Mon Oct 22, 2018 1:30 pm

JPH wrote:
Mon Oct 22, 2018 1:01 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.

JT
It's the same study I posted about here, including a link to the original peer-reviewed article. The headline may be sensational, but why do you think the study is "misleading?" It seems like a pretty well done study to me. Would you like to defend your opinion with a review of the actual study?
Edited to add correct link
viewtopic.php?f=2&t=261734
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

User avatar
VictoriaF
Posts: 18604
Joined: Tue Feb 27, 2007 7:27 am
Location: Black Swan Lake

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF » Mon Oct 22, 2018 1:31 pm

JoMoney wrote:
Mon Oct 22, 2018 12:57 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
...
To keep this actionable how does one protect themselves from this financial threat?
Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB. But I prefer to pay for partly overlapping coverage rather than to pay for expensive treatments. New cancer treatments are appearing, e.g., immunotherapy. They are probably more expensive than chemotherapy and radiation therapy but easier on one's body. It's worth paying extra to preserve your health.

If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.

Victoria
WINNER of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 1:36 pm

VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm
JoMoney wrote:
Mon Oct 22, 2018 12:57 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
...
To keep this actionable how does one protect themselves from this financial threat?
Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.

User avatar
VictoriaF
Posts: 18604
Joined: Tue Feb 27, 2007 7:27 am
Location: Black Swan Lake

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF » Mon Oct 22, 2018 1:42 pm

dm200 wrote:
Mon Oct 22, 2018 1:36 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm
JoMoney wrote:
Mon Oct 22, 2018 12:57 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
...
To keep this actionable how does one protect themselves from this financial threat?
Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.
Just because it worked for your friend and his wife for ten years does not mean that it will work for them in the future, or for anyone else:
- Medicare Plan B options and coverage will be evolving
- FEHB options and coverage will be evolving
- Doctors and hospitals accepting Medicare and FEHB will be changing
- While your friend may have learned the statistics of the likelihood of his need for various coverage, for the individuals the major threat is personal, not statistical.

Paying extra $100/month for marginally useful coverage is a small price if you get this "margin call."

Victoria
WINNER of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 2:00 pm

VictoriaF wrote:
Mon Oct 22, 2018 1:42 pm
dm200 wrote:
Mon Oct 22, 2018 1:36 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm
JoMoney wrote:
Mon Oct 22, 2018 12:57 pm
Nate79 wrote:
Mon Oct 22, 2018 11:57 am
...
To keep this actionable how does one protect themselves from this financial threat?
Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.
Just because it worked for your friend and his wife for ten years does not mean that it will work for them in the future, or for anyone else:
- Medicare Plan B options and coverage will be evolving
- FEHB options and coverage will be evolving
- Doctors and hospitals accepting Medicare and FEHB will be changing
- While your friend may have learned the statistics of the likelihood of his need for various coverage, for the individuals the major threat is personal, not statistical.
Paying extra $100/month for marginally useful coverage is a small price if you get this "margin call."
Victoria
Yes - I do not disagree with you at all.

mariezzz
Posts: 269
Joined: Mon Oct 02, 2017 11:02 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by mariezzz » Mon Oct 22, 2018 2:09 pm

dm200 wrote:
Mon Oct 22, 2018 2:00 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:42 pm
dm200 wrote:
Mon Oct 22, 2018 1:36 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm
JoMoney wrote:
Mon Oct 22, 2018 12:57 pm

Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.
Just because it worked for your friend and his wife for ten years does not mean that it will work for them in the future, or for anyone else:
- Medicare Plan B options and coverage will be evolving
- FEHB options and coverage will be evolving
- Doctors and hospitals accepting Medicare and FEHB will be changing
- While your friend may have learned the statistics of the likelihood of his need for various coverage, for the individuals the major threat is personal, not statistical.
Paying extra $100/month for marginally useful coverage is a small price if you get this "margin call."
Victoria
Yes - I do not disagree with you at all.
I can see a downside of having multiple insurance plans: when something is wrongly decided, you then have to fight with two, not one, insurance company, to get them to change the decision - and they may also be complicating things with arguments about whose responsibility it is. I'd opt for one excellent insurance plan - but even then, you may be arguing (but only with one company). For sure, live in a state that has good consumer protections in the insurance realm. Even better - get citizenship in a country with better insurance protections.

User avatar
JoMoney
Posts: 6153
Joined: Tue Jul 23, 2013 5:31 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by JoMoney » Mon Oct 22, 2018 2:16 pm

mariezzz wrote:
Mon Oct 22, 2018 1:13 pm
dm200 wrote:
Mon Oct 22, 2018 12:22 pm
Seems that way to me as well.
It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
It's also important to note that bad luck plays a bigger role overall. See https://www.scientificamerican.com/arti ... -bad-luck/ (and other sources). Not surprisingly, it's complicated; the quote below is an attempt to convey the complexity.
using health records from 69 countries, they conclude that 66 percent of cancer-causing genetic mutations arise from the “bad luck” of a healthy, dividing cell making a random mistake when it copies its DNA. ... After a roundabout calculation, the researchers concluded that DNA-copying mistakes are responsible for 66 percent of the mutations, while 29 percent are due to environmental factors and 5 percent to heredity. Different cancers differ significantly.
Screening can help with some kinds of cancers (HPV screening and pap smears combined for cervical cancer). However, for other types of screening (PSA, mammogram), the benefits of screening have been overstated and the risks of screening (stress, invasive procedures, radiation, and others) have been understated . There have been large scale studies showing this problem, esp. with screening for breast cancer, in recent years, but more often than not, what physicians and health care organizations recommend is more screening that was recommended by some of the large task forces that reviewed all the literature. https://www.nytimes.com/2017/07/17/well ... sorry.html )

Overscreening has financial costs, as well as health costs (which can have financial impacts) - due to the stress, potential infection from invasive procedures, immediate and long-term health impacts of chemo/radiation; and cost of time lost due to screening & follow-up procedures.

Cancer research gets massive amounts of money from the government and various private foundations. The state of our knowledge is constantly improving; new screening tests may be developed, and so on. What is true at the current moment may be rethought in 5-10 years, so it's important to be informed (and be aware, physicians are often not as informed as they should be).
If you look at mortality statistics, it looks like some form of heart disease or cancer is inevitable (if you live long enough avoiding auto accidents, drugs, and suicide).
"To achieve satisfactory investment results is easier than most people realize; to achieve superior results is harder than it looks." - Benjamin Graham

sawhorse
Posts: 3109
Joined: Sun Mar 01, 2015 7:05 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by sawhorse » Mon Oct 22, 2018 2:19 pm

Dottie57 wrote:
Mon Oct 22, 2018 12:28 pm
No, this is misleading.

I had a co-worker with stage4 cancer. Disability kicked in for about 5 months while drs were working on the diagnosis and coming up with a treatment plan. After chemo was started and he knew how it would go, he returned to work 4 days a week.
So people can work while being treated for cancer. He had no complaints on healthcare coverage.

So you need a good emergency fund, disability, healthcare insurance, loving family and friends.
Not all cancer patients can work while being treated. My aunt was constantly throwing up, had ulcers all over her skin including the soles of her feet so much that she couldn't walk, and slept whenever she wasn't throwing up. She also had a few surgeries that required significant recovery time.

It depends on the type of cancer, the type of treatment, and people's reactions to the treatment, among other things.
visualguy wrote:
Mon Oct 22, 2018 1:27 pm
Rupert wrote:
Mon Oct 22, 2018 12:43 pm
The disability insurance may replace all or part of your salary if you could not work during or after your treatment. The cost varies depending on coverage and underwriting. Many employers offer a group plan. Most Bogleheads recommend skipping that in favor of individual DI or at least supplementing the employer coverage with individual DI. There are many prior threads on the topic. "True own occupation" coverage is, ideally, what you want. Note that most (all?) DI policies require you to also apply for Social Security disability benefits (SSDI). If Social Security decides you are disabled, you become eligible for Medicare coverage at an earlier age (it's either two years after you become disabled or two years after Social Security determines you are disabled, I can't remember which), which helps with the health insurance problem. DI insurance would not provide you with health coverage. You'd have to try to somehow stay on your employer's policy, pay for COBRA coverage (if your employer is large enough to be eligible), or purchase individual insurance for coverage during the two years before you become eligible for Medicare.
I would find it daunting to deal effectively with all these bureaucracies even when healthy. What a nightmare it would be when seriously ill... Frankly, there's no substitute for having enough money to avoid being totally at their mercy.
Definitely. Dealing with insurance or any other red tape is 100x harder and more complicated when you're very ill.
Rupert wrote:
Mon Oct 22, 2018 12:01 pm
The difference between the two figures may be one just counting medical expenses during the crisis and the other counting all the extras, e.g., home care, lost wages, etc. Anyway, to answer your question, one way is to purchase adequate disability insurance.
Absolutely. It's not just the bills. It's the lost wages, the hired helpers you may need, the fact that a family member might have to take substantial time off work, and more.

Not everyone can get disability insurance or life insurance for that matter. I can't due to previous health problems. I'd be surprised if someone who has had a prior bout with cancer can get disability insurance that would cover a cancer recurrence.

visualguy
Posts: 859
Joined: Thu Jan 30, 2014 1:32 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by visualguy » Mon Oct 22, 2018 2:24 pm

JoMoney wrote:
Mon Oct 22, 2018 2:16 pm
If you look at mortality statistics, it looks like some form of heart disease or cancer is inevitable (if you live long enough avoiding auto accidents, drugs, and suicide).
Not sure I would say "inevitable", but these are the leading causes of death for older adults, and certainly very common... There's also stroke, Alzheimer's, and others. Most of these illnesses require expensive care.

ChrisC
Posts: 708
Joined: Tue Jun 19, 2012 9:10 am
Location: North Carolina

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by ChrisC » Mon Oct 22, 2018 3:15 pm

dm200 wrote:
Mon Oct 22, 2018 2:00 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:42 pm
dm200 wrote:
Mon Oct 22, 2018 1:36 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm
JoMoney wrote:
Mon Oct 22, 2018 12:57 pm

Insurance.
Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.
Just because it worked for your friend and his wife for ten years does not mean that it will work for them in the future, or for anyone else:
- Medicare Plan B options and coverage will be evolving
- FEHB options and coverage will be evolving
- Doctors and hospitals accepting Medicare and FEHB will be changing
- While your friend may have learned the statistics of the likelihood of his need for various coverage, for the individuals the major threat is personal, not statistical.
Paying extra $100/month for marginally useful coverage is a small price if you get this "margin call."
Victoria
Yes - I do not disagree with you at all.
Well, actually $100 is not the margin call for many. In my case, the margin call for my wife is $187 for this year and 2019, and will spike up to $348 in 2020 (after we're done with Roth conversions for tax year 2018). I didn't sign up for Medicare Part B recently as I become eligible in December. I'm relying on the strong coverage that a good FEHB plan will provide. I'm well acquainted with the great health coverage one could have with Medicare Part B and an FEHB plan, as I manage my BIL's health bills with his MS and he's a retired FED-- but if you'll always be at high IRMAA levels because of a great CSRS annuity, high Social Security benefits (from one or both spouses) and significant 401K, TSP or IRA portfolios, then paying the extra margin call for Part B might not make a lot of sense, when FEHB plans have exceptional catastrophic loss coverage.

Back to the original scope of this thread; cancer treatments I'm sure are expensive. Nonetheless, there are other illnesses which require high medicare care and then morphs into additional long term nursing care. My mother had major cardiac issues, which called for extensive, initial medicare care, but the care coincided with the onset of dementia, so typical medical issuance won't cover the latter. My BIL with MS currently has monthly infusion/chemo type therapy which is billed at $20K per month, covered by Medicare B and BCBS, and he lives at an assisted living facility that bills us at $3500 per month. Unfortunately, however, his condition will only get progressively worse and then we're looking at a skilled nursing facility at $7500 per month (and that is cheap as my mother's cost was $15K per month before she departed this past March after being in a nursing home for 11 years).

I think the real risk is in the illnesses that have very long goodbyes, like Parkinsons, MS, Alzheimers, or other neurological illnesses requiring intensive long term health care management. Health insurance will only take you so far.

Big Dog
Posts: 884
Joined: Mon Sep 07, 2015 4:12 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Big Dog » Mon Oct 22, 2018 3:34 pm

Note the date of the study -- only through 2014, which is when the ACA got rolling. If the ACA was doing what it was supposed to do, the numbers of underinsured and uninsured cancer patients should have been reduced substantially.

User avatar
dm200
Posts: 18772
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 » Mon Oct 22, 2018 3:45 pm

Back to the original scope of this thread; cancer treatments I'm sure are expensive. Nonetheless, there are other illnesses which require high medicare care and then morphs into additional long term nursing care. My mother had major cardiac issues, which called for extensive, initial medicare care, but the care coincided with the onset of dementia, so typical medical issuance won't cover the latter. My BIL with MS currently has monthly infusion/chemo type therapy which is billed at $20K per month, covered by Medicare B and BCBS, and he lives at an assisted living facility that bills us at $3500 per month. Unfortunately, however, his condition will only get progressively worse and then we're looking at a skilled nursing facility at $7500 per month (and that is cheap as my mother's cost was $15K per month before she departed this past March after being in a nursing home for 11 years).
I had similar health/surgical issues - one turned out to be cancer and the other was not even suspected to be cancer. Both had surgery and the costs/treatments for both conditions were about the same. Not all cancer requires super expensive treatments.

visualguy
Posts: 859
Joined: Thu Jan 30, 2014 1:32 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by visualguy » Mon Oct 22, 2018 4:05 pm

ChrisC wrote:
Mon Oct 22, 2018 3:15 pm
Back to the original scope of this thread; cancer treatments I'm sure are expensive. Nonetheless, there are other illnesses which require high medicare care and then morphs into additional long term nursing care. My mother had major cardiac issues, which called for extensive, initial medicare care, but the care coincided with the onset of dementia, so typical medical issuance won't cover the latter. My BIL with MS currently has monthly infusion/chemo type therapy which is billed at $20K per month, covered by Medicare B and BCBS, and he lives at an assisted living facility that bills us at $3500 per month. Unfortunately, however, his condition will only get progressively worse and then we're looking at a skilled nursing facility at $7500 per month (and that is cheap as my mother's cost was $15K per month before she departed this past March after being in a nursing home for 11 years).

I think the real risk is in the illnesses that have very long goodbyes, like Parkinsons, MS, Alzheimers, or other neurological illnesses requiring intensive long term health care management. Health insurance will only take you so far.
Yup - this is similar to what I've seen in my family. Unfortunately, this is what many of us have waiting for us in the future, and the reason I take health-care and long-term care expenses very seriously in my retirement planning. It's easy to be in denial about this until you see it happening to family and friends.

Rupert
Posts: 3740
Joined: Fri Aug 17, 2012 12:01 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Rupert » Mon Oct 22, 2018 4:08 pm

dm200 wrote:
Mon Oct 22, 2018 3:45 pm
Back to the original scope of this thread; cancer treatments I'm sure are expensive. Nonetheless, there are other illnesses which require high medicare care and then morphs into additional long term nursing care. My mother had major cardiac issues, which called for extensive, initial medicare care, but the care coincided with the onset of dementia, so typical medical issuance won't cover the latter. My BIL with MS currently has monthly infusion/chemo type therapy which is billed at $20K per month, covered by Medicare B and BCBS, and he lives at an assisted living facility that bills us at $3500 per month. Unfortunately, however, his condition will only get progressively worse and then we're looking at a skilled nursing facility at $7500 per month (and that is cheap as my mother's cost was $15K per month before she departed this past March after being in a nursing home for 11 years).
I had similar health/surgical issues - one turned out to be cancer and the other was not even suspected to be cancer. Both had surgery and the costs/treatments for both conditions were about the same. Not all cancer requires super expensive treatments.
But just for planning purposes, do you plan for cheap cancer or expensive cancer?

sawhorse
Posts: 3109
Joined: Sun Mar 01, 2015 7:05 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by sawhorse » Mon Oct 22, 2018 4:34 pm

Big Dog wrote:
Mon Oct 22, 2018 3:34 pm
Note the date of the study -- only through 2014, which is when the ACA got rolling. If the ACA was doing what it was supposed to do, the numbers of underinsured and uninsured cancer patients should have been reduced substantially.
Good catch! Any updated estimate? Keeping in mind of course that an average is of limited use as there is so much variation.

cs412a
Posts: 19
Joined: Sun Dec 17, 2017 1:37 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by cs412a » Mon Oct 22, 2018 4:47 pm

JPH wrote:
Mon Oct 22, 2018 1:30 pm
JPH wrote:
Mon Oct 22, 2018 1:01 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.s

JT
It's the same study I posted about here, including a link to the original peer-reviewed article. The headline may be sensational, but why do you think the study is "misleading?" It seems like a pretty well done study to me. Would you like to defend your opinion with a review of the actual study?
Edited to add correct link
viewtopic.php?f=2&t=261734
The article was interesting, and I don't have any quarrel with the methodology used. However, I wish the authors had provided medians as well as means for their results. I believe this would have made the results more understandable. The authors did provide the standard deviations and confidence intervals for their findings, which are essential to really appreciate the results.

A quote from the study
The average net worth at year+2 decreased by $92,098±1,945,627 from an initial average net worth of $644,031±2,183,014. Some 42.4% had their entire life's assets depleted at year+2, with 38.2% at year+4.
The standard deviations reveal that the effects on individuals varied enormously and suggest that the underlying distribution of net worth and net worth loss was not a normal, bell curved distribution (in which the median would equal the mean). To say that the mean decrease in net worth was $92,098 with a standard deviation of $1,945,627 means that 68% of the (very large) sample experienced a decrease in net worth ranging from no loss (i.e. a gain of $1,853,529) to a horrendous loss of $2,037,725.

If we don't consider the variability of the sample and the range of the outcomes, we could look at the initial average net worth of $644,031 and the average decrease of $92,098 over the first 2 years since diagnosis and think that, well, this average person still has a net worth of over $500,000. So why is 42% of the sample broke at the end of 2 years?

Of course, we know that only a small proportion of the US population has a net worth of more than $600,000. The mean net worth reported in the study is misleading - especially since the study also reports that the mean level of education was 12 years (i.e. a high school diploma). The mean for average net worth is skewed, and using the median in addition to the mean would provide a more representative measure of the "average" net worth and the "average" loss of net worth. (I suspect that the mean and median for the level of education, on the other hand, are fairly representative of the US population over the age of 50.)

In a very confusing way, the study reveals what we already know: The higher your net worth, the better able you are to deal with financial shocks of any kind.

User avatar
VictoriaF
Posts: 18604
Joined: Tue Feb 27, 2007 7:27 am
Location: Black Swan Lake

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF » Tue Oct 23, 2018 6:40 am

ChrisC wrote:
Mon Oct 22, 2018 3:15 pm
dm200 wrote:
Mon Oct 22, 2018 2:00 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:42 pm
dm200 wrote:
Mon Oct 22, 2018 1:36 pm
VictoriaF wrote:
Mon Oct 22, 2018 1:31 pm

Having a medical insurance is good. Having two insurances is even better. When I become eligible for Medicare I will get Medicare Part B and will keep my FEHB insurance. Some Federal retirees are planning to forego either Part B or FEHB, but I prefer to pay for partly overlapping coverage than to pay for expensive treatments. If I never need expensive treatments, I will win regardless of how much I will have spent on insurance.
Victoria
A longtime friend is a retired Federal employee and his wife has significant health and medical issues. He researches everything and has some background in health issues. He is someone often described as "if you ask him what time it is, he will explain how to build a watch!". After, I am sure, extensive research and their own medical/health issues, he concluded he would not opt for Medicare Part B. He and his wife have been on medicare for almost ten years.
Just because it worked for your friend and his wife for ten years does not mean that it will work for them in the future, or for anyone else:
- Medicare Plan B options and coverage will be evolving
- FEHB options and coverage will be evolving
- Doctors and hospitals accepting Medicare and FEHB will be changing
- While your friend may have learned the statistics of the likelihood of his need for various coverage, for the individuals the major threat is personal, not statistical.
Paying extra $100/month for marginally useful coverage is a small price if you get this "margin call."
Victoria
Yes - I do not disagree with you at all.
Well, actually $100 is not the margin call for many. In my case, the margin call for my wife is $187 for this year and 2019, and will spike up to $348 in 2020 (after we're done with Roth conversions for tax year 2018). I didn't sign up for Medicare Part B recently as I become eligible in December. I'm relying on the strong coverage that a good FEHB plan will provide. I'm well acquainted with the great health coverage one could have with Medicare Part B and an FEHB plan, as I manage my BIL's health bills with his MS and he's a retired FED-- but if you'll always be at high IRMAA levels because of a great CSRS annuity, high Social Security benefits (from one or both spouses) and significant 401K, TSP or IRA portfolios, then paying the extra margin call for Part B might not make a lot of sense, when FEHB plans have exceptional catastrophic loss coverage.
1. Reference for the "$100/month for a margin call":
I am currently using the FEHB GEHA HDHP for $125/month. When I become eligible for Medicare, Medicare will provide primary coverage, and I will continue paying $125/month with small annual increases for the secondary coverage. If I develop a serious condition that will require special treatments, I will pay whatever is necessary the first year and will optimize Medicare Plan B and FEHB choices for the following years.

2. Roth Conversions and Medicare Part B cost:
If you finish all your conversions in 2018, Medicare Part B will spike in 2020, but then it will probably (see item-3 below) go down because you won't have any more conversions.

3. You'll always be at high IRMAA levels because of a great CSRS annuity, high Social Security benefits (from one or both spouses) and significant 401K, TSP or IRA portfolios
If you are a well to do retiree with all these resources, then even $350/month is a small change for you. You can easily "throw away" $4k-$5k/year to protect yourself from a remote chance that you would require expensive treatments.

Victoria
WINNER of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)

User avatar
jharkin
Posts: 1873
Joined: Mon Mar 28, 2016 7:14 am
Location: Boston suburbs

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by jharkin » Tue Oct 23, 2018 6:57 am

visualguy wrote:
Mon Oct 22, 2018 4:05 pm

Yup - this is similar to what I've seen in my family. Unfortunately, this is what many of us have waiting for us in the future, and the reason I take health-care and long-term care expenses very seriously in my retirement planning. It's easy to be in denial about this until you see it happening to family and friends.
Yes, and its also easy to write off cancer as "something that happens to people who make bad lifestyle choices" until it hits one, or 4, of your closest relatives. all at once. without warning.

We lost a relative to pancreatic cancer this year. Fit guy in his 50s. runner. No obvious "bad habits" Just started feeling really tired one day and got a stage 4 diagnosis. 6 months later he is gone.

Another is a relative in her 30s. Also healthy, nonsmoker, minimal drinker. never been overweight or any other obvious risk factors. Stage 2 Lymphoma diagnosis that was only caught by chance as part of an unrelated test.


DO NOT assume that if you "live right" it wont happen to you.

User avatar
VictoriaF
Posts: 18604
Joined: Tue Feb 27, 2007 7:27 am
Location: Black Swan Lake

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF » Tue Oct 23, 2018 7:04 am

jharkin wrote:
Tue Oct 23, 2018 6:57 am
DO NOT assume that if you "live right" it wont happen to you.
I do not assume that if I live right, cancer, Alzheimer's or something like that will not happen to me.

I do assume that if I live right, the probability of a serious disease affecting me would be lower, the severity of the disease would milder, the treatments would be less extreme, and my chance for recovery would be higher.

Too often people use the fact that living right does not provide 100% protection as an excuse for not living right.

Victoria
WINNER of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)

User avatar
JPH
Posts: 810
Joined: Mon Jun 27, 2011 8:56 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by JPH » Tue Oct 23, 2018 7:13 am

cs412a wrote:
Mon Oct 22, 2018 4:47 pm
The standard deviations reveal that the effects on individuals varied enormously and suggest that the underlying distribution of net worth and net worth loss was not a normal, bell curved distribution (in which the median would equal the mean). To say that the mean decrease in net worth was $92,098 with a standard deviation of $1,945,627 means that 68% of the (very large) sample experienced a decrease in net worth ranging from no loss (i.e. a gain of $1,853,529) to a horrendous loss of $2,037,725.
I agree with you about those standard deviations. I was shocked that they were that high. But they used a representative sample, so I guess it is what it is. It demonstrates how hard it is to plan an effective national healthcare program that will meet the needs of all.
While the moments do summersaults into eternity | Cling to their coattails and beg them to stay - Townes Van Zandt

User avatar
bottlecap
Posts: 5857
Joined: Tue Mar 06, 2007 11:21 pm
Location: Tennessee

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by bottlecap » Tue Oct 23, 2018 7:47 am

JPH wrote:
Mon Oct 22, 2018 1:01 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.

JT
It's the same study I posted about here, including a link to the original peer-reviewed article. The headline may be sensational, but why do you think the study is "misleading?" It seems like a pretty well done study to me. Would you like to defend your opinion with a review of the actual study?
How does it "seem" well done? It may be that the study was "well done", but you don’t really know that.

In any event, it’s not shocking that the net worths of people with health problems decline, on average. However, two years after diagnosis, average net worth declined $92k +/- $1,945,000. And it doesn’t even seem to indicate it was because of the costs of cancer. More than half were on Medicare.

That doesn’t sound as scary, does it.

The conclusions largely use averages, which are also misleading.

The average age of the people in the study was 68.6 years old. You would expect their net worth to decline, on average, even if they didn't have cancer. They are in the distribution phase. I’m sure many had other health problems, too.

38.2% burning through their life savings isn’t a big deal if many of the folks don’t have much in the bank to begin with and are largely living on pensions or social security.

It reminds me of the "study" that said healthcare costs cause the majority of bankruptcies. To qualify, the respondents had to have at least $1,000 in medical debt and agree that that's what pushed them into bankruptcy. Never mind that these people had tens of thousands more in credit card debt. Having to buy a new refrigerator would have pushed these people into bankruptcy, but the study found it was medical expenses.

The study you cite also starts right before a huge stock market crash, has a housing crash in the middle and includes the "Great" recession. Lots of people's net worth declined during many of these years.

Perhaps they controlled for some of these variables, but if they did, they didn’t explain it well.

I could go on, but it’s not my job to defend a study with a sensational title and easily questioned conclusions.

JT

longinvest
Posts: 3056
Joined: Sat Aug 11, 2012 8:44 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by longinvest » Tue Oct 23, 2018 8:46 am

VictoriaF wrote:
Tue Oct 23, 2018 7:04 am
I do assume that if I live right, the probability of a serious disease affecting me would be lower, the severity of the disease would milder, the treatments would be less extreme, and my chance for recovery would be higher.

Too often people use the fact that living right does not provide 100% protection as an excuse for not living right.
There's so much wisdom, in these words! Thanks, Victoria.
Bogleheads investment philosophy | Lifelong Portfolio: 25% each of (domestic/international) stocks / (nominal/inflation-indexed) long-term domestic bonds | VCN/VXC/VLB/ZRR

Valuethinker
Posts: 36395
Joined: Fri May 11, 2007 11:07 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Valuethinker » Tue Oct 23, 2018 9:04 am

JoMoney wrote:
Mon Oct 22, 2018 2:16 pm

If you look at mortality statistics, it looks like some form of heart disease or cancer is inevitable (if you live long enough avoiding auto accidents, drugs, and suicide).
Some incredible fraction of (the male part) of this readership will get prostate cancer.

The real question is whether something else will kill us first - it usually does.

Valuethinker
Posts: 36395
Joined: Fri May 11, 2007 11:07 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Valuethinker » Tue Oct 23, 2018 9:08 am

dm200 wrote:
Mon Oct 22, 2018 12:22 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.
JT
Seems that way to me as well.

It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
Which lifestyle choices?

- not smoking - yes, definitely. But less than 30% of adults smoke (it may now be down to 20%, at least in the UK I think it is just about there)

- not being obese - cue the incredible long and complex discussion of why America has the world's highest obesity rate (other than places in Polynesia) -- Canada, Australia, UK are also in the top 4. By and large, more affluent people have less risk of obesity - so maybe the lesson there is to be affluent (within your society)?

- not drinking excessively - agreed. Although what our parents viewed as normal drinking, or what many of us did in undergrad, is now viewed as a very significant risk factor. The amount of alcohol now viewed as medically recommended is very low

- don't eat red meat - again, agreed. That is definitely a risk factor

Other than that, what can one do? If your childhood home was near a coal fired power station or a chemical plant, that's not something you had much control over? If you live on a farm or in a rural area, you will be exposed to pesticides and fertilizers.

Cancer is one of those things where it's easy to see how one can tilt the table against one -- as above. It's hard to see how one can tilt the table towards one.
Last edited by Valuethinker on Tue Oct 23, 2018 9:12 am, edited 1 time in total.

Valuethinker
Posts: 36395
Joined: Fri May 11, 2007 11:07 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Valuethinker » Tue Oct 23, 2018 9:09 am

jharkin wrote:
Tue Oct 23, 2018 6:57 am
visualguy wrote:
Mon Oct 22, 2018 4:05 pm

Yup - this is similar to what I've seen in my family. Unfortunately, this is what many of us have waiting for us in the future, and the reason I take health-care and long-term care expenses very seriously in my retirement planning. It's easy to be in denial about this until you see it happening to family and friends.
Yes, and its also easy to write off cancer as "something that happens to people who make bad lifestyle choices" until it hits one, or 4, of your closest relatives. all at once. without warning.

We lost a relative to pancreatic cancer this year. Fit guy in his 50s. runner. No obvious "bad habits" Just started feeling really tired one day and got a stage 4 diagnosis. 6 months later he is gone.

Another is a relative in her 30s. Also healthy, nonsmoker, minimal drinker. never been overweight or any other obvious risk factors. Stage 2 Lymphoma diagnosis that was only caught by chance as part of an unrelated test.


DO NOT assume that if you "live right" it wont happen to you.
Oh indeed.

Ex business partner has lung cancer - 2 year survival rate is zero. A triathlete in his early 50s. Never smoked. Much of his life was spent on a farm, so it may be something in farming.

finite_difference
Posts: 1050
Joined: Thu Jul 09, 2015 7:00 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by finite_difference » Tue Oct 23, 2018 9:14 am

dm200 wrote:
Mon Oct 22, 2018 12:22 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.
JT
Seems that way to me as well.

It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
Yeah, lifestyle choices like breathing air (which is polluted by factories and autos.)

Aside from not smoking, eating healthy, exercising, getting enough sleep and trying not to be stressed, there isn’t all that much you can do. I think it’s at least half genetics and luck.
The most precious gift we can offer anyone is our attention. - Thich Nhat Hanh

Rupert
Posts: 3740
Joined: Fri Aug 17, 2012 12:01 pm

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Rupert » Tue Oct 23, 2018 10:04 am

finite_difference wrote:
Tue Oct 23, 2018 9:14 am
dm200 wrote:
Mon Oct 22, 2018 12:22 pm
bottlecap wrote:
Mon Oct 22, 2018 12:19 pm
Don't be terrified. It's a very misleading headline and an only slightly less misleading study.
JT
Seems that way to me as well.

It is also true that lifestyle choices greatly affect the chances that we will get many kinds of cancer.
Yeah, lifestyle choices like breathing air (which is polluted by factories and autos.)

Aside from not smoking, eating healthy, exercising, getting enough sleep and trying not to be stressed, there isn’t all that much you can do. I think it’s at least half genetics and luck.
It's not even half genetics. It's mostly bad luck in the form of random genetic mutation. I totally agree with VictoriaF, above, that a person should control what he/she can by living a reasonably healthy lifestyle. Who can argue with that? You'll feel better while you are alive, and overall good health -- mental and physical -- does improve your odds of surviving many diseases. But often here at Bogleheads I see people citing their present good health and lack of family medical history as justifications for not buying adequate insurance even when they are fortunate enough to be able to afford adequate insurance. That's magical thinking bordering on stupid.

visualguy
Posts: 859
Joined: Thu Jan 30, 2014 1:32 am

Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by visualguy » Tue Oct 23, 2018 11:21 am

finite_difference wrote:
Tue Oct 23, 2018 9:14 am
Yeah, lifestyle choices like breathing air (which is polluted by factories and autos.)

Aside from not smoking, eating healthy, exercising, getting enough sleep and trying not to be stressed, there isn’t all that much you can do. I think it’s at least half genetics and luck.
One thing to add is to avoid radiation exposure as much as possible. Avoid unnecessary X-rays, CTs, and other medical tests involving radiation. They are over-prescribed.

In general, be smart and cautious when dealing with the medical system. Invasive tests, medication, and surgeries can cause more harm than good. Don't let them do anything potentially harmful to you without thorough research and multiple opinions. Don't assume that "first, do no harm" is a guiding principle in the practice of medicine. It is not - particularly in the US where the system is profit-driven.

Post Reply