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

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

Post by Big Dog »

By and large, more affluent people have less risk of obesity - so maybe the lesson there is to be affluent (within your society)?
Not quite correct per the CDC. For example,
Among men, the prevalence of obesity was lower in both the lowest (31.5%) and highest (32.6%) income groups compared with the middle-income group (38.5%). This pattern was seen among both non-Hispanic white and Hispanic men, although among non-Hispanic white men, the difference between the highest-income and middle-income groups was not statistically significant. Among non-Hispanic black men, obesity prevalence was higher in the highest income group (42.7%) than in the lowest income group (33.8%). There was no difference in obesity prevalence by income among non-Hispanic Asian men.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6650a1.htm
ChrisC
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by ChrisC »

VictoriaF wrote: Tue Oct 23, 2018 6:40 am 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.
Not so fast now. I'm currently on FEHB GEHA-HDHP Family Plan and I pay $269 per month, with my wife going off HSA contributions in 2016 when she enrolled in Medicare A & B and with myself going off HSA contributions this December when I go on Medicare Part A. So, you're looking at going off the HDHP when you go on Medicare and procuring a traditional health insurance plan in FEHB, like BCBC-Basic or Aetna Direct, both of which dovetail nicely with Medicare Parts A and B. My BIL has Medicare A&B and BCBS-Basic and pays $159 per month with a $600 rebate back to him from BCBS. Medicare Part B is currently at $134 per month.


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.

We'll be doing conversions up until I can't, when I reach 70 in 5 years. My wife will likely have converted all of her remaining balances in 3 years when she reaches 70, but we're still looking at converting $350K plus over that period of time. As for me, I'll convert a slightly higher amount once wife is finished with her conversions, but I'll still have a 2 comma plus balance in my 401K/TSP, especially if the market does not drop like a rock.

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.

This thought has already crept into my mind, as we're already throwing away $4200 per year in LTCi and $2244 in current Part B premiums, soon to tick upwards to $4176 in 2020 and stay there for many years. But I'm having second thoughts about throwing away money for the LTCi and I'm also thinking that the extra $4176 in Medicare Part B premiums for me would be worth it for piece of mind. Most FEHB traditional plans cap your losses for those expensive medical treatments at $6-7K so I'd be covered in case that occurs, and meanwhile wouldn't be paying $4176 annually in Medicare Part B premiums.
MathWizard
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by MathWizard »

This following paper is based on Korean health records, but does show higher incidence
of cancer for lowest income quintile vs. highest income quintile.

Code: Select all

https://www.ncbi.nlm.nih.gov/pubmed/22799334
Even if the incidence were totally unrelated, half the patients would be below the median
income for their age. The table below (from 2014, but probably still fairly accurate) shows
the median household net worth for various age ranges. $209,200 is the highest list.
It would be pretty easy for someone to go through $209K over 2 years when having major health problems,
potentially no health insurance, and probably not much for disability insurance.

Since the incidence of cancer is disproportionately among lower income, and these are
likely to have lower net worth, 50% of those with cancer would even have a lower net worth
than the median household net worth of the general population.

From

Code: Select all

https://www.census.gov/data/tables/2014/demo/wealth/wealth-asset-ownership.html
Table 1. Median Value of Debt for Households, by Type of Debt and Selected Characteristics: 2014


Age of Householder
Less than 35 years 7,670
35 to 44 years 55,390
45 to 54 years 98,790
55 to 64 years 163,300
65 years and over 198,000
65 to 69 years 193,400
70 to 74 years 209,200
75 and over 194,900
Rupert
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Rupert »

MathWizard wrote: Tue Oct 23, 2018 3:41 pm This following paper is based on Korean health records, but does show higher incidence
of cancer for lowest income quintile vs. highest income quintile.

Code: Select all

https://www.ncbi.nlm.nih.gov/pubmed/22799334
Even if the incidence were totally unrelated, half the patients would be below the median
income for their age. The table below (from 2014, but probably still fairly accurate) shows
the median household net worth for various age ranges. $209,200 is the highest list.
It would be pretty easy for someone to go through $209K over 2 years when having major health problems,
potentially no health insurance, and probably not much for disability insurance.

Since the incidence of cancer is disproportionately among lower income, and these are
likely to have lower net worth, 50% of those with cancer would even have a lower net worth
than the median household net worth of the general population.

From

Code: Select all

https://www.census.gov/data/tables/2014/demo/wealth/wealth-asset-ownership.html
Table 1. Median Value of Debt for Households, by Type of Debt and Selected Characteristics: 2014


Age of Householder
Less than 35 years 7,670
35 to 44 years 55,390
45 to 54 years 98,790
55 to 64 years 163,300
65 years and over 198,000
65 to 69 years 193,400
70 to 74 years 209,200
75 and over 194,900
Does this study include all cancers? I wonder if the conclusion holds if you eliminate lung cancer from the cancer stats, lung cancer being one of the few cancers for which you can significantly reduce your lifetime risk via a lifestyle choice, i.e., not smoking. Lower income & lower education = more smoking.
MathWizard
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by MathWizard »

From abstract

RESULTS:

In men, the risk of stomach cancer for Income Class 5 (lowest) was 1.12 times (95% CI 1.02-1.23) higher than that of Income Class 1 (highest), for lung cancer 1.61 times (95% CI 1.43- 1.81) higher, for liver cancer 1.22 times (95% CI 1.08-1.37) higher, and for rectal cancer 1.37 times higher (95% CI 1.18-1.59). In women, the risk of stomach cancer for Income Class 5 was 1.22 times higher (95% CI 1.08-1.37) than that for Income Class 1, while for cervical cancer it was 2.47 times higher (95% CI 2.08- 2.94). In contrast, in men, Income Class 1 showed a higher risk of thyroid cancer and prostate cancer than that of Income Class 5, while, in women the same was the case for thyroid cancer.
Wakefield1
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Wakefield1 »

I would suspect that a lot of people,especially if still able bodied at the time,if diagnosed with cancer,especially if one of the Monsters (I really would like to use a curse word here) such as Pancreatic or Small/Oat Cell of the Lung would tend to spend a great deal of their savings on an expensive cruise or vacation around the world or buy an expensive motor home and start touring everything in the USA that can be toured. That would burn up the savings.
the quote "Live like there is no tomorrow for there might not be one" where did it come from?
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dm200
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 »

Wakefield1 wrote: Tue Oct 23, 2018 5:17 pm I would suspect that a lot of people,especially if still able bodied at the time,if diagnosed with cancer,especially if one of the Monsters (I really would like to use a curse word here) such as Pancreatic or Small/Oat Cell of the Lung would tend to spend a great deal of their savings on an expensive cruise or vacation around the world or buy an expensive motor home and start touring everything in the USA that can be toured. That would burn up the savings.
the quote "Live like there is no tomorrow for there might not be one" where did it come from?
I have never known anyone who has done this..
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VictoriaF
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF »

ChrisC wrote: Tue Oct 23, 2018 11:54 am
VictoriaF wrote: Tue Oct 23, 2018 6:40 am 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.

Not so fast now. I'm currently on FEHB GEHA-HDHP Family Plan and I pay $269 per month, with my wife going off HSA contributions in 2016 when she enrolled in Medicare A & B and with myself going off HSA contributions this December when I go on Medicare Part A. So, you're looking at going off the HDHP when you go on Medicare and procuring a traditional health insurance plan in FEHB, like BCBC-Basic or Aetna Direct, both of which dovetail nicely with Medicare Parts A and B. My BIL has Medicare A&B and BCBS-Basic and pays $159 per month with a $600 rebate back to him from BCBS. Medicare Part B is currently at $134 per month.
I think I will be able to keep GEHA-HDHP with HRA instead of HSA. But, when the time comes, I will check out other options, too. Your BIL's plan looks good.

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

Post by BruDude »

Shows the importance of a quality individual disability insurance policy....
sawhorse
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by sawhorse »

dm200 wrote: Tue Oct 23, 2018 5:18 pm
Wakefield1 wrote: Tue Oct 23, 2018 5:17 pm I would suspect that a lot of people,especially if still able bodied at the time,if diagnosed with cancer,especially if one of the Monsters (I really would like to use a curse word here) such as Pancreatic or Small/Oat Cell of the Lung would tend to spend a great deal of their savings on an expensive cruise or vacation around the world or buy an expensive motor home and start touring everything in the USA that can be toured. That would burn up the savings.
the quote "Live like there is no tomorrow for there might not be one" where did it come from?
I have never known anyone who has done this..
I have only known one, a 15 year old girl, and she had to cut it short because she felt so bad. The treatment causes so many side effects and requires a lot of appointments, and the illness causes a lot of pain and weakness. By the time you get the terminal diagnosis, extravagant experiences are often out of the question. A lot of people spend their final months planning their deaths, getting documents sorted and things like that.
sawhorse
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by sawhorse »

BruDude wrote: Tue Oct 23, 2018 10:08 pm Shows the importance of a quality individual disability insurance policy....
If you can get one. I'm in my 30s and have never been able to get a disability insurance policy because of previous health problems. I'm fairly certain that people with prior cancer would not be able to get a disability policy that covers recurrences. Many if not most cancer deaths are from recurrences. In addition, a lot of cancer patients are old and no longer working, so they can't get disability policies that cover lost wages.
BruDude
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by BruDude »

sawhorse wrote: Tue Oct 23, 2018 10:15 pm
BruDude wrote: Tue Oct 23, 2018 10:08 pm Shows the importance of a quality individual disability insurance policy....
If you can get one. I'm in my 30s and have never been able to get a disability insurance policy because of previous health problems. I'm fairly certain that people with prior cancer would not be able to get a disability policy that covers recurrences. Many if not most cancer deaths are from recurrences. In addition, a lot of cancer patients are old and no longer working, so they can't get disability policies that cover lost wages.
Which is why I always harp on buying one when you are young and healthy. I understand that some people won’t be able to qualify, but for those that do, it is extremely important.
ChrisC
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by ChrisC »

VictoriaF wrote: Tue Oct 23, 2018 9:34 pm

I think I will be able to keep GEHA-HDHP with HRA instead of HSA. But, when the time comes, I will check out other options, too. Your BIL's plan looks good.

Victoria
You can keep the GEHA-HDHP with the HRA but you should realize that the GEHA-HDHP won't pay for Medicare deductibles or co-pays under Part A or B, which kinda makes the HDHP quite unattractive for someone trying to be completely free of paying any medical expenses by virtue of having dual FEHB and Medicare insurance coverage. The Part A deductible is $1340 and Part B is $183 with 20% co-pays afterwards. In addition, one must also meet the separate GEHA deductible to be completely covered under GEHA-HDHP as the secondary insurance coverage with Medicare as the primary coverage. I don't see the benefit of having a GEHA-HDHP overlap with Medicare coverage. In the 2 years we've had the HDHP for my wife with Medicare coverage, we're essentially not getting any benefit from having the HDHP, unless we were to meet the high deductible mark for the HDHP, and there the benefit is marginal when measured against the premium costs.

Perhaps, I'm missing something but I think the better play is to get a tradtional health insurance plan that pays/waives Medicare deductibles and co-pay. FEHB medical insurance coverage should operate like a Medicare supplemental or gap plan, which pays/waives Medicare Part A and B deductibles and co-pays.
Wakefield1
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by Wakefield1 »

sawhorse wrote: Tue Oct 23, 2018 10:13 pm
dm200 wrote: Tue Oct 23, 2018 5:18 pm
Wakefield1 wrote: Tue Oct 23, 2018 5:17 pm I would suspect that a lot of people,especially if still able bodied at the time,if diagnosed with cancer,especially if one of the Monsters (I really would like to use a curse word here) such as Pancreatic or Small/Oat Cell of the Lung would tend to spend a great deal of their savings on an expensive cruise or vacation around the world or buy an expensive motor home and start touring everything in the USA that can be toured. That would burn up the savings.
the quote "Live like there is no tomorrow for there might not be one" where did it come from?
I have never known anyone who has done this..
I have only known one, a 15 year old girl, and she had to cut it short because she felt so bad. The treatment causes so many side effects and requires a lot of appointments, and the illness causes a lot of pain and weakness. By the time you get the terminal diagnosis, extravagant experiences are often out of the question. A lot of people spend their final months planning their deaths, getting documents sorted and things like that.
The Terry Fox story comes to mind ("Marathon of Hope") although he did not have one of the almost universally terminal cancers. Although his cancer killed him.
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VictoriaF
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by VictoriaF »

ChrisC wrote: Tue Oct 23, 2018 10:43 pm
VictoriaF wrote: Tue Oct 23, 2018 9:34 pm

I think I will be able to keep GEHA-HDHP with HRA instead of HSA. But, when the time comes, I will check out other options, too. Your BIL's plan looks good.

Victoria
You can keep the GEHA-HDHP with the HRA but you should realize that the GEHA-HDHP won't pay for Medicare deductibles or co-pays under Part A or B, which kinda makes the HDHP quite unattractive for someone trying to be completely free of paying any medical expenses by virtue of having dual FEHB and Medicare insurance coverage. The Part A deductible is $1340 and Part B is $183 with 20% co-pays afterwards. In addition, one must also meet the separate GEHA deductible to be completely covered under GEHA-HDHP as the secondary insurance coverage with Medicare as the primary coverage. I don't see the benefit of having a GEHA-HDHP overlap with Medicare coverage. In the 2 years we've had the HDHP for my wife with Medicare coverage, we're essentially not getting any benefit from having the HDHP, unless we were to meet the high deductible mark for the HDHP, and there the benefit is marginal when measured against the premium costs.

Perhaps, I'm missing something but I think the better play is to get a traditional health insurance plan that pays/waives Medicare deductibles and co-pay. FEHB medical insurance coverage should operate like a Medicare supplemental or gap plan, which pays/waives Medicare Part A and B deductibles and co-pays.
Chris,

First, I highly appreciate your explanations. You already have experience, whereas for me, at this time, these are just vague thoughts.

Second, my goal is not to avoid paying anything. My goal is to avoid a financial disaster. Paying annual deductibles is not a disaster.

Third, in most years, I don't reach the annual deductible. In some years, I have expenses that exceed my deductible, and I then bunch in other services such as dermatology screening.

Fourth, GEHA HDHP puts $75/month into HRA, or $900/year. If I pay the full HDHP deductible, I "lose" $600/year. If I don't reach the deductible, I lose less, and sometimes even "win."

Victoria
WINNER of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)
randomguy
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by randomguy »

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?
My networth decreased in 2000,2001, 2002, and 2008 by over 92k and I didn't get cancer:) Seriously the decreases is 92k+-1.9 million. I am pretty confidant that 1.9 million decreases are not a result of cancer.

Is it shocking that a bunch of americans get wiped out by a 100k bill? Not really. There are a lot of people with basically 0 net worth out there.
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dm200
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 »

No medical or statistical credentials here -- but I wonder how all "Cancer patients" were identified in this study to follow financially. My cancer ( and subsequent neck surgery) 31 years ago caused no adverse financial impact on me.
MnD
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by MnD »

Not surprising considering the latest Federal Reserve survey of consumer finances (SCF) indicates the median value (50th percentile) of household total financial assets is $23,500. Not hard to burn through that over 2 years when something comes up.

https://www.federalreserve.gov/econres/ ... Charts.pdf
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AlphaLess
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by AlphaLess »

As always people with the plan will do better.

Here is a plan:

1. Keep healthy. Eat healthy. Exercise. Sleep enough. Consume moderate amount of research showing what things cause cancer, and what things can prevent cancer. Do regular check-ups: once a year for your physical, mammograms for women, and more advanced tests at first warning sign. Once you have had warning signs, do the extra tests EVERY year. Don't listen to what the recommended guidelines are,

2. Save a lot. Have a good investment plan. Carry some (extra) disability insurance. Do research so that you don't get bad insurance policies (with potentially deadbeat insurance companies that don't pay),

3. Ensure that you have good health policies. Attempt to stay employed with at least medium-sized companies with excellent insurance policies, with a spouse who also targets similar. Even if financially independent, keep one foot in the labor market,

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

Post by HIinvestor »

My neighbor and his wife both had cancer. Both got all their initial care covered by their HMO policy at Kaiser (including all chemo and radiation). Kaiser also gave them the choice of all travel and treatment expenses including 4-5 months lodging at Sloan Kettering in NU (where their D lives) or UCLA for stem cell treatment that the local MDs don’t perform but is considered “state of the art” for his type of cancer. Both the patient H and caregiving W were transported!

They also both have Medicare A&B. The W says they don’t get bills for any balance, the HMO and Medicare cover it all!

My lifetime BCBS insurance has a max $3k/year cap for my copay. It has allowed me to be treated by the providers of my choice, nearly all of which are in network nationwide.
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dm200
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Re: 50% of Cancer Patients Burn Through Their Life's Savings in Just 2 Years

Post by dm200 »

HIinvestor wrote: Thu Oct 25, 2018 3:05 am My neighbor and his wife both had cancer. Both got all their initial care covered by their HMO policy at Kaiser (including all chemo and radiation). Kaiser also gave them the choice of all travel and treatment expenses including 4-5 months lodging at Sloan Kettering in NU (where their D lives) or UCLA for stem cell treatment that the local MDs don’t perform but is considered “state of the art” for his type of cancer. Both the patient H and caregiving W were transported!
They also both have Medicare A&B. The W says they don’t get bills for any balance, the HMO and Medicare cover it all!
My lifetime BCBS insurance has a max $3k/year cap for my copay. It has allowed me to be treated by the providers of my choice, nearly all of which are in network nationwide.
wow .....
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