With so much news about health care swirling around this weekend, now seemed to be a good time to reflect on this rhetorical question: Why do patients without insurance pay more than patients with insurance? You would think “cash is king”—that someone paying for their own treatment should be the ones getting a break. But our system works in an opposite way. One needs only to look as far as their last insurance statement. My new carrier is Cigna—My wife Pattie’s employer mandated company. The cost of my initial consultation with my myeloma specialist/oncologist, Dr. Melissa Alsina, was $438. Now I don’t know if that is a fair price, or charge, for that service or not. I did meet with several different medical professionals during my visit, including Dr. Alsina’s medical fellow/assistant and her oncology nurse. Dr. Alsina is a well known multiple myeloma expert—which is one of the reasons I chose Moffitt Cancer Center in Tampa for my medical care. Cigna only allows, and is only paying $157.95. The balance is written off. That’s a 63% discount. Similarly, Pattie also recently visited Moffitt. The insurance “discount” on her labs went as high a 85%. One fee, a $231 “facility charge,” was disallowed altogether.

I have no problem with any of this. If Cigna can negotiate health care costs down on our behalf—great! But what if I didn’t have any health insurance? What if I was expected to pay that bill? Would I receive similar discounts? NO! That’s fair? This is so counter-intuitive to me.

Watching CNN last week, a financial health care advisor recommended negotiating your bill down if you are paying yourself—saving you up to 30%. What? 30% is far less than the Cigna billed discounts. Worse yet, why should you or I need to negotiate a medical bill. That is one of the reasons I hate buying a car. The negotiation. What ever happened to bottom line, fair pricing—for autos or health care?

Feel good, keep smiling and hold on to your wallets! Pat

2 thoughts on “Why Should Cancer Patients Without Insurance Pay More For Their Health Care?

    Prostaglandins are infinitesimal, ephemeral and powerful signaling molecules that self-regulate the chemistry of every cell in the body, including cells regulating mood, and those regulating immune function. When produced within normal limits, prostaglandins regulate the physiology of every cell; when produced excessively, physiology becomes pathology. When brain cells produce excessive concentrations of prostaglandins, they depress mood and immunity. In 1973, David Horrobin showed that antidepressants inhibit prostaglandins, and in 1977 that prostaglandins regulate nucleic acids (DNA and RNA).1,2 Others subsequently showed that prostaglandins regulate the synthesis, inhibition, and expression of genes, and the growth, differentiation, and replication of cells, with cancer the accelerated replication of abnormal cells.1,2 Excessive synthesis of prostaglandins induces cancer, with genes determining the variations. In 1998, Brenda Penninx showed that at age 70, chronically depressed people have an increased risk of 88% of developing cancer, and 50% of dying of it. Others have shown that depression increases and accelerates cancer mortality.
    More than seventy clinical, laboratory, and epidemiological studies have shown that antidepressants kill cancer cells, inhibit their proliferation, convert multidrug resistant cells to chemotherapy sensitive, augment chemotherapy, protect nonmalignant cells from damage by radiation and chemotherapy toxicity, and target the mitochondria of cancer cells while sparing those of healthy ones.1,2 Antidepressants have therapeutic potential in many cancers that are often treatment resistant, such as gliomas, cancers of the lung, kidney, liver, and uterus, inflammatory breast cancer, resistant lymphomas, and multiple myelomas.2 Antidepressants are capable of arresting lung cancer in advanced stages, occasionally arresting it, and significantly extending life. That antidepressants are effective for a multitude of malignancies, decries the myth that cancer is a hundred diseases, when it is one disease with a hundred variations.3
    Antidepressants alleviate cancer pain, alone or combined with narcotics, remit nausea and vomiting, promote sleep, relieve anxiety and depression, and combat fatigue. Other inhibitors of prostaglandins, such as non-steroidal, anti-inflammatory drugs as aspirin, indomethacin, ibuprofen, and piroxicam, and COX-2 inhibitors, also have potential value in preventing and treating cancer.
    The components are in place for a revolution in cancer prevention and treatment, as may be confirmed by accessing Medline or Pubmed, and entering “antidepressants” and “cancer.” In “Against Method” Paul Feyerabend wrote that suppressing a paradigm in preference to one politically favored could permanently damage society, and that resistance to progress could be so intractable that political intervention might be needed.
    Julian Lieb, M.D
    1.Lieb, J.”The multifaceted value of antidepressants in cancer therapeutics.” Eur J C Editorial Comment. (2008) 172-174
    2 Lieb,J.”Defeating cancer with antidepressants.”ecancermedicalscience”DOI.10.3332/eCMS.2008.88
    3.Lieb, J “Killing Cancer.” (1010) Amazon (in press).

  2. What? At first I thought this comment was a mistake or joke. But after reading it again, the physician author may be making a good, but overcomplicated point: "Don't worry–be happy!"
    Julian- I would be glad to include some of this info for my readers… E-mail me and you can post a follow-up if you like. But it would help if you could tone it down a bit and translate for those of us who aren't medically trained! Pat

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