Cancer cases create insurance conundrums

    U.S. Sen. Ted Kennedy’s recent cancer diagnosis resonates with me because it is the same malignant "glioma" that ended my father’s life in 1970 at age 49. Yes, just 49!

    As I "celebrate" one of those milestone birthdays that puts even more years between my own age and Dad’s early death, I find myself in a particularly pensive mood.

    To wit, it is interesting to recall that Dad’s major medical policy had a $250 deductible and a lifetime limit of just $50,000. Remarkably, a team of neurosurgeons and a 110-day hospital stay did not exhaust that modest policy limit!

    Roll the clock forward 38 years, and now you are hearing many lament the "cost shift" burden of high deductibles and even modest co-pays. Some speak of the growing underinsured problem – never mind the fact that a $250 deductible from 1970 inflated using regular CPI should today be around $1,500; using medical CPI, well over $3000.

    In truth, the underinsured problem is not with front-end deductibles and co-pays but instead the back-end insurance policy limits of between $2 million and $5 million.

    In this vein, Regina Herzlinger speaks of cancer drug therapies alone (e.g. Erbitux or Zevalin to name just two) that can cost $24,000! With evolving, ever more expensive treatments, the real debate on health care may need to focus on how much is a life worth?

    And, should an HMO or government bureaucrat make that call? We might also ponder this: with identical cancers, should Joe Lunchbucket get any less care than Sen. Kennedy?

    These are tough questions that do not allow for sound bite answers. My birthday wish is that more folks who really care would step forward and publicly address the gravity of the matter.

    Jon Rauser is president of The Rauser Agency Inc., Milwaukee. He writes an ongoing blog about the health care industry at www.rauserhealthreview.com.

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