Tan Kin Lian's Blog: Expensive medical treatment

Saturday, March 29, 2008

Expensive medical treatment

My friend's wife passed away recently from cancer. She was in her early 50s.

This was the third cancer attack over the past 15 years. My friend appointed a private cancer specialist to treat her. The initial estimate was $50,000. The total medical bill increased to $150,000.

My friend knew that the chance of recovery was very slim. When the initial estimate was exceeded, he found it difficult to decline the suggestion of further treatment. He had to spend so much money, when there was virtually no hope. He earned a modest income, so the medical bill represented many years of his earnings.

He had made an insurance claim on an earlier cancer treatment. The latest episode was not covered by insurance.

Lesson: There is no point in spending so much money for treatment, when there was virtually no chance of recovery. He should have obtained independent, objective advice from another specialist (other than the specialist that treated his wife).

15 comments:

Anonymous said...: Well, your friend has not much choices but to seek any treatment to try to cure his wife, because it is a life at stake.
If one of our family members is in this situation ie suffered from cancer, won't we try all ways and means to save him or her?
Even if we know it is already in the final stage, are we going to do nothing but watch by the bedside?

bungerstar; March 29, 2008 11:16 PM
Anonymous said...: My younger sister passed away at 40years old after breast caner and bone cacer. It was in 2003. The NUH bill was $30k covered by company insurance. Her doctor was a NUS professor. She gave up herself to fight the cancer! She was told the sucessful rate. She spent her last few days in a CHARITY hospice home. The monthly room rate was S$8500 without aircon. After a mean test, the monthly rate is S$2500. Before admitted to the CHARITY hospice home, there was a long Q !

A NUH Social Worker had cautious me to keep as much money as possible for the last moment especially elderly !!

Healthy life style is a better medical insurance policy.; March 29, 2008 11:49 PM
Anonymous said...: First I felt sad for your friend's wife and sympathise with his unexpected financial stress.

I agree with you that second opinion is needed. However, I beg to differ from your view on "no point spending so much money for treatment, when there is virtually no chance of recovery". It may not work for you, Mr. Tan. But for me, I would have grab that slim chance for my wife or my parents.

In fact, I am quite disappointed by your statement that there is "no point in spending so much money ...". Through the years, that my wife stuck with me through thick and thin and looking after the children, and my parents for the sacrifices they have made for me, I think I would be quite heartless and selfish to let them go without exhausting all ways and means.

The questions I have are:

1. Why is the treatment so expensive ... how can the doctor increase 3-fold from the original estimate, isn't this a heartless doctor? Can your friend give name of doctor and perhaps someone can help him lodge a complaint. Is there a law to protect normal consumers from such unethical doctors?

2. Why did your friend appoint a private specialist when he only earns a modest income? He could have opted for a restuctured hospital specialist, for example, from National Cancer Centre.

3. Is it possible for his wife to stay in C - class ward and get the 85% government subsidy? What about his Medishield, the plan you recommended, isn't it enough to cover his wife's hospital bills? Does his wife have a death policy that pays out a lumpsum to offset the expenses due to her death?

4. Why is it not possible for his wife to go overseas for treatment, after all this was the third cancer treatment? Supposed the second opinion showed that a different treatment costs more but can have 50% chance of recovery, what would your friend have done? What would you have done?

5. Are you recommending us to judge how much is the "financial value" of our loved ones to decide how much to spend on them?

R.; March 29, 2008 11:50 PM
Anonymous said...: What is the issue here? money or life? Trying to keep hope alive or life alive , both require money.
In the first place , it might have helped if the afflicted wife had a medishield or incomeshield. It would have helped to cushion for a long time, if the relapse recurred and recurred.
That is the wonder of an H&S plan.It is cheap and yet so useful for life time.
What about a critical illness plan? I know someone would suggest it. But look, it is so useless in the face of a dire need like this. It is one off and quickly the lumpsun payment is dissipated but not the H&S. How about buy a huge CI cover? A whole life or limited LPPL? Who can afford such large cover? What if it doesn't happen? It is money down the drain.
My conclusion is , nothing beats the wonder of an H&S plan. Don't give me the crap of a wholelife CI or a vivolife. It would be living in fear to the fullest. How inadequate.; March 30, 2008 12:00 AM
Anonymous said...: How to seek a second opinion in a public hospital?
Change an appointment date during treatment!

Why seek treatment at NUH?
A subsidised patient has a chance to be treated by teaching faculty. Few years back, there was a court case between a private hospital and a Malaysian over the unexpected medical charges. Why go private hospital if beyond budget?; March 30, 2008 12:19 AM
Jordan Goh said...: Dear Mr Tan,

What will you do if you were in your friend's shoes when there is "virtually no chance of recovery" for your loved one (wife) or someone who is closest to your heart?

What will you do after obtaining "independent, objective advice from another specialist" who conclude there's virtually no chance at all?

Just curious.

Jordan; March 30, 2008 1:02 AM
Anonymous said...: I do understand what it will be like when we are in the man"s shoe. I too will be in a delima. Yes , it is easy said than done. It is an emotional issue and emotional issue is very often irrational .
We will be torned between doing our best for our loved ones and to be saddled with huge debt.The former is often our choice especially she is someone whom you love very much.Money isn't an issue then. Priority is healing.
I don't understand why his wife wasn't covered by a minimum medishield. That plan would have borne some huge amount of the medical bill.; March 30, 2008 9:05 AM
Anonymous said...: After reading all the comments my conclusion is the basic medical plan H and S is the MOST important , far more important than living plan.
I hope insurance agents who read this case have a heart for their clients when recommending the living plan. Don't sell them a small whole life but a big term plan so that when it is needed it is enough. I am really disappointed with insurance agents when they put their interest first disregarding the needs of the client. I truly agree with the comments which condemn the agents for heartless conscienceless selling.; March 30, 2008 9:27 AM
Anonymous said...: Late 1990's, a TV feature program interview a construction businessman. He stay in a landed property value at S$1m. After he diagnosed a kidney patient, he sold his property. His money is not enough to cover medical cost in private medical center. Later, he seek the help from NKF.
A millionare became a subsidised poor patient !

Good Luck.; March 30, 2008 12:01 PM
hongjun said...: There is nothing wrong to be objective in giving a friend advices but then in then end, support should be given to him on whatever decision he makes.

He must have loved his wife a lot and his only wish is to have his wife cured.

hongjun; March 30, 2008 12:04 PM
Anonymous said...: The best insurance against illness is not having an H&S or CI plan but a plan of daily exercise and healthy diet. This plan can prevent the other
plans cannot. Having the other plans only make you complacent and let down your guards.; March 30, 2008 12:35 PM
Anonymous said...: HOW TO LOVE OUR FAMILY MEMBER IF HE/SHE IS VERY SICK?
First, you tell yourself you must be strong, eat well and exercise regularly to relief your stress. You may eat banana - happy fruit!

Next, tell the Nursing Officer you want to meet a Social Worker. She is availbale at all wards of all restructure hospitals and Polyclinics. A counselling session will be conducted. End of session, you ask for the CARE PLAN for both patient and patient's family. Now, your problem (inclusive finacial difficulty) may be half solved . Someone is behind you, you feel better and able to love your family wholeheartly.

In case of private hospital treatment, family can telephone SOS if needed or visit nearest Family Center in all new town for emotion support at very cheap cost.

Good luck.; March 30, 2008 2:32 PM
Anonymous said...: hi mr tan,

it sounds like your friend's wife is terminal.
i think that this doc should lay the prognosis on the table and let the patient and husband decide if they wish to carry on with expensive treatment with only a very slim chance of cure.
if the patient decides to go ahead, there is nothing else to say, but pay and hope for the best.

but if the doc pushes for more chemo/radiotherapy without letting the patient know the chances of cure, then that is not ethical.

it is difficult to measure life with money, but when one is terminally ill, our society and mindsets have to change....make a move towards palliation (making remaining life comfortable and as much quality as possible) rather than attempting cure (heroic medicine, which usually ends in failure and lots more suffering). so yes, i agree with mr tan, if this is a terminal case.; March 30, 2008 5:43 PM
Anonymous said...: I think whatever the decision, it should based on the quailty of life of the patient. Why put rhe patient through the pain and get nothing out of the treatment. I know it is not easily when you are in that situation.
Just my opinion.; March 31, 2008 9:19 AM
Anonymous said...: Sometimes it is not that the insurance agents did not advise clients to take up crit illness or hospital plans but the clients themselves who do not take up the agents advice.Anyway, healthy lifestyle is impt but cannot guard against crit illness. And why blame the ins cos for the high prem, why not blame the hospitals for charging so much?; April 24, 2008 7:40 PM