The Climbing Costs of Cancer Care

Extract

Juggling bills has become a way of life for Robert Marraro. Over the past year, his electricity and water have been turned off at various times, and he is 4 months behind on his mortgage. “We determine which bills are most important and pay those first, and then go back and catch up with the rest of them. You learn just how far behind you can fall so that they don’t turn something off or take it away from you, and then you wait another 2 or 3 months while you pay something else. I call it creative financing.” Marraro is unemployed, which accounts for much of the problem, but much of the money that does come in goes immediately toward expenses for his fiancée, Rebecca Esparza, who has cancer. Esparza is also jobless, mainly because she is too debilitated to work after treatments for ovarian and thyroid cancer.

Esparza and Marraro are not alone: For millions of patients and their loved ones, cancer's financial effects can be just as devastating as its clinical consequences. Earlier this year, Scott Ramsey, M.D., Ph.D., drove home that point when he presented the findings of a study on bankruptcy among cancer patients at the annual meeting of the American Society of Clinical Oncology.