The Cost of Cancer, updated (hang on to your hats)

Recently I came to the realization that I only get estimate of benefit ("EOB") statements if Blue Cross believed I was responsible for a remaining balance.  This explained a few things, such as why I had only seen charges for one round of chemo and seen nothing at all for radiation and seemed to be missing charges for one of my Neulasta injections.  After inquiring with BCBS I received a summary of all claims from 7/26/15 through early March.  It is jaw-dropping. I'll give you the numbers up front, followed by some thoughts:

Grand total:                    876,358.46

Chemotherapy                  112,638.30
Chemotherapy-related      146,856.91 (Neulasta)
Clinic/Consultation            18,676.55
Emergency Room                 4,118.00
Inpatient                           233,622.67
Labs/Scans                         76,635.84
Medical Mileage                     182.34
Medical Supplies                 8,906.07
Radiation                          119,350.62
Surgery                             153,506.89
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TOTAL                             874,494.19

then add in the updated out-of-pocket breakdown:

Clothing/supplies                    261.86
Copays- appts                         375.00
Copays- scrips                        121.23
Food                                       360.18
Parking                                   746.00
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TOTAL OOP                       1,864.27

First of all.. what?!?!  Yes.  Cancer is expense.  Surgery is, too.  I noticed that sometimes items aren't billed for nearly six months after the date of service.  I'll ask for another summary towards the end of the summer, after my next & last surgery (May) and next scan (June).  And I will keep doing that until I'm on a less frequent post-treatment scan schedule; I was told to expect one every six months for possibly three years, since my case was particularly nasty.  I'll take bets on when the total hits a cool million.

I am fascinated by a number of things:

 - Neulasta is no longer the most expensive thing on the list.  The BCBS summary was not as categorical as the EOBs so I had to guess where to put some things.  I think this is pretty close though.  Staying in the hospital now looks like a big chunk of my overall treatment, given how critical that was when I was first diagnosed, and my desire to return to anatomic normalcy.

- BCBS only sends an EOB if I might owe something; it's almost like they don't want me to know how much things cost.

- BCBS sent the summary in a .pdf file.  I'm a data head so I entered all the gory detail into the excel I've been maintaining.  I think someone with lesser analytic curiosity and data entry skills would not have bothered.  Again, it's almost like they don't want you know how much it all costs.

- Medical professionals and insurance companies make administrative mistakes.  I do not know how they keep their records, but I think I found a couple of duplicate charges, and given how the information is presented (at least to me via this summary), those charges were paid each time.  I wonder how many mistakes are out there and how much they contribute to inflated medical costs because we're reporting and analyzing the wrong data. 

-  I understand that before the ACA, there were lifetime caps on how much insurance would spend on you.  I'm thinking I might have hit that cap.  And I'm only 44.  And have no family history of or genetic disposition for the disease I got.  And am otherwise perfectly healthy.  Sobering.

- The insurance "discount" given for everything makes no sense at all.  If a service provider is okay with not getting paid what they say a service costs, why do they bother charging that price at all?  So that people without insurance have to cough up the full, arbitrary cost?  And insurance companies don't?

- I think I hate insurance companies, despite the fact that without my insurance I'd probably be dead.  Or at least destitute.

- Say it with me: SINGLE PAYER.

I'm just flabbergasted.  Once upon a time when I worked as a fund accountant at Investors Bank & Trust, I worked on a fund with around ~$10 billion in assets.  For whatever reason this amount didn't phase me.  One day the amount of cash assets hit $1 billion, just for that one day.  For whatever reason, because it represented cash -- like money in my pocket, and not some bizarro mythological representation of a (sometimes made-up) financial instrument's worth -- that number phased me.  I could not imagine such a vast sum of money.  Inconceivable. 

Now that I'm sort of grown up and have a mortgage, I can mostly digest the cost of my cancer treatment, even though it's much, much more than my mortgage.  What I can't digest is that there are people without insurance, because a majority of politicians running our country don't believe that taking care of our citizens' health is a right, and that those lacking insurance will live if they are immensely wealthy or die if they are not.  Inconceivable.  Sadly, in this case, it means what I think it means.