The Numbers So Far

I believe that I have repeatedly promised to deliver some cost data for this fiasco, without doing any actual work to make that happen. But recently I have made some progress in the right direction on this, maybe. The health insurance company's web site can deliver claim information in the form of comma-delimited report files that can be swallowed by Excel and then subjected to the usual analytical torments. The major impediment to this being truly useful is that these reports include no information that can be used to categorize the claims. But then, I don't care for the categories used in this database in the first place. For example, for my purposes, making a distinction between physician consultations that occurred in a hospital setting vs. those that occurred in an office setting is pointless. On the other hand, I think it is useful to distinguish between image-based diagnostics vs. blood tests. If you disagree, then... get your own blog. OK, so anyway, here are the numbers (all denominated in USD) for the period from June 4, 2009 -- the day the ambulance took me to the hospital -- through September 30, 2009. My apologies if the columns do not seem to quite line up; I am not an HTML god.

Category	Billed Amount	Network Discount	Paid by Plan	Paid By Patient
Ambulance	713.50	-	713.50	-
Chemotherapy	2,660.00	1,967.68	692.32	-
Consultation	10,619.00	2,423.39	7,990.61	205.00
Diagnostics	11,832.00	4,484.23	7,347.77	-
Home Health Care	5,610.00	3,960.00	1,650.00	-
Hospital	61,478.81	2,459.15	58,519.66	500.00
Laboratory	7,009.42	2,605.35	4,404.07	-
Medical Supplies	3,374.00	2,676.10	697.90	-
Radiation Therapy	4,514.00	2,062.21	2,451.79	-
Surgery	9,418.00	7,074.86	2,343.14	-
Total	117,228.73	29,712.97	86,810.76	705.00

The "Network Discount" numbers are the amounts by which claims were reduced in honor of the insurance plan's contracts with the providers. There is no way to know how much the providers get up front for being in the plan, or how those numbers could be pro-rated to show the "true" cost to the insurance company. The "Chemotherapy" category touches only the Aredia IVs I have been getting; I didn't know what else to do with these. None of the other medications are in here, which is too bad, but they are in a repository on the mail-in pharmacy's web site. In any case, the cost of medications is completely dominated by Revlimid, which costs the insurance company more than USD 7K per cycle -- close to USD 30K in total for the four cycles so far. And of course, the "Paid By Patient" category doesn't include anything that didn't involve the health insurance company, such as the expensive lift recliner.

I have been trying to get some readings on the cost of stem cell transplants; the numbers I am getting so far are in the USD 100K - 400K range, depending on the "complications" encountered in individual cases. There is no such thing as a "typical" stem cell transplant.