C Stands for Ca-Ching

My friend is home from his second round of immunotherapy at UCSF and is doing well. He arrived shortly before the first invoice did and, thankfully, was already lying down when he opened the manila envelope. The 12 itemized pages included 5 days of ICU, 14 doses of interferon at $5,000 per dose, the PICC line and every other item needed during his fight for survival. Bottom line for those 5 days? $289,000. Doctor's fees not included - those will come later. As will the invoice for the 2nd week which includes another $30,000 for interferon and 3 days of ICU.

I know all this because in addition to being his friend, I'm also his HR go-to and will be helping him organize and track the expenses. He is very, very unlucky to have melanoma and is very, very lucky to have good health insurance coverage. When we talked today, I said "congratulations, you've spent more than the company's annual premium for 30 families in only one week. That's a record!" We both laughed - what else could we do, start crying?

It's my job now to make sure that he keeps that coverage, by keeping him compliant with the insurance eligibility requirements. That means he has to a) work a minimum of 30 hours per week (regardless of how he feels), or b) be placed on protected FMLA medical leave (12 weeks allowed in a 12 month period) or c) be moved onto COBRA if a and b are no longer options. Federal COBRA has a maximum 18 month enrollment. I refuse to even look at option d, where he'd exceed the 18 months and then be left with absolutely no coverage and no possibility of ever getting coverage again.

A few minutes after I talked to him, I read internet articles about the health care industry agreeing to work with the Obama administration on health care reform. I'm not sure where the changes will come, but I hope all the sides will finally come to a large table and work out some viable options. The system we have now works for many of us, but there are a lot of large, scary, black holes in the safety net. Hopefully within the next few years some of those holes will be filled so that cancer patients can focus on wellness instead of bankruptcy.

In the meantime, my friend and I are waiting for the second, third, and fourth envelope with a UCSF addresses to arrive. Overall charges for his health?: priceless.