A November 30 2020 post to Reddit’s r/awfuleverything spread virally across platforms, prompting discussions all over social media about u/binkybrain’s original comment and the cost of cancer care in the United States:
Another account, Smexyredditor69, shared screenshots without a date:
My wife has cancer, it took 5 months to wipe out 20 years of life savings and that was with insurance. The experience has turned me into a hateful, bitter person. We did everything we were told. We went to college, got degrees, avoided credit card debt, spent wisely, saved a nice chunk of money in savings accounts and retirement accounts and minded our own business. The USA healthcare system took all of our savings and retirement and forced us to refinance our house so that we lost 15 years of equity. This is a country I’m supposed to be proud of? I hate this system and anyone that defends it.
is the us healthcare really that fucked up. i was thinking of moving to the us for a tech job in the future but hearing people story about us healthcare made me scared. How bad is it really?
On the same day, another Reddit user shared the post to r/LateStageCapitalism:
At least three iterations of the same post were shared on Imgur, two of which were posted on November 30 2020. A third was shared on August 5 2020, indicating that the comment was not new when it circulated in late November and early December 2020.
As of December 1 2020, the Reddit account of u/binkybrain was suspended for unknown reasons. Their comment appeared to have originally been a response to a July 1 2020 post to r/ABoringDystopia, featuring a tweet by former U.S. Labor Secretary Robert Reich:
They were responding to one of three separate comments about the cost of cancer care in the United States. The first read:
The numbers are just so insane that it’s not even something that you can budget for. It’s I cannot understand how this system ever came into being.
“Oh you don’t have $90,000? Then why did you get cancer dummy?”
It makes no sense whatsoever. Yes, the people that work in the healthcare industry should be paid, and paid well. But having third parties with literally NO ethical incentive be in control of the companies they work for at the shareholder level is literally the worst system I can think of.
Another commenter responded:
I know It’s just an example, but I want to add that $90,000 will not get you very far at all in cancer treatment. I’m not an oncologist but I treat cancer patients. There are non-surgical procedures I do that cost well over $50,000. There’s one drug I rarely have occasion to use, but it’s over $50,000 for a one time dose.
As far as funding healthcare workers and facilities, a huge chunk of that money vanishes into the ether of international conglomerates. The hospital recovers their cost and makes a small amount of money.
A third, shorter comment added:
I can’t believe this is considered normal where you live
The claims made in u/binkybrain’s comment were not dissonant with published research about the “financial toxicity” that a cancer diagnosis can cause in the United States. A 2018 study in the American Journal of Medicine was soberly titled “Death or Debt? National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer,” and the abstract’s conclusion stated:
This nationally-representative investigation of an initially-estimated 9.5 million newly-diagnosed persons with cancer who were [under] 50 years of age found a substantial proportion incurring financial toxicity. As large financial burdens have been found to adversely affect access to care and outcomes among cancer patients, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance.
Another section, “Results,” said:
At [and after the second year following diagnosis], 42.4% depleted their entire life’s assets, with higher adjusted odds associated with worsening cancer, requirement of continued treatment, demographic and socioeconomic factors (ie, female, Medicaid, uninsured, retired, increasing age, income, and household size), and clinical characteristics (ie, current smoker, worse self-reported health, hypertension, diabetes, lung disease) ( P<.05); average losses were $92,098. At year +4, financial insolvency extended to 38.2%, with several consistent socioeconomic, cancer-related, and clinical characteristics remaining significant predictors of complete asset depletion.
NPR cited the study in February 2019, profiling cancer patients’ struggles with the private insurance system in the United States:
More than 42 percent of the 9.5 million people diagnosed with cancer from 2000 to 2012 drained their life’s assets within two years, according to a study published [in 2018] in the American Journal of Medicine. Cancer patients are 2.65 times more likely to file for bankruptcy than those without cancer, and bankruptcy puts them at a higher risk for early death, according to research.
But those statistics don’t convey the daily misery of a patient with a life-threatening disease trying to navigate the convoluted financial demands of the U.S. health care system while simultaneously facing a roller coaster of treatment and healing.
Stephanie Wheeler, a professor at the University of North Carolina at Chapel Hill, said the number of bills coming from different providers can be overwhelming.
“It’s oftentimes multiple different bills that are rolling in over a period of several months and sometimes years,” says Wheeler, who has conducted survey research with metastatic cancer patients. “As those bills start to accumulate, it can be very stress inducing.”
In a January 2020 fact check, we examined similar claims about medical bills and their role in bankruptcy (and again in February 2020, in a similar article about Americans being jailed over medical debt):
In late November and early December 2020, u/binkybrain’s July 2020 comment about their wife’s cancer diagnosis spread virally across platforms, but Reddit is largely anonymous and the comment’s details were unverified; the suspension made it difficult to contact them for verification. Nevertheless, that claim was congruent with published research about the depletion of assets and savings among cancer patients in the United States, with more than 42 percent having “drained their life’s assets,” as the NPR story put it, in a period of two years or less following their diagnosis.