Cancer: The Ugly Side of Having a Health Insurance

Johnny (not real name) is a 46-yar-old male. He was diagnosed with colon cancer and underwent a surgery which turned out to have gone wrong. A second corrective surgery had to be performed. Later Johnny was asked to undergo chemotherapy which he declined. Seven months after the above episode we sat down to talk with Johnny about his nightmarish experience. The following are excerpts of our conversation.

Question: When you were told to have a surgery, did you have a chance to think more about it before you went ahead with it?

Johnny: I had no time to think about it at all. The way the doctor talked to you seemed that the whole world was coming down -- It was serious and if you dont get rid of it by next week, nobody was going to do anything for you anymore. We cannot help you because Chinese New Year is around the corner. So in a way, I had no chance. I asked the doctor: Can I come back after the Chinese New Year? He replied: Cannot, cannot. It is up to you. I can only give you my advice. By that time (i.e. if you waited for three weeks more) the cancer may block the colon and you cannot pass out stools. No body can help you if that happens during the Chinese New Year.

The doctor told me: If you do not operate, remember that the cancer can grow very fast. It is going to block the intestine and by that time nobody can help you anymore you can die from that.

After the operation I felt okay and was subsequently discharged from the hospital. Then something went wrong. I could not eat and had severe hiccups -- in one minute I hiccupped 30 to 40 times until I could not even breathe. I was discharged at about 2 p.m. and by 4 or 5 p.m. the hiccup problem became serious. The next morning, I was brought back to the hospital again. Four days later, I had my second operation.

Q: But, when you went to see the doctor, was there any blockage?

A: No -- I could still pass out stools. But the stools were a bit thin. If I were to say that I wanted to pay the hospital bills with my own money, I believe the story would have been different. The doctor asked me: Do you have any insurance? I replied: Yes. He said: You better get rid of it -- anyway, it is not going to be your money. What have you to be afraid of -- the insurance is going to pay for you. If I were you I would get rid of it. In my mind, I felt that if I were to pay the bills myself, he would have told me to come back after the Chinese New Year for the operation.

Cost of Surgery and Health Insurance

Q: Did they tell you beforehand how much the operation is going to cost you?

J: No, they didnt. And I dont know how they charged me either. This is because I did not pay cash. I depended on my insurance. My first operation costs RM 13,000 plus. My second surgery costs RM 16,000 plus.

Before the operation one doctor came and we discussed. He asked: Are you covered by insurance? I replied: But the limit is only very little, around RM 20,000. He said: Enough already. It is going to be around RM 10,000 plus. It should be okay. I then enquired: What, if I were to pay cash? He said: Below RM 10,000 if you are willing to pay cash. I will estimate and tell you right now how much it is going to cost.

Pay cash, the cost is going to be below RM 10,000 but with an insurance it is going to be more than RM 10,000. See, RM 19,000 is still above RM 10,000. All this happened because I told him that my insurance has a limit of RM 20,000.

Q: Were you happy with the doctor who did the colonoscopy and later advised you to go for surgery?

J: I was not happy. He was not sincere in giving me his advice. Later I found out that he actually asked a friend of mine to tender his apology to me for the foul up that happened. He said this to my friend: I felt sorry for what had happened to your friend. I apologize on behalf of the hospital. Tell you friend that we were really sorry for him. I was really not satisfied because in the first instance I was told it was going to be just a simple operation. Then, there was a second operation and many problems cropped up with it. I spent the whole month in the hospital. I was really fed up.

Some time later, I met up with this doctor. He told me: I recommended the best surgeon in town for you. I did not know what had gone wrong. So far in the history of the hospital you are the first person to have encountered this type of problem. This doctor then suggested that I went to see the oncologist of his own hospital instead of the oncologist at the cancer hospital for my chemotherapy. I told him that I did not want to do any chemotherapy. He said: Why not, you should go for chemotherapy. I replied: You want to take my life? You mean I have no other options? Many of my friends went for chemotherapy and all of them were gone. Can I still trust chemotherapy? He replied: No, no. There are many kinds of drugs Grade 1, grade 2, grade 3. I responded: Until today, you doctors take for granted that patients will go for this and that and the money will come to you! Your main concern is money. You specialists and your hospital are more concerned with money. You people dont care so much about the patients whether they die or live is not important. He replied: No, no. We did our best for our patients.

Indeed I was not satisfied with this doctor because he was not sincere enough. What he said was nice but what he did to you was another story.

The lessons we can learn from this true-life story:

1. It is good to have an insurance cover, but make sure that the insurance plan is one that suits you.

2. Buy an insurance plan that pays an outright lump sum in the event that you are diagnosed with any critical illness. This give you a total flexibility to do what you like with the payout lump sum -- to seek any treatment of your choice.

3. Do not buy an insurance that pays only the doctors and hospitals bills. The story above shows the ugly side of having such an insurance plan. You may just be enriching the doctors and hospitals at the same time at the expense of your own perils.

4. Hear what Dr. Robert Medelsohn (in: Confessions of a medical heretic) wrote about the hospital: You should try your best to stay out of it (it is) one of the most dangerous places on earth.

5. Just because the insurance pays for your medical treatment like surgery, chemotherapy, etc. these do not mean that they are good or necessary for you. Look at it another way -- unnecessary treatment could be outright dangerous or may even kill you!