Financial Toxicity ‒ how Did We Get Here?

This Blog post represents a partnership between the Women in Medicine Summit and Healio Women in Oncology. An excerpt appears blow, and please find the full length piece at Healio’s Women in Oncology blog.

My introduction to financial toxicity came before I even knew what the term meant. My grandmother was diagnosed with congestive heart failure and chronic obstructive pulmonary disease when I was in high school. By my college graduation, she was on oxygen and in and out of the hospital every couple of months.

Costs of care

As the hospital visits increased, we realized that her care needs required extended time at a skilled nursing facility. The average cost of a nursing home in our area is more than $150,000 annually and we soon realized that it was not covered by Medicare. To get Medicaid in New Jersey, my grandmother’s assets needed to be less than $4,000. My mother carefully read the fine lines of the Medicaid spend down policy and understood the transfer penalties; she cashed out her life insurance, moved money into appropriate family members’ accounts, and bought easily returnable items to show we were spending her money.

These tactics were purposeful; the capital that my grandmother had built in a lifetime was meant to contribute to the future stability of her family as generational wealth or at least to help make my grandmother’s twilight years more comfortable. It was at risk for being exhausted by a single year of bad health, leaving my grandmother destitute in her old age.

Thankfully, my mother was by her side through all of this, helping her preserve some of her life savings and, thus, her quality of life as she got sicker, but what happens to those who don’t have this level of support to rely on? Do they lose everything?

About the author: Kenya Braxton is a second-year medical student at Rutgers Robert Wood Johnson Medical School.