MARY LOUISE KELLY, HOST:
This is what having cancer in the U.S. these days entails - grueling treatment, yes, but also surprising medical expenses, insurance denials, depleted savings accounts, even bankruptcy. Anna Gorman reports from Texas on one family coping with the financial fallout of cancer.
ANNA GORMAN, BYLINE: Carol Marley is 50 years old. She has pancreatic cancer. Every day counts. And every day brings a frustrating phone call with an insurer or medical provider.
CAROL MARLEY: This is Carol Marley calling. I'm getting ready to be going out of town for a treatment for my cancer, so I really - I need some help. If you could please call me today, I would appreciate it.
GORMAN: Even though pancreatic cancer is one of the deadliest cancers, Carol's doctors caught it earlier than most.
C MARLEY: I have faith in God that my cancer is not going to kill me. I have a harder time believing that this is going to get straightened out and isn't going to harm us financially.
GORMAN: Carol is a nurse near Austin, Texas. She was diagnosed in July, and the cancer hasn't spread beyond her pancreas. Her health and the finances weigh on her.
C MARLEY: It's incredibly stressful. I mean, I don't sleep at night. I take anxiety medication, you know, more often than I want to.
(SOUNDBITE OF DOG BARKING)
C MARLEY: Rascal, lay down.
GORMAN: Carol has a husband, a daughter in college and two small dogs. Her father, who has dementia, also lives with her. But after months of chemotherapy, Carol realized that she could no longer care for him. She found a place for him in a memory care home.
C MARLEY: And I knew that there would come a day. I didn't think it would be so soon, and I didn't know, you know, under these circumstances.
GORMAN: Families facing cancer have to make dramatic choices, like spending through college savings or taking out second mortgages. Stephanie Wheeler is an associate professor at the University of North Carolina at Chapel Hill.
STEPHANIE WHEELER: In some cases, patients are having to work longer than they anticipated and make very different decisions about their household than they would have otherwise had to make.
GORMAN: Carol and her husband, Randall, pride themselves on living frugally. They pay their credit card every month and keep an emergency fund. He says they planned to retire early, but that's on hold.
RANDALL MARLEY: We're at a standstill.
GORMAN: But first, they have to get through treatment. The couple has hope, but they're also realistic.
MARLEY: You know, I have to confront the possibility that she's not going to make it through this.
GORMAN: Randall says the hardest part for him has been the toll taken on his wife - the pain, the uncertainty. They worry about finances, both now and in the future. Carol had to stop working and had to apply for long-term disability.
C MARLEY: We're just bleeding money, you know, with payments.
GORMAN: Carol has private insurance through her work. Still, they're out thousands and thousands, and that's before radiation and surgery. She says managing cancer and cancer bills is a full-time job, one she isn't trained for.
C MARLEY: Even as a nurse, I feel like it's impossible to understand.
GORMAN: She can spend hours a day clarifying bills or trying to fix mistakes - an $18,000 chemotherapy bill not sent to insurers on time, a $900 MRI bill denied incorrectly.
C MARLEY: There's no recourse for me except to just keep making phone calls.
GORMAN: This afternoon, Carol's trying to get a provider that overcharged her to credit her account. It's taken months. After 15 minutes, the computer system crashes. The clerk apologizes. Carol puts down the phone and puts her head on the desk. She's feeling overwhelmed.
(SOUNDBITE OF DOGS BARKING)
GORMAN: She joins her father downstairs. The dogs jump on her lap.
C MARLEY: Have you fed these dogs today?
UNIDENTIFIED PERSON: I don't feed dogs (laughter).
C MARLEY: These aren't your dogs?
UNIDENTIFIED PERSON: I don't think so.
C MARLEY: (Laughter) I'm teasing you.
GORMAN: Soon, Carol will start radiation. But in this moment, she tries not to think about what's to come. I'm Anna Gorman in Round Rock, Texas.
(SOUNDBITE OF GEOFF FARINA SONG, "PRICK UP YOUR EARS")
KELLY: And Anna Gorman is with our partner, Kaiser Health News.
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