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美国国家公共电台 NPR Chronically Ill, Traumatically Billed: $123,019 For 2 Multiple Sclerosis Treatments

时间:2018-12-03 05:28:23

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Chronically1 Ill, Traumatically Billed: $123,019 For 2 Multiple Sclerosis Treatments

AUDIE CORNISH, HOST:

Every month, NPR and Kaiser Health News take a close look at medical bills that you send us. Today we hear about a woman whose medical bill for a drug to treat multiple sclerosis was so high that she considered asking her doctor to put her on other medication. Dr. Elisabeth Rosenthal is editor in chief of Kaiser Health News. She joins us now in the studio. Welcome.

ELISABETH ROSENTHAL: Thanks for having me.

CORNISH: So tell us a little bit more about this woman and her situation.

ROSENTHAL: Sure. This month we spoke2 with an Ohio woman named Shereese Hickson. She was diagnosed with MS, or multiple sclerosis, several years ago. And she's on disability now and can't work because of her disease. But she's able to take care of her son, and she's fairly active given her condition.

CORNISH: And we should note that MS attacks the central nervous system, right? So there are a bunch of symptoms that can come with that - fatigue3, blindness, even the inability to walk.

ROSENTHAL: Yes, but the good news is that there are a bunch of new drugs over the last couple of decades which dramatically change the course of this disease. When I was a practicing doctor, many of the people with MS would end up in wheelchairs or in nursing homes. That doesn't happen today. So when Shereese was first diagnosed, she was severely4 disabled. And many of her symptoms resolved on some of these new medicines. But she had persistent5 fatigue, and she just was falling sometimes. So her doctor decided6 to try her on a new drug. And that's when this saga7 began.

CORNISH: Right. Reporter Marlene Harris-Taylor of Ideastream in Cleveland actually went to meet her.

MARLENE HARRIS-TAYLOR: Shereese Hickson is tenacious8. The 39-year-old single mother had to fight her way back. She was nearly fully9 debilitated10 by the time a battery of tests confirmed she had multiple sclerosis. That was 2012, when her son Isaiah was 2 years old. Shereese says she had to get better for Isaiah.

SHEREESE HICKSON: I had to learn how to walk and basically do everything all over again. And I was home right before his third birthday.

HARRIS-TAYLOR: Shereese says she's now stable. She can't work, but she's able to take care of Isaiah, who is full of energy, like most 8-year-olds.

What grade are you in?

ISAIAH HICKSON: Third grade.

HARRIS-TAYLOR: At times, though, Shereese's fatigue is overwhelming.

HICKSON: I fight through it, but some days it's really difficult. And some days it's like I need to sit down because if I take one more step, I'm falling on my face.

HARRIS-TAYLOR: Her doctor at the Cleveland Clinic about an hour west of her home in Girard, Ohio suggested Shereese try a new medication to keep her MS from progressing.

HICKSON: We have Ocrevus, which is the infusion11, and we would like to try this on you. And I was just like - I'm like, I don't want anything to do with needles.

HARRIS-TAYLOR: Shereese eventually agreed and received two Ocrevus infusions12 at the clinic. The drug is delivered through an IV drip like chemotherapy. After the second dose in September, Shereese was surprised when a bill arrived in the mail a few weeks later.

HICKSON: And I'm just like, what is this?

HARRIS-TAYLOR: Shereese is on disability and has both Medicare and Medicaid health insurance, so her medical bills are usually fully covered. But this time was different.

HICKSON: Total charges, $122,873.30.

HARRIS-TAYLOR: But as she continued to read the bill, Shereese realized she was not being asked to pay the full price. The hospital was, however, billing her for the copay.

HICKSON: Minimum balance due, $3,619.98.

HARRIS-TAYLOR: Shereese was confused. She thought it was a mistake, and she immediately called the hospital about the bill.

HICKSON: I can't pay this. I'm on a fixed13 income. I'm a single mom. And what you guys are asking me to pay is six months of my income.

HARRIS-TAYLOR: Cleveland Clinic eventually told Shereese she wouldn't have to pay because of her income. She's relieved. But her next appointment for another dose of Ocrevus is in January. She says it can take up to a year to know if Ocrevus is working. But Shereese is thinking of bailing14 and asking her doctor to find another drug.

HICKSON: It's unfair. It's very unfair. You're sick, and you have to now deal with another headache on top of being ill.

HARRIS-TAYLOR: Shereese says the whole ordeal15 was stressful, but she is lucky. She knows there are many who take the same drug who don't qualify for financial assistance. They get stuck with the outrageous16 bill, she says. For NPR News, I'm Marlene Harris-Taylor.

CORNISH: And we're back with Elisabeth Rosenthal, editor in chief of Kaiser Health News. Shereese Hickson's story raises a bunch of questions. First she was billed a few thousand dollars for a copay of her drug even though she had Medicaid and Medicare. Was that a mistake by the hospital?

ROSENTHAL: Well, apparently17 not because the hospital didn't say, oh, you know, Medicaid will cover this. They said, well, we'll write it off as charity care. And I think this is one thing people need to be aware of - that when you get an - infused drugs, the rules can - of your insurance can apply very differently.

CORNISH: Also, the full price of Hickson's two doses of this one drug was over a hundred thousand dollars. What explains that very high price?

ROSENTHAL: Well, MS drugs have followed this weird18 trajectory19. It's called sticky pricing. And when each new drug comes into the market, the new drug is priced slightly higher than the old ones. And instead of all of them competing and lowering the price, they all go up to that higher ceiling, that sticky ceiling. So what we've seen over time is all of the MS drugs in the U.S. go up and up and up in price, double what they were a decade ago. In the rest of the world, they go down over time because there is some competition.

CORNISH: So what should people do if they are faced with a big copay like this for an expensive drug?

ROSENTHAL: Well, you can be like Shereese and pick up the phone and say, what's this about? Are there any other solutions for me - because all hospitals have what they call financial aid or charity care programs. You may think, oh, I make too much money to qualify. That's often not true.

The second thing to keep in mind and what her situation illustrates20 so well is if you get a drug by infusion, something you need to get in a clinic or a hospital, there are all sorts of ancillary21 charges that can make the bill far, far bigger. So if you have a choice of taking a drug as an infusion or one that you could give yourself at home either as a pill or as an injection at home, you're often much better off with the latter because you won't be subjected to these surprise bills.

CORNISH: That's Elizabeth Rosenthal, editor in chief of Kaiser Health News. Thank you for being here.

ROSENTHAL: Thanks for having me.

CORNISH: And if you have a medical bill you want us to investigate, head on over to NPR's Shots blog.


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点击收听单词发音收听单词发音  

1 chronically yVsyi     
ad.长期地
参考例句:
  • Similarly, any pigment nevus that is chronically irritated should be excised. 同样,凡是经常受慢性刺激的各种色素痣切勿予以切除。
  • People chronically exposed to chlorine develop some degree of tolerance. 人长期接触氯气可以产生某种程度的耐受性。
2 spoke XryyC     
n.(车轮的)辐条;轮辐;破坏某人的计划;阻挠某人的行动 v.讲,谈(speak的过去式);说;演说;从某种观点来说
参考例句:
  • They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
  • The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。
3 fatigue PhVzV     
n.疲劳,劳累
参考例句:
  • The old lady can't bear the fatigue of a long journey.这位老妇人不能忍受长途旅行的疲劳。
  • I have got over my weakness and fatigue.我已从虚弱和疲劳中恢复过来了。
4 severely SiCzmk     
adv.严格地;严厉地;非常恶劣地
参考例句:
  • He was severely criticized and removed from his post.他受到了严厉的批评并且被撤了职。
  • He is severely put down for his careless work.他因工作上的粗心大意而受到了严厉的批评。
5 persistent BSUzg     
adj.坚持不懈的,执意的;持续的
参考例句:
  • Albert had a persistent headache that lasted for three days.艾伯特连续头痛了三天。
  • She felt embarrassed by his persistent attentions.他不时地向她大献殷勤,使她很难为情。
6 decided lvqzZd     
adj.决定了的,坚决的;明显的,明确的
参考例句:
  • This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
  • There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。
7 saga aCez4     
n.(尤指中世纪北欧海盗的)故事,英雄传奇
参考例句:
  • The saga of Flight 19 is probably the most repeated story about the Bermuda Triangle.飞行19中队的传说或许是有关百慕大三角最重复的故事。
  • The novel depicts the saga of a family.小说描绘了一个家族的传奇故事。
8 tenacious kIXzb     
adj.顽强的,固执的,记忆力强的,粘的
参考例句:
  • We must learn from the tenacious fighting spirit of Lu Xun.我们要学习鲁迅先生韧性的战斗精神。
  • We should be tenacious of our rights.我们应坚决维护我们的权利。
9 fully Gfuzd     
adv.完全地,全部地,彻底地;充分地
参考例句:
  • The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气,然后全部呼出。
  • They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。
10 debilitated 57ee38572622e0d4bbe125b2b935d9db     
adj.疲惫不堪的,操劳过度的v.使(人或人的身体)非常虚弱( debilitate的过去式和过去分词 )
参考例句:
  • Prolonged strike action debilitated the industry. 长时间的罢工削弱了这个行业的活力。
  • This is especially important when dealing with the geriatric or debilitated patient. 这对老年和虚弱病人尤其重要。 来自互联网
11 infusion CbAz1     
n.灌输
参考例句:
  • Old families need an infusion of new blood from time to time.古老的家族需要不时地注入新鲜血液。
  • Careful observation of the infusion site is necessary.必须仔细观察输液部位。
12 infusions a599e37c1db9952bb8bd450f8702ce2e     
n.沏或泡成的浸液(如茶等)( infusion的名词复数 );注入,注入物
参考例句:
  • Intravenous infusions are also used to administer medications. 静脉输液也可作为一种给药方法。 来自辞典例句
  • INTERPRETATION: GKI infusions significantly reduced plasma glucose concentrations and blood pressure. 结论:静脉滴注GKI显著降低血压和血糖浓度。 来自互联网
13 fixed JsKzzj     
adj.固定的,不变的,准备好的;(计算机)固定的
参考例句:
  • Have you two fixed on a date for the wedding yet?你们俩选定婚期了吗?
  • Once the aim is fixed,we should not change it arbitrarily.目标一旦确定,我们就不应该随意改变。
14 bailing dc539a5b66e96b3b3b529f4e45f0d3cc     
(凿井时用吊桶)排水
参考例句:
  • Both fountains were going furiously and both pumps bailing with might and main. 两个人的口水只管喷泉似地朝外涌,两个抽水机全力以赴往外抽水。
  • The mechanical sand-bailing technology makes sand-washing operation more efficient. 介绍了机械捞砂的结构装置及工作原理,提出了现场操作注意事项。
15 ordeal B4Pzs     
n.苦难经历,(尤指对品格、耐力的)严峻考验
参考例句:
  • She managed to keep her sanity throughout the ordeal.在那场磨难中她始终保持神志正常。
  • Being lost in the wilderness for a week was an ordeal for me.在荒野里迷路一星期对我来说真是一场磨难。
16 outrageous MvFyH     
adj.无理的,令人不能容忍的
参考例句:
  • Her outrageous behaviour at the party offended everyone.她在聚会上的无礼行为触怒了每一个人。
  • Charges for local telephone calls are particularly outrageous.本地电话资费贵得出奇。
17 apparently tMmyQ     
adv.显然地;表面上,似乎
参考例句:
  • An apparently blind alley leads suddenly into an open space.山穷水尽,豁然开朗。
  • He was apparently much surprised at the news.他对那个消息显然感到十分惊异。
18 weird bghw8     
adj.古怪的,离奇的;怪诞的,神秘而可怕的
参考例句:
  • From his weird behaviour,he seems a bit of an oddity.从他不寻常的行为看来,他好像有点怪。
  • His weird clothes really gas me.他的怪衣裳简直笑死人。
19 trajectory fJ1z1     
n.弹道,轨道
参考例句:
  • It is not difficult to sketch the subsequent trajectory.很容易描绘出它们最终的轨迹。
  • The path followed by a projectile is called its trajectory.抛物体所循的路径称为它的轨道。
20 illustrates a03402300df9f3e3716d9eb11aae5782     
给…加插图( illustrate的第三人称单数 ); 说明; 表明; (用示例、图画等)说明
参考例句:
  • This historical novel illustrates the breaking up of feudal society in microcosm. 这部历史小说是走向崩溃的封建社会的缩影。
  • Alfred Adler, a famous doctor, had an experience which illustrates this. 阿尔弗莱德 - 阿德勒是一位著名的医生,他有过可以说明这点的经历。 来自中级百科部分
21 ancillary EwCzg     
adj.附属的,从属的
参考例句:
  • The transport corps is ancillary to the infantry.运输队是步兵的辅助部队。
  • This is just an ancillary business.这仅仅是一项辅助业务。

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