Charles Engelke's Blog

All I want to see is, will this tool actually publish to my own blog?

Treating cancer is expensive. I knew that. But I can still be shocked. Really shocked. $5900 for a single shot shocked!

You read that right. The bill we got for a single 6mg injection of Neulasta was $5900. That’s a bit less than $28,000,000 per ounce. Of course, you don’t just get the 6mg of Neulasta; it’s diluted in solution. Perhaps a fairer way to look at the cost is by volume. That’s only about $50,000 per teaspoon. (Don’t spill it!)

Luckily, we don’t have to pay that much. First of all, Laurie’s insurance has a discount negotiated with the doctor, and the discounted price is only $3687.50 per injection; barely more than $17,000,000 per ounce or about $30,000 per teaspoon. (Medicare gets an even better deal: $2938.40 per shot. Drugstore.com charges about the same “low” price as Medicare.)

In fact, we aren’t having to pay a cent. Laurie’s excellent insurance has a $1500 per year “out of pocket” limit. We hit that almost instantly once she was diagnosed with breast cancer, and everything since then has cost us nothing. (We’ll start paying again in January until we hit the limit, which will happen very quickly.)

Still, it’s not free… everyone is paying for it via health insurance and Medicare taxes. Is it worth it?

Yes. I’d like it to be cheaper, and hope it will get cheaper. But it’s worth it, and we’d pay that much out of our own pockets if we had to. Even if we had to go into debt to do it.

Put it in perspective. Laurie’s going to get six chemotherapy treatments, with an injection of Neulasta after each of them (yesterday was treatment number 3). Chemotherapy is extremely tough on the patient. Laurie’s mother had it in the late 1970s, and when she had a new cancer in 1990 she said at first that she would rather die than go through it again. (Unfortunately, the cancer advanced so fast that time that it turned out not be an issue.)

But the only side effects Laurie has been having from her chemotherapy treatments are hair loss, a day or two of queasiness, and several days of fatigue. (The effect has been that her 4cm lump has shrunk to the point where her oncologist can’t detect it any more with manual examination.)

In short, chemotherapy has been wonderful for Laurie. And Neulasta is undoubtedly one of the reasons for that. It keeps her immune system strong, even though the chemo is breaking it down.

Neulasta doesn’t get all the credit for the lack of side effects (and it doesn’t get any credit for the effect, either). Still, it’s worth the $18,000 or so the full six doses would cost at discount (Medicare or Drugstore.com).

The chemo treatments themselves seem to be costing about $8000 each, discounted to about $5000 to our insurance. So the course of 6 chemo treatments will come to about $30,000.

Neulasta plus chemo will cost $48,000. For the last few weeks, I’ve seen the stupid “December to Remember” Lexus commercials over and over again, suggesting buying a Lexus on a whim as a surprise present. A Lexus GS 300 costs about the same $48,000.

The price for the treatments don’t seem so bad anymore.

WELCOME TO DELTA’S WEEKLY FARE SPECIALS
Weekly Fare Specials for September 24-27, 2005

All fares require a Saturday departure and return travel on either Monday or Tuesday.

Atlanta, GA (ATL) to:
— Houston-Intercntl, TX (IAH) – $138

Houston-Intercntl, TX (IAH) to:
— Cincinnati, OH (CVG) – $148

That Saturday departure to or from Houston should be exciting:

I never thought it was possible! But an article in today’s Washington Post (registration or bugmenot required) shows them apparently thinking about actual security instead of security theater. The new TSA head (Edmund S. “Kip” Hawley) told his staff to review air security screening procedures, and on August 5, they responsed very sensibly:

The staff’s first set of recommendations, detailed in an Aug. 5 document, includes proposals to lift the ban on various carry-on items such as scissors, razor blades and knives less than five inches long. It also proposes that passengers no longer routinely be required to remove their shoes at security checkpoints.

Hawley still has to approve it, and might fall back on the typical bureaucratic impulse to never change anything because that way you can’t be blamed. But there seems to be a chance he’ll stick his neck out to make security screening less obnoxious and more effective.

More effective? But you’re reducing screening, so how can that be? Simple: all those resources now spent looking for scissors and Swiss Army knives that can’t actually threaten a plane in any way aren’t looking for the real threats. Now that cockpit doors are closed and strong, that means bombs, not knives.

0x30, to be specific. It’s been a nice birthday.

I just voted electronically here in Macon, Georgia this morning. I
left the polling place quite upset, and with little confidence in the
process. First, the smart card I was given was programmed incorrectly,
and didn’t include the Democratic presidential preference primary. When
I reached the end of the ballot without seeing that race I complained,
and the pollworkers came over and examined the screen. So much for a
secret ballot. They then pressed the “Cast Vote” button over my
protests, saying that they would void the vote later. I then got a
correctly programmed smart card and voted again.

(more…)

There’s been a long hiatus in this blog. Most of it was due to my
taking a lot of vacation around Christmas and getting away from work
for a while. But now I’m back posting articles. Pretty soon the
DocBook section should start getting lively again.

I’ve done some redesign work on this blog, as you can probably see.
Appearance is now controlled via CSS, instead of the 14 column (or so)
table it had. I also spiffed up the links in the sidebar, and added
a separate print stylesheet that will look better on paper than the
standard web design.

Note: revised because I decided to make all story bodies XML.

(more…)