The catastrophe of cancer - money or health?
USA Today/Kaiser Family Foundation/Harvard School of Public Health National Survey of Households Affected by Cancer
Kaiser Family Foundation
November 20, 2006
Survey of Families Affected by Cancer Shows People With and Without Health Insurance Often Suffer Serious Financial Hardships
A major national survey of people affected by cancer provides an in-depth examination of how families cope with cancer and highlights problems of health insurance and health care costs through the lens of those who have experienced this major illness. The results show how health care and health insurance systems can fail to protect people when they are most in need.
The survey found that one in four families affected by cancer say the experience led the person with the disease to use up all or most of their savings, and one in eight say they borrowed money from relatives. The illness also made it harder for some to find and keep health insurance - with about one in 10 saying they couldn’t buy health insurance because they had been diagnosed with cancer, and 6% saying they lost their coverage as a result of the disease.
Having health insurance at all times during treatment helped to limit the financial consequences of a cancer diagnosis, but even those with consistent coverage faced difficulties - one in five used up all or most of their savings, one in 10 borrowed money from relatives and 9% were contacted by a collection agency.
Among those who did not have health insurance consistently during their illness, the financial burden was even greater. More than one in four said that they delayed or decided not to get treatment because of its cost - five times the rate reported by those who had health insurance consistently. Nearly half used all or most of their savings; four in 10 were unable to pay for basic necessities; one in three sought the aid of a charity or public assistance program; and 6% filed for personal bankruptcy.
“This is one of the most disturbing of the hundreds of surveys we have done,” said Kaiser Family Foundation President and CEO Drew E. Altman, Ph.D. “When people with cancer are deferring care and experiencing such serious financial hardships because of inadequate insurance or because they have no health insurance, it casts a new light on the need to address our nation’s health insurance problems.”
http://www.kff.org/kaiserpolls/pomr112006pkg.cfm
Comment:
By Don McCanne, MD
How many times have you heard the opponents of health reform say that insurance should not pay for an oil change for your automobile, nor for a bag of potato chips at the supermarket? They contend that the only purpose of insurance is to indemnify an individual against catastrophic financial loss.
When a biopsy is not obtained in a timely manner because of financial limitations, doesn’t that result in a catastrophic loss? When potentially curable interventions are declined because of financial considerations, doesn’t that result in a catastrophic loss? When a victim of cancer decides to decline care in order to protect his or her limited assets in order to help pay for food and shelter for the surviving children, doesn’t that result in a catastrophic loss? Admittedly these questions redefine catastrophic loss as a loss of health or life, and not merely a loss of a large amount of personal funds. But, really, which is more important?
It is truly tragic that both the uninsured and the insured potentially face catastrophic losses. Our national policies are currently aimed at expanding coverage to the uninsured by exposing those insured to greater risks. Instead, we should be adopting policies that improve access to care by removing financial barriers for both the insured and uninsured.
This is certainly “one of the most disturbing of the hundreds of surveys” that KFF has done. What is particularly disturbing is that we understand the policy options that would allow us to remove the financial barriers without increasing health care spending. A single payer system does precisely that, by design.
For those who would prefer to accept the status quo simply because they’re healthy and their employers provide them with insurance, we should not wish that they would be the next to face the tragedy of cancer in their families. But we can grieve in the realization that our fellow Americans do not have the decency to support policies that would help protect other individuals and families (and possibly even their own!) against these tragedies.
It is not a matter of spending more money, because we don’t have to. It’s a matter of egalitarianism - apparently a foreign concept for Americans.