Statement of Stephen Finan, Associate Director of Policy, American Cancer Society
House of Representatives
Committee on Ways and Means
Subcommittee on Health
April 15, 2008
Little Help Available for Those with Inadequate Insurance
The stories we are giving you come from our Health Insurance Assistance Service (HIAS), which is a service offered through the American Cancer Society’s National Cancer Information Center (NCIC). HIAS is a free resource that connects callers with health insurance specialists who work to address their needs.
Conclusion
Much of the public debate today is about the need to cover the 47 million uninsured, and the American Cancer Society fully shares that concern. However, we need to recognize more fully the very significant problem of underinsurance. Health plans vary enormously in their deductibles, co-pays, benefits covered, and exceptions. Insurance plans are written in very detailed legalistic language that very few lay people can begin to comprehend, and the summary plan documents that are provided to enrollees almost never begin to convey the adequacy of coverage. Put another way, if you were to look at an array of plans that might be available to you as a consumer, and you were to ask, what would be the adequacy of your coverage if you were to be diagnosed with cancer or some other serious disease, you would probably conclude that you have no idea whether the plan would be adequate. As we see all too often in our HIAS cases, people often discover after their diagnosis what their plan really means — and that is a point where for most patients it is virtually impossible to change coverage.
Hearing Witness List and Testimony:
http://waysandmeans.house.gov/hearings.asp?formmode=detail&hearing=624
Testimony of Stephen Finan:
http://waysandmeans.house.gov/hearings.asp?formmode=view&id=6865
And…
Co-Payments Soar for Drugs With High Prices
By Gina Kolata
The New York Times
April 14, 2008
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
Insurers say the new system keeps everyone’s premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost $100,000 and more a year.
But the result is that patients may have to spend more for a drug than they pay for their mortgages, more, in some cases, than their monthly incomes.
http://www.nytimes.com/2008/04/14/us/14drug.html?_r=2&hp=&oref=slogin&pagewanted=all&oref=slogin
Comment:
By Don McCanne, MD
To keep premiums affordable, the private insurance industry has no choice other than to pass more of the costs of health care on to individuals who have greater health care needs – thus the epidemic of underinsurance.
The current leading political proposals for reform call for using government policies and/or market forces to cover more of the uninsured with private health plans with affordable premiums. Since plans that would cover high-cost care, such as $100,000 drugs, are no longer affordable, underinsurance is rapidly becoming the standard in the private insurance market.
Covering the uninsured with private plans that do not prevent financial hardship is about like whitewashing a rotting picket fence. It might look prettier very briefly, but certainly not after it soon collapses.
Let’s do it right. Put away the whitewash. Let’s build a proper fence.