Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System
By Karyn Schwartz, Gary Claxton, Kristi Martin, and Christy Schmidt
Kaiser Family Foundation
American Cancer Society
February 2009
1) High cost-sharing, caps on benefits and lifetime maximums leave cancer patients vulnerable to high out-of-pocket health care costs.
2) People who depend on their employer for health insurance may not be protected from catastrophically high health care costs if they become too sick to work.
3) Cancer patients and survivors are often unable to find adequate and affordable coverage in the individual market.
4) While high-risk pools are designed to help cancer patients and others who are uninsurable, they are not available to all cancer patients and some find the premiums difficult to afford.
5) Waiting periods, strict restrictions on eligibility, or delayed application for public programs can leave cancer patients who are too ill to work without an affordable insurance option.
It is impossible to determine exactly how many privately insured individuals in the United States are at risk for high out-of-pocket health costs. However, research indicates that a growing percentage of the population is already facing high out-of-pocket costs. Gaps in the current private health insurance system leave cancer patients and others with serious illnesses vulnerable even when they have coverage.
Addressing the holes in the current health insurance system will be key to providing the privately insured with economic security and access to health care in the face of illness.
Spending to Survive (55 pages):
http://www.kff.org/insurance/upload/7851.pdf
An excellent test of how well our insurance system is working is to determine how well it serves those individuals who have the tragic misfortune of developing cancer. This report shows that all too often the insurance system fails to protect cancer patients from the additional burden of financial hardship, defeating one of the most important reasons for having health insurance in the first place.
KFF and ACS are to be commended for producing this important report exposing these injustices in our health insurance system, but, at the same time, they can be condemned for their timidity in their suggested solution for this tragic problem. “Addressing the holes in the current insurance system” might be the politically safe recommendation, but we’ve been doing that for half of a century. Patching holes doesn’t fix a rotten system.
People need the support of a financing system that provides them access to the health care that they need, when they need it. They do not need a financing system that exposes them to financial hardship merely because fate has handed them the misfortune of illness or injury.
We could add hundreds of billions of dollars to our current health care financing system and still leave people vulnerable, or we could dump our dysfunctional system and replace it with one that works – a single payer national health program. It seems like the decision should be ours, but we have turned it over to the Washington clique that supports our rotten system. How smart is that?