WASHINGTON – Cancer patients can face severe challenges paying for life-saving care, even when they have private health insurance, says a new report by the Kaiser Family Foundation and the American Cancer Society.
The report, "Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System," profiles 20 patients and illustrates the potential difficulties people diagnosed with cancer or other serious illnesses have in maintaining affordable health insurance and paying for their healthcare.
"Cancer patients too often find out that their insurance doesn't protect them when they need care the most," said John R. Seffrin, national chief executive officer of the American Cancer Society. "High out-of-pocket costs coupled with the high cost of insurance premiums can force cancer patients to incur huge debt and to delay or forgo life-saving treatments."
The patients in the report were selected to illustrate typical cases from the people who call the American Cancer Society's Health Insurance Assistance Service, which helps families affected by cancer who encounter problems navigating the healthcare system.
The report claims these patients, who had private health insurance at the time of their cancer diagnosis, were not protected from high out-of-pocket costs. The patients were left with large debts to cover their treatment costs and some were forced to skip or delay necessary treatments.
"The stories of people with cancer in this study show what our earlier survey work found: that the insurance system often fails people when they need it most, when they get really sick," said Drew Altman, the Kaiser Family Foundation's president and CEO.
The report highlights five key gaps in the healthcare system that can leave people with cancer and other life-threatening diseases in financial jeopardy as a result of their diagnosis:
- High cost-sharing and caps on benefits leave cancer patients vulnerable.
- Those patients with employer-sponsored coverage may not be protected from catastrophically high healthcare costs if they become too sick to work.
- Cancer patients and survivors are often unable to find adequate and affordable coverage in the individual market.
- High-risk insurance pools are not available to all cancer patients, and some find the premiums difficult to afford.
- Waiting periods, strict restrictions on eligibility or delayed applications for public programs can leave people who are too ill to work without an affordable insurance option.
Researchers at the Kaiser Family Foundation and the American Cancer Society jointly authored the report. The Kaiser Family Foundation also released a separate video documentary profiling three of the patients featured in the report.
