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High Costs of Cancer Treatments for Patients Not on Medicare

Posted Feb 10 2009 12:10pm

Last week I wrote about the challenges of people with Medicare getting the best treatments for cancer.   Today, the Kaiser Family Foundation released a report examining the challenges people who get insurance through the private system, (i.e. employer based or individually purchased),  have affording their cancer treatments. And how the public insurance programs, (i.e. Medicare and Medicaid), have waiting periods or other enrollment requirements that delay or prevent patients from being covered immediately - something which is of particular concern for patients with cancer.

The Kaiser Family Foundation’s report presents an excellent mix of data analysis and individual patient examples.  The report’s conclusions are that our health system has a significant number of holes (or cracks) that people can slip into causing them to suffer clinicall and/or financially.  This situation clearly exists not only for patients with cancer, but also for other serious and costly diseases, which is why it should be one of the priority foci for health care reform in the coming years.

The specific aspects of our healthcare financing system that the Kaiser Family Foundation’s report identified as potentially causing problems for cancer patients are: [empahsis added]

  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.

These features of our “crazy quilt” health financing system are not new discoveries, nor are they unique to patients with cancer.  But the report highlights the importance of understanding them, and if these issues are not addressed in our nation’s ongoing “health reform” efforts, then the specific proposals produced by those efforts are unlikely to gather enough public (and political) support to actually become law and improve people’s lives.

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