Article Highlights:
- Rising health-care and insurance costs are playing a role in cancer patients choosing to delay or even forgo follow-up treatments, according to a new study.
- The report, which was written by a Wake Forest University medical researcher, is being published in the online version of Cancer, a peer-reviewed journal of the American Cancer Society.
- The study of 2003-06 data from the National Health Interview Survey found that 18 percent of cancer survivors, or about 2 million Americans, did not get one or more needed medical services because of financial concerns.
By Richard Craver, Winston-Salem Journal, N.C.
Rising health-care and insurance costs are playing a role in cancer patients choosing to delay or even forgo follow-up treatments, according to a new study.
The report, which was written by a Wake Forest University medical researcher, is being published in the online version of Cancer, a peer-reviewed journal of the American Cancer Society.
The study of 2003-06 data from the National Health Interview Survey found that 18 percent of cancer survivors, or about 2 million Americans, did not get one or more needed medical services because of financial concerns.
The findings raise concerns about the long-term health and well-being of cancer survivors, said Kathryn Weaver, an assistant professor in the Division of Public Health Sciences for the university's School of Medicine.
There has been a surge in uninsured Americans in the past 2 1/2 years because of record-high unemployment rates, according to economists and health-care officials. That has more people dependent on high-cost health-insurance products, such as from the COBRA health-insurance law -- the federally backed plan that extends coverage for people who lose their jobs.
For example, a study released last week by advocacy group Families USA found that the average monthly premium cost of COBRA insurance in North Carolina was $1,108 -- or about 85 percent of the average monthly unemployment benefit. For those North Carolinians who receive a federal subsidy from COBRA, the cost is $388, or 30 percent.
"Many U.S. cancer survivors live years after diagnosis, which emphasizes the importance of health-care access for survivors," Weaver said.
"Medical needs of cancer survivors include surveillance for primary recurrence and second malignancies, monitoring for chronic and late effects, treatment for other medical co-morbidities, mental-health services and general preventive care."
The study found that about 8 percent of the 6,602 adult cancer survivors surveyed said they passed on getting medical care because of financial concerns. About 10 percent did not get prescriptions filled, 11.5 percent passed on dental care and about 3 percent on mental-health care. Cancer survivors younger than 65 were more likely to delay or forgo medical care than those who did not have a history of cancer. Blacks and Hispanics were more likely to forgo prescriptions and dental care than whites. "Although the large number of survivors going without care was somewhat surprising, it has long been recognized that cancer can have a negative impact on the financial health of survivors," Weaver said. "This is important because cancer survivors have many medical needs that persist for years after their diagnosis and treatment. The implications of this financial stress for their ongoing medical care are just beginning to be recognized." The cost of health care has been a topic rarely discussed by doctors and patients. But that's changing. Millions of Americans have no health insurance, and many of those that do are facing increasing costs, higher deductibles and larger co-pays. The result: doctors and patients are being encouraged -- if not forced -- to talk money upfront like they would about buying a set of tires. Not having the conversation could prove financially devastating. Researchers at Harvard University reported that medical problems caused 62 percent of all personal bankruptcies in 2007. Of those bankruptcies, 60 percent of the filers had private medical insurance. The Wake Forest study found that breast- and prostate-cancer survivors were least likely to forgo services, while cervical-cancer and melanoma survivors were the most likely to forgo services. Also, the most likely survivors to forgo services were those within the first year of post-diagnosis or very long-term survivors. Weaver said that one limitation of the study was that respondents could have meant they felt they needed no services in their reply, rather than they needed services and lacked access. The researchers have plans to ask more specific questions in a future study. "It is important to gain a better understanding of the role of insurance coverage and out-of-pocket expenses when evaluating financial barriers to needed care," Weaver said. // var ranNum = Math.round(Math.random()*1000000); document.write('http://content.yellowbrix.com/images/content/cimage.nsp?ctype=full_story&story_id=146167853&id=thirdage&ip_id=McClatchy-Tribune+Business+News&source_id=Winston-Salem+Journal&category=Healthcare&random=' + (ranNum));// ]]>//
