Americans battling cancer are more likely to go bankrupt than their peers who are do not receive a cancer diagnosis, according to a new study from the University of Washington.
The study’s lead author Scott Ramsey is the director of the Hutchinson Institute for Cancer Outcomes Research in the Public Health Sciences Division of the Fred Hutchinson Cancer Research Center, and professor of medicine at the University of Washington. He said that while that numerous studies had already looked at the relationship between high medical expenses and the likelihood of filing for bankruptcy, a cancer diagnosis specifically had not been examined.
Exact numbers regarding how many Americans have cancer is not known, but a report from the American Cancer Society on cancer statistics and figures in 2012 expects there were about 1,638,910 new cancer cases diagnosed in 2012. That number does not include carcinoma in situ (noninvasive cancer) of any site except urinary bladder, and does not include basal and squamous cell skin cancers, which are not required to be reported to cancer registries.
Researchers collected data from about 400,000 adults living in Washington state, with about half having received treatment for cancer and the other half being cancer-free. Those with cancer were found via a western Washington cancer registry. Cancer-free counterparts were matched with the cancer patients by age, zip code and sex.
Researchers then looked to see which of the adults had filed bankruptcy between 1995 and 2009 using court records. What they found was that cancer patients were 2.65 times more likely to go bankrupt than people without cancer.
“We need to look into why this happening and see if there is something we as a society can do to reduce that risk,” Ramsey said.
The study notes that data from the Medical Expenditure Panel Survey indicates that of the some $20.1 billion spent on cancer on those younger than 65 years, about $1.3 billion or 6.5 percent comes from the patients themselves.
Even if a patient has medical insurance, Ramsey says deductibles and copayments for cancer treatments, supportive care, and related services, along with nonmedical costs such as child care and lost income, may be financially devastating.
While the study didn’t take into account whether or not those cancer patients in the study who claimed bankruptcy had health insurance, he says that previous studies have shown that Americans who cite major health issues as a reason for filing bankruptcy are often insured.
A 2009 study from Harvard Medical School found more than 60 percent of bankruptcies in the U.S. were a result of large medical bills. Most of those who filed bankruptcy were middle-class, well-educated homeowners, and about 75 percent of them had health insurance.
“That was actually the predominant problem in patients in our study — 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services,” says lead author Steffie Woolhandler, M.D., of the Harvard Medical School in Cambridge, Mass. “Other people had private insurance but got so sick that they lost their job and lost their insurance.
“Unless you’re a Warren Buffett or Bill Gates, you’re one illness away from financial ruin in this country,” Woolhandler said. “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that’s the major finding in our study.”
Health insurance coverage has not been all-encompassing when it comes to treatment for cancer patients, since many insurance plans do not cover the lifesaving cancer screenings, treatments or follow-up care. As a result, this issue has been specifically addressed in the Affordable Care Act.
The new health care law does away with co-pays for preventive services in new plans and provides coverage for cancer screening, treatment and follow-up care, among other things. Health insurance coverage will also be more affordable, as the law bars insurance companies from charging more for people who are sick and limits the amount patients must pay in out-of-pocket costs and deductibles.