At least 2 million Americans whose cancer went into remission decided against getting recommended follow up treatment mostly because their health insurance wouldn’t fully cover it. That cost-cutting and life-threatening decision was made by one in six cancer “survivors” in the country, according to research published last week headed by Kathryn Weaver of Wake Forest University Baptist Medical Center. The study was based on data collected between 2003 and 2006, before the recession hit and unemployment figures skyrocketed.
“We’re hearing more and more of these stories than we used to,” Anna McCourt, a supervisor at the National Cancer Information Center, told Sid Kirchheimer, a reporter for AARP’s online bulletin. “Because of out-of-pocket costs, people are avoiding tests they know they need, they’re taking half doses of medication to make it last longer. But if you freeze because you can’t afford heat this winter, cancer medication isn’t going to be that helpful anyway.”
Some might say these patients are simply exercising their “right to health care choice” in a free market system. Others however are celebrating the fact that national health care reform legislation directly addresses the insurance problems that cause cancer patients to skimp on care.
Kirchheimer reports that those hardest hit have been patients who are “diagnosed before they are eligible for Medicare at age 65—and typically depend on employer health insurance.” He says a “perfect storm” of woes has made the country’s employer-based health insurance system a catastrophe for sick people who actually have to depend upon it.
Employers for years have been reducing benefits even as health care costs have steadily increased. What’s more, employed cancer survivors often reach their annual or lifetime coverage limits and get cut off or are asked to bail out of employer insurance programs because they will raise rates for everyone else. In the economic downturn, as more people are laid off and can’t find work, insurance has moved beyond reach for larger swaths of the population and often falls away altogether. What’s more, employers thinking about the cost of providing benefits, move the resumes of sick people to the bottom of the stack.
“You go on job interviews and they notice a gap in your employment. Admit that you were on medical leave, and employers think it’s because of mental issues or cancer—and no one wants to hire someone with either” cancer survivor Demise Hicks told Kirchheimer.
The health care “choices” a lot of cancer survivors come to face can look like an experiment in capitalist Darwinism.
In small businesses especially, some cancer survivors face a tough choice: “My employer said my treatment was raising rates for everyone else, so I was asked to find private insurance to not impact my coworkers,” says Anne Creech, 64, who battled colon and breast cancer. She complied, but could only afford a policy with riders to exclude coverage for screenings or other cancer-related care—only to recently learn her cancer had returned. Weeks before the diagnosis, her big concern was coming up with $3,700 for a recommended colonoscopy. Now, she learns that her insurer won’t pay for any treatment
These cancer patients who are forgoing treatments are among the tens of millions of Americans who will benefit almost immediately from the new federal “high-risk pools” created to provide coverage for people with preexisting medical conditions. By 21014, the new federal law will make it illegal for Americans with preexisting conditions to be denied coverage.
The new law will also prohibit insurance companies from setting lifetime and annual care-cost limits. As Kirchheimer explain, beginning in September insurance companies are banned from placing lifetime limits on their coverage.
Also beginning Sept. 23, insurers must cover annual medical expenses up to at least $750,000. The minimum annual threshold rises to $1.25 million in September 2011 and increases to $2 million beginning in September 2012. Limits will be completely prohibited starting Jan. 1, 2014.
In Colorado, the Independence Institute’s “Right to Health Care Choice” Amendment 63, which aims to block provisions of “Obamacare,” will appear on the ballot in November. The amendment seeks mainly to prevent the law from forcing Coloradans to buy insurance, a key provision meant to lower costs partly by making sure all care being delivered is being paid for and that those who fall sick don’t have to pay the entire cost of care.