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Oncology Times:
doi: 10.1097/01.COT.0000359041.61430.0c
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Survey: Americans Fear Paying for Cancer Treatment as Much as Dying of the Disease

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A survey commissioned by the Community Oncology Alliance (COA) found that the inability to pay for cancer care is among Americans' top fears about the disease. Seven out of 10 people reported being very concerned about paying for cancer treatment if they developed the disease (69%), the same proportion who are very concerned about dying of cancer (68%). Only the cancer consequences of having a poor quality of life (75%) and being in pain (72%) evoke slightly more concern.

COA commissioned Opinion Research Corporation to survey a statistically representative sample of 1,022 adult Americans 18 years of age or older. The survey was conducted June 26–30 of this year, with 79% of respondents saying that they have a family member or friend diagnosed with cancer.

Other top concerns regarding a cancer diagnosis include being unable to work (61%) and leaving their families in debt (59%).

“The need for health care reform is especially critical for cancer care,” Patrick Cobb, MD, COA President and managing partner of Hematology-Oncology Centers of the Northern Rockies in Billings, MT, explained in a news release. “The increasing cost of drugs, declining Medicare reimbursement, and current financial crisis have created a ‘perfect storm’ that jeopardizes community cancer clinics, where most Americans with cancer are treated.”

The survey also showed that only 45% of respondents believe that their private insurance plans would cover the full cost of cancer treatment, while only 25% believe Medicare would cover treatment costs. Only 41% believe they would be covered for care in a community cancer clinic, where 84% of cancer treatment actually occurs.

“Although the US has the best cancer care delivery system in the world, the system is now in first-stage crisis because Medicare has substantially cut payments for cancer drugs and essential services,” Dr. Cobb continued. “Oncologists are spending an inordinate amount of time dealing with patient financial issues, including trying to find ways to navigate the insurance maze and identify drug and co-payment assistance for patients in need. Community cancer clinics have had to close satellite facilities and cut staff. Smaller clinics are struggling to operate and more will close.”

The survey found that most Americans say they could not afford the typical monthly cost of cancer treatment not covered by insurance plans. Only about a third (37%) say they could pay up to $1,000 a month towards their cancer care not covered by insurance plans, and only 16% say they could pay up to $2,500 per month towards cancer care.

To pay for cancer care, Americans report they would take a variety of dire steps. Nearly seven out of ten (66%) report they would go on government assistance to pay the cost of cancer treatment. Four out of ten or more would sell their cars (48%) or their homes (38%), would borrow the money (44%) or declare bankruptcy (40%). Fully one third (33%) say they would simply stop the cancer treatment.

Most (85%) of Americans believe a government-run health plan would have significant disadvantages for cancer care, compared with their own current insurance plans, the survey found. Higher taxes were listed as the mostly likely disadvantage of a government-run health plan (74%), while more than half of respondents cited negative impacts on treatment and quality of care: longer wait for medical appointments (62%), less coverage of expensive cancer medications or treatments (60%), less coverage of cancer detection and diagnostic tests (54%), and lower quality of care in general (56%).

“The need for health care reform is especially critical to cancer care,” COA's Executive Director, Ted Okon, said in the news release. “However, the proposals currently under consideration by Congress and the Administration to reform the health care payment system do not take into account the special circumstances and requirements of cancer care. What is needed is a substantive program developed with the involvement of oncologists to enhance the delivery of quality cancer care.”

HR 2872, the “Medicare Quality Cancer Care Demonstration Act of 2009,” has been introduced into the US House of Representatives by Representatives Artur Davis (D-AL), Steve Israel (D-NY), and Mary Jo Kilroy (D-OH). “The project offers a means of moving forward immediately, and an architecture for a solution to the current crisis in cancer care,” Dr. Cobb said.

Earlier this year, Senator Arlen Specter (D-PA) introduced into the Senate S 1221,“The Medicare Prompt Pay Correction Act,” as the companion to HR 1392. Both seek to address problems with Medicare reimbursement for cancer drugs and help alleviate the problem affecting the delivery of cancer care treatment to patients, almost all of whom are treated in community oncology clinics close to their homes, the news release notes.

© 2009 Lippincott Williams & Wilkins, Inc.

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