Patients with cancer in the United States are poorly served by their health insurance companies and healthcare systems and often suffer financially, says a national survey by the newspaper USA Today, the Kaiser Family Foundation, and the Harvard School of Public Health.
Half of US cancer patients and their families had problems with coordination of care. Most patients were treated well by their employers, but 25% of families (including both the insured and the uninsured) said that the person with the disease used up most or all of their savings and some money borrowed from relatives.
Having health insurance during treatment limited the financial consequences, but, even so, 20% of those who had always had insurance used up most or all of their savings, and some had to borrow money. Some people couldn't buy health insurance after their diagnosis, and some lost their health insurance during diagnosis and treatment.
The financial burden was greatest for patients who did not have health insurance. Some people delayed or did not get treatment, nearly half (46%) spent most or all of their savings, and some sought help from a charity or public help programme or even filed for bankruptcy.
The National Survey of Households Affected by Cancer was a nationally representative survey of 930 US adults aged 18 or older. Ten per cent of people surveyed said that they or a family member in their household had been diagnosed with or treated for cancer in the past five years (excluding non-melanoma skin cancer).
Although 95% of patients had health insurance, they still reported problems with costs and billing. US residents with health insurance usually have to pay part of the cost of their care. They may have to pay for care immediately after treatment and then seek reimbursement from their insurance company.
Of people with insurance, about 25% said that their insurance plan paid less of their bill than expected; 10% said that they reached the limit of what their insurance plan would pay for; and one in 12 said that they were unable to get a specific treatment because of insurance problems.
Two thirds of people who did not have health insurance at least at some time during treatment said that the cost was a burden to their families. Younger people with lower incomes and minorities were most affected.
Almost half (44%) of people with cancer were in work at the time of diagnosis, and three quarters of people said that they were well treated by their employers. However, more than a third of people said they couldn't do their jobs as well as before.
Although most people gave good ratings to their doctors and the healthcare system, more than a quarter said that their doctors did not pay attention to factors such as a support network. Almost half of patients reported problems with the coordination of care: a quarter reported conflicting information from different healthcare providers, 21% said that they were sent for duplicate tests, and 20% said that they were confused about prescribed drugs.
More optimistically, more than half the people surveyed said that their experience of cancer had changed their outlook on life in a positive way.
The survey is available at www.kff.org/kaiserpolls/7591.cfm. The USA Today articles are available at www.usatoday.com.