Health Insurance Reform and Breast Cancer: Making the Health Care System Work for Women

Rising health care costs and inadequate coverage burden many Americans.  Alarmingly, those Americans most likely to fall through the cracks are also those who need care the most.  Breast cancer patients face great uncertainty in the current health care system.  Women diagnosed with breast cancer, whether insured or not, face significant and sometimes devastating hurdles to receiving timely, affordable treatment. 

 

Breast cancer is the second leading type of cancer among women.¹  The disease will affect one in eight American women during their lifetime,² with treatment costs totaling $7 billion in 2007.³ Older women are more likely to develop breast cancer, as well as women who are obese and those who have a history of cancer in their family.⁴ This year alone, an estimated 192,370 American women will be diagnosed with breast cancer and 40,170 will die from the disease, making it the second leading cause of cancer deaths in women.⁵

 

 

The affordability of treatment is often a concern for women diagnosed with breast cancer. Rising health care costs have left a growing number of Americans either uninsured or with less meaningful coverage than they need and deserve. The results of a recent survey estimated that 72 million, or 41 percent, of nonelderly adults have accumulated medical debt or had difficulty paying medical bills in the past year – and 61 percent of those experiencing difficulty paying medical bills had insurance.⁶ Health insurance reform seeks to eliminate these hurdles to ensure that women with breast cancer, along with all Americans, get the quality, affordable health care they deserve.   

 

HEALTH INSURANCE COSTS FOR WOMEN WITH BREAST CANCER

 

Problem: Breast cancer patients have high and potentially ruinous out-of-pocket health care costs.

 

With each passing year, women face increasingly high deductibles, copayments, and other cost-sharing requirements, forcing them to make difficult decisions to make ends meet. Women affected by breast cancer are particularly susceptible to these rising costs. Breast cancer patients with employer-based insurance had total out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket spending for patients with asthma, diabetes, chronic obstructive pulmonary disease (COPD), or high blood pressure.⁷

 

 

In addition to rising deductibles, copayments, and coinsurance, health insurance plans often contain annual and lifetime benefit caps, particularly in the non-group insurance market.⁸ Because breast cancer treatment is costly and long-term, patients are more likely to surpass these benefit caps, leaving them essentially uninsured. In one recent national survey, ten percent of all cancer patients reported that they reached a benefit limit in their insurance policy and were forced to seek alternative insurance coverage or pay the remainder of their treatment out-of-pocket.⁹  

 

Jamie Drzewicki, Florida
Jamie reached her employer-sponsored insurance plan’s $100,000 annual limit after she was diagnosed with breast cancer. As a result, she amassed about $75,000 in unpaid medical bills. Her hospital eventually forgave $40,000 of her debt, but about $30,000 in debt remains. The medical debt caused significant stress for Jamie, who received many calls from collection agencies. “I am a hard worker and now I am making decisions between paying for my groceries and paying off some of my bills,” she says. “I stress about my bills, my job, my cancer.”¹⁰

  

You need to register to comment.