Cancer Costs: Shedding Some Light on its Impact and Resources
Network - Summer 2007
Every cancer survivor knows that cancer costs — physically, psychologically, socially, spiritually and financially. While information about the first four is emerging, data on the financial impacts is more difficult to find.
Yet, the economic consequences of survival can be just as daunting when employment, earnings and health insurance are affected.
This concerns Angela Simmons, director of Clinical Revenue and Reimbursement at M. D. Anderson, as she watches the economic burden of cancer increase in three areas:
- Direct costs: including expenditures for medical procedures and services associated with treatment, and totaling $78.2 billion in 2006
- Morbidity costs: including loss of income, transportation, child care, pain and suffering, and totaling $17.9 billion in 2006
- Mortality costs: measured as lost income associated with premature death, and totaling $110.2 billion in 2006
If predictions prove true, by 2011, the direct costs alone will increase to $98.921 billion, according to the American Cancer Society. Plus, few of us will escape being affected. Statistics show that each year there are 2.3 million new cases diagnosed, 560,000 deaths and that one out of two men and one in three women will be challenged by cancer.
“In an effort to come to terms with this, I view the national disease burden through three windows,” Simmons says. “The first window gives the perspective of patients and their families; the second, of employers; and the third, of society.
“If we look at cancer from the patients’ and caregivers’ perspective, we encounter the direct medical expenses of lost wages, child care, meal planning, lodging, time, transportation, stress, pain, parking, to name a few.”
In addition, employment issues that patients and families deal with include:
- Earnings and lost wages due to a reduction in the number of hours worked
- A changed working environment, deciding who needs to know what and how much, and the potential inability or difficulty in changing jobs
- Reduced or lost benefits
- Early retirement (forced)
- Workplace re-entry problems after treatment
- Refusal of insurance companies to provide coverage
“The situation looks slightly different through the employer’s window,” Simmons says. “A company has the stress of dealing with absenteeism and reduced productivity and/or work displacement. Someone’s got to cover for employees who are patients or caregivers when they are going through treatment. Then, if the employee leaves work, there’s the cost of replacement and training.”
Society sees the impact through yet a third, more global window with increased pressure on the health care system, the family as a unit and the disability system; scarce resources to cover cancer research and care costs; and an aging, baby boomer population.
With more than 45 million Americans with no health insurance coverage, our society faces some difficult challenges. Cancer survivorship costs are a significant piece of this puzzle.
As the number of cancer survivors reaches 10.5 million, there are increasing resources on the Internet. Some reputable sites that provide helpful information are listed below. The more informed patients and caregivers are from the beginning, the better they can advocate for themselves in financial matters.
- A resource for working women with cancer is Cancer and Careers.org. This website also provides valuable tips on how to keep a work/life balance to any cancer patient staying in or returning to the workplace.
- The National Coalition for Cancer Survivorship offers a survivors toolbox that lists various resources.
- The Association of Cancer Online Resources offers a listserv for long-term survivors with information on insurance, disability benefits, employment and education discrimination. Click on “information and support mailing lists,” then scroll to LT-Survivors and follow instructions for logging on.
Other important considerations
- The American With Disabilities Act: Know your civil rights as a cancer survivor. The Americans With Disabilities Act makes it illegal to be denied a loan or other financial service based on your cancer history. The U.S. Department of Health and Human Services Office of Civil Rights has basic information to help you understand the rules and process your complaints.
- Medical coverage: Explore Medicare and Medicaid.
- Income alternatives: Look into Social Security disability income and supplemental security income.
- Life insurance: Investigate if this can be an important source of cash or the basis for a loan. Keep your policy if you leave your job. Some life insurance companies offer an accelerated death benefit with a pre-death payment. Or you may be able to sell your life insurance policy to a company for a portion of its value.
- Retirement plans: Find out if this could be a source of cash and a way to fund a disability. Read your benefits book so that you fully understand your plan. Funds may be available if you are still employed and meet the plan’s hardship provisions.
- Managing the money you have: Make minimum payments on your credit card bills and keep the cards in your name only. Consider getting credit disability or credit life insurance on your card, if available.
- Other important plans: Make sure you have a durable power of attorney, a living will and a regular will with a letter of instructions.
Network - Summer 2007
- Cancer Costs: Shedding Some Light on its Impact and Resources
- Survivorship Issues: New Tools for Assessing Symptom Distress
- People Profile: Processing and Philosophizing — A Recipe for One Patient's Survival
- Doctor Doctor: When Is an Emergency an Emergency?
- The Power of Hope: Living Fully With and Beyond Cancer Conference
- Briefs: Share Your Cancer Experience