The Effect of Insurance on Breast Cancer
Early diagnosis is incredibly important in determining the chance of survival that someone with breast cancer will have. Screening and detection methods for breast cancer have made leaps and bounds over the years, but only for those people who have access to regular screening. Insurance plays a huge role in this, and while far from perfect, the Affordable Care Act (commonly known as ObamaCare or the ACA) has done wonders for women’s health. From increasing accessibility to contraceptive methods to increasing the number of people who have insurance the ACA has made women’s health a priority. According to recent research at Loyola University Chicago, the ACA has also made a positive impact on breast cancer survivorship.
In June of 2017 they published in the journal Cancer Epidemiology about how more patients with stage 1 breast cancer were diagnosed after the ACA went into effect. This increased rate of early diagnosis meant that these patients could receive treatment early on when the cancer was most susceptible to it, thus improving survival rates.
The study looked at 470,000 breast cancer patients between the ages of 50 and 74. All of these patients had either private insurance or Medicare and were newly diagnosed. They looked at diagnosis rates from 2007 to 2009 (before the ACA came into effect) and compared them with diagnosis rates from 2011 to 2013 (after the ACA went into effect). Their results showed that diagnoses of stage 1 breast cancer increased by 3.6 percent after the ACA started. They also noticed a decrease in stage 2 and stage 3 diagnoses which mean that breast cancer was being caught earlier. Given that the majority of the people that were uninsured prior to the ACA were of lower socioeconomic status, and the largest increase in diagnoses was seen in the African-American and Latino populations, the increase in early diagnoses is likely due to an increase in insured people.
The financial burden
If you have to choose between paying for a check-up and keeping your electricity on, which are you going to do? The ACA preventative services provision (PSP) removes copays for things such as mammograms and other cancer screening methods which meant that people no longer had to choose between getting their physicals or feeding their kids. Personal health could be a priority.
In the United States, chronic diseases are very costly. Even with insurance many patients will end up picking up the tab for part of care. When patients have advanced cancer, their financial burden is greater than those with early stage cancer. Yet, the financial burden will be there regardless of what stage cancer a person has. If he or she does not have insurance, this burden will often be completely unmanageable.
The senior manager of practice operations at the University of Florida Health Cancer Center, Jackie Weber, is able to provide some personal insight. As a person working in the health field, and a breast cancer survivor herself, she has some firsthand knowledge. Weber says that she feels having had insurance when battling breast cancer was a key factor in her survivorship. She stated, “I feel like I’m a good example of having insurance and things going well because I do have insurance. We do know even though we do our best to try to get access for screening mammograms, if a woman doesn’t have insurance she’s not likely to have the follow-up diagnostics.” So, it is not just about that initial screening. The initial screening that leads to the diagnosis is the first step, but if the patient cannot pay for follow-up or treatment, their prognosis will be left unchanged.
Weber was diagnosed approximately three years ago with a triple negative very aggressive form of breast cancer. She was lucky that it was caught early. After chemo, surgery, and radiation, she is now cancer free and living with a great prognosis due to her early treatment.
Yet for many, their health is not their first priority. This is not because they do not care about it, but it is often due to their being so many other things that they have to put first in their lives. For people who are already struggling financially, their home payments, food, and utilities as well as providing for their children will come first on their priority list. This may mean that personal health falls at number 10 on the list. By the time these people find out that they have cancer, it may be so advanced that their chances of survival even if they can manage to pay for treatment is slim. Plans that cover routine care are great for detection, but there is still work to be done in the area of follow up.
Other financial resources
If you are unable to afford follow up care after a diagnosis, take a deep breath. The one advantage about this particular diagnosis is that it has received an immense amount of attention and therefore there are many resources available to help you. Organizations like the AVON Foundation supports programs that offer financial help to underserved breast cancer patients. Breastcancer.org and the Susan G. Komen foundation also have lists of organizations that can help patients fund their care. It is important to remember that you are not alone, and this is not a hopeless situation. Talk with your provider about your concerns and perhaps he or she can help you locate the necessary resources. Check out your local community as well. There are often resources or funds on the local level that are available for helping people who are battling breast cancer.
Weber also said that she and her team work to help patients with not only paying for treatment and transportation to the hospital, but that they also work with pharmaceutical companies to try and lower the costs of drugs, and are often successful. This is welcomed news considering how frequently we hear about pharmaceutical companies just trying to make a buck off of patients. Weber says that with cancer patients, pharmaceutical companies can have a much more supportive and helpful attitude.
This kind of assistance is helpful for people who have basic coverage, but struggle when it comes to paying for their medications. By looking into the services that your healthcare facility has for cancer patients, you may be able to locate similar resources. It is important to not be shy about your financial situation. If you are struggling let someone in your healthcare team know so that everyone can work together to find you financial support or put you on a payment plan. Your job should be to focus on healing and coping with the other challenges that a cancer diagnosis brings, not stressing out endlessly about how you will manage paying for treatment.
Ultimately, developing comprehensive insurance for all people will greatly impact the financial burden that people face when fighting a chronic and/or life-threatening disease. The ACA has had a positive effect on breast cancer survivorship. If the ACA ensured that follow up care was also included in coverage, the number of people surviving breast cancer would continue to increase. Screening and detection is just the first step.
