Navigating Breast Cancer Without Health Insurance

In early September of 2017, Julia Louis-Dreyfus celebrated a lifetime career achievement by breaking the record for the most Emmy Awards won by a performer for a single role. For six consecutive seasons, she won the best “lead actress in a comedy” award for her work in “Veep,” an HBO political satire comedy that premiered in 2012. She boasts a total of seven Emmy awards, including one that she won in 2006 for her work in “The New Adventures of Old Christine.”

The day after her historic win, after reaching a record-breaking career milestone, Louis-Dreyfus received a breast cancer diagnosis. She announced the news via Twitter with a post that read: “1 in 8 women get breast cancer. Today, I’m the one. The good news is that I have the most glorious group of supportive and caring family and friends, and fantastic insurance through my union. The bad news is that not all women are so lucky, so let’s fight all cancers and make universal health care a reality.”

Her announcement was retweeted and reposted by many fans, supporters, peers, and admirers. Entrepreneur and filmmaker Adam Best retweeted the post, adding: “Few people could get diagnosed with cancer and immediately think of others instead of themselves.” For Louis-Dreyfus, who has supported cancer research in the past by partnering with the Livestrong Foundation, thinking of others was no different than her everyday life.

She understands that simply having health insurance can be a matter of life or death for women over the age of 40.

Read on to learn more about the uninsured and what breast cancer treatment means to them.

Statistics of the uninsured

As of the end of October 2017, it was estimated that just over one in ten women (11%) live uninsured. This is frightening when compared to the current statistical model that shows that approximately one in eight women will be diagnosed with some form of breast cancer in their lifetimes. As the Affordable Care Act and existing health care system falls into question, threatened by state legislators and the new administration, the future trends of health coverage remain uncertain.

More than half of all women who are insured receive coverage from their spouse’s employer. If one or both spouses works part-time, they are both considerably less likely to receive health insurance through their employer, and without any workers in the family, the chances of being insured are far less. Women are also more likely to be covered as a dependent, which means that if their spouse or provider is injured or otherwise loses their job, the woman is left uninsured.

More likely than not, health care will only get less accessible as time progresses. Over the last ten years, the cost of health insurance premiums has gone up by 55% for both individuals and families. Prioritizing health care is becoming more and more difficult for families even in the middle class, especially if their employer does not provide or only partially provides for the employee.

Medicaid, the state-federal program for low-income individuals, does not cover women proportionately to their poverty status. Though it exists, it tends to be more problematic than anything else, and yields lower quality of care for those who do manage to qualify for it. The program has various eligibility requirements depending on the state in question, making it even more difficult to qualify in certain states. All of these reasons and more contribute to the gap in health care between those with insurance and the 11% of women without.

The risks of being uninsured

Julia Louis-Dreyfus made the call for universal health care in part because she knew that women who are diagnosed with breast cancer without health insurance face significantly slimmer odds of surviving the cancer.

A recent study published by the National Cancer Society concluded that uninsured women are as much as 60% more likely to die from breast cancer than those with coverage.

A study published in the Cancer scientific journal concluded that “insurance status at diagnosis and sociodemographic are associated with breast cancer mortality.” By analyzing over 50,000 cases of breast cancer over a two-year period, researchers were able to draw the conclusion, as well as several other interesting conclusions regarding those who are not insured and the risks that they face accordingly. The study is titled: “Breast cancer stage variation and survival in association with insurance status and sociodemographic factors in US women 18 to 64 years old.”

The results of the study found that several groups of women were more likely to be diagnosed in a later stage of breast cancer. All in all, uninsured women were 2.6 times more likely to be diagnosed at a later stage of breast cancer. Following that, researchers were able to distinguish several other significant factors. Being uninsured, black, single, and between the ages of 18 and 39 all led to significantly poorer outcomes than being insured, white, married, and between the ages of 40 and 64.

Once receiving a diagnosis, individuals without insurance must either forgo treatment altogether, or plummet deep into debt. A general estimate of the cost of fighting cancer is $140,000 out of pocket for the uninsured, which is brought down to between $5,000 and $10,000 with good insurance coverage. Even still, those who pay out-of-pocket for health care are likely to receive a lower standard of care.

Every test, hospital day, treatment, and surgery is incredibly expensive, and this presents a nearly insurmountable challenge for those already struggling with the fact that they have a disease that will kill them if they don’t act. There is hope, however, as time may have everything to do with increasing the odds of survival and lowering the cost of treatment.

Catching cancer later

While simply having health insurance can increase the odds of survival for anyone diagnosed with cancer, researchers suspect that the largest part of this is the regular checkups and mammograms that help doctors to catch cancer earlier. The earlier a cancer is caught, the higher the odds of survival by a significant margin. Those with health coverage reap the benefits of quicker diagnosis and often immediate treatment, which may in and of itself lead to significantly better outcomes.

Uninsured women sometimes delay treatment until they can find health coverage, but this only gives cancer the chance to spread further throughout the body. Cancer found in later stages may have already spread throughout the body, leading to even worse health outcomes. When it comes to cancer, catching it early and fighting it fast is the best way to increase the odds of survival. Cancer caught early enough can be fought into remission before it even spreads to other areas of the body, reducing overall costs.

All women should seek mammograms regardless of their coverage or age. Many different groups offer free or low-cost mammograms, including Planned Parenthood and American Cancer Research Foundation. Many clinics will offer discounted screenings during the month of October, which is national Breast Cancer Awareness month. The FDA has a list of approved cancer screening centers and their locations on its website. Simply going in for a mammogram or a screening can greatly increase an individual’s chance of surviving cancer. As Julia Louis-Dreyfus suggested, anyone can be the one in eight that will be diagnosed in their lifetime.

References

http://people.com/bodies/julia-louis-dreyfus-breast-cancer-without-insurance/

http://www.breastcancer.org/research-news/uninsured-women-more-likely-to-die-from-bc

http://onlinelibrary.wiley.com/doi/10.1002/cncr.30722/abstract

https://www.kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage-fact-sheet/

http://www.cnn.com/2017/09/28/entertainment/julia-louis-dreyfus-cancer/index.html