Cancer = Financial Toxicity
This past weekend, I found myself engaged in a Facebook debate with friends during my Saturday morning coffee over the U.S. Congress House of Representatives passing of the AHCA healthcare bill. As a cancer survivor and as a healthcare administrator in a cancer center, my radar was on high alert for the pre-existing condition limit aspects resulting from the bill. Not all my Facebook friends agreed.
We scoured over the 126-page bill, summaries, news articles, projections and studies, in search of facts to support our opinions and attempting to debunk non-truths circulating about the bill. I spent the better part of Saturday morning hard at work on this. The end result was not to sway each other’s beliefs. Perhaps we are all better informed. But we solved nothing.
Cancer is expensive. Patients face high medical bills, large out-of-pocket payments and often are only able to work less than they could prior to cancer treatment, due to poor health during cancer treatment. In cancer health care, we recognize that 100% of our patients qualify for some type of need based financial assistance during active treatment. Financial toxicity is the official term and financial navigation is a growing field in cancer care. Financial navigators are devoted to helping patients find financial assistance to pay for treatment, including insurance enrollment, pharmaceutical company and other grants and patient needs assistance funds. We regularly see patients who cannot have chemotherapy treatment because they cannot afford the transportation to the infusion center. We see patients become homeless due to the high medical bills of cancer. Financial toxicity is a secondary diagnosis to cancer. It becomes a downward spiral, as cancer patients end up with higher medical bills and a lowered ability to pay for them. Regardless of our political or other beliefs about how this cost should be divided, cancer care is expensive. So, the debate rages on — who should pay for it? Insurance companies? Pharmaceutical companies? The federal government? The state government? Healthcare centers? The tax payers? The insured in the insurance pool? The individual patient? There are no easy answers. And our country is embroiled in great debate over this quandary.
But consider this. There is one thing that we can agree upon. If we prevent cancer, we won’t have to pay for it. And we will no longer spend our time arguing over who should be paying for cancer care. If we devoted the man hours, brain power, research and media attention that is being given to the AHCA / ACA issue of pre-existing conditions instead to cancer prevention, just think what we could accomplish. Envision the time and money that could be instead diverted to research, education and programming for cancer prevention. Imagine if each person who has spent time watching and reading media pieces about AHCA v. ACA coverage donated $1 to cancer prevention. Imagine if each media outlet reporting on this bill spent equal time educating the public about cancer prevention. Imagine if each company spent the time it has devoted to coming up the corporate position on the AHCA v. ACA idea, instead on cancer prevention programming for its employees. Better yet, imagine if individuals, organization and companies alike donated $1 to cancer prevention EACH time they devoted time, energy or resources to this healthcare debate. Think what we could accomplish. Once someone gets cancer, we focus on treatment and “the cure.” If we prevent cancer altogether, we reduce the cost of cancer and eliminate the debate over who should pay for it.
