by Carol A. Westbrook
You can't afford to have cancer without insurance. Medical bills from cancer run from tens of thousands to hundreds of thousands of dollars, not to mention the unreimbursed personal costs, such as loss of income, babysitting, caregiver's costs, and transportation.
Paying for this is a complex process. About 60% of peple with cancer will be 65 or older, and thus will be insured through Medicare. A few percent more will qualify for Social Security disability insurance. Some of the rest will have health insurance. The others face loss of savings, huge loans, and even bankruptcy.
But even with insurance or Medicare, many medical costs are not reimbursed–these include deductibles, co-pays for clinic visits, medical supplies, and outpatient medication. Cancer patients face especially high unreimbursed costs because their treatment may require frequent clinic visits or expensive chemotherapy pills with exorbitant co-pays.
Cancer patients and their doctors are concerned about the uncertainty of health care costs with the threatened repeal of the Affordable Care Act (ACA), or Obamacare with the new presidential administration. What will be the impact on cancer care?
In reality, the impact may be smaller than you think. Obamacare has helped with cancer care in some ways, but has made it worse in others. The most significant positive impact is guaranteeing health insurance coverage even in the face of pre-existing conditions, including cancer. Another improvement is in the ability to obtain insurance, even if you never had any in the first place. But the uninsured are still liable for the medical bills they already owe before their insurance kicks in–and they have to wait for the open enrollment period (December to January) to sign up for it through the insurance exchanges.
Where Obamacare has really failed is in cost containment. Enactment of the ACA led to rapid and often exorbitant increases in insurance premiums, or even the loss of coverage for those whose policies did not meet ACA standards. Worse yet, medical costs have continued skyrocket; there are continued increases in deductibles, co-pays, medication, medical supplies, and hospital charges. Although Obamacare does not apply to Medicare, there were collateral effects on its recipients, who faced mounting costs for their medication, for their Medicare supplemental insurance, and higher deductibles. Obamacare did nothing to stop the increase in health costs, and may have made it worse.