Members of the American Cancer Society launched a program last year to "call attention to the urgent need for quality, affordable care for all Americans," they said.
"As part of the initiative, which is an unprecedented effort in the 94-year history of the organization, the Society will devote significant resources toward creating an aggressive public awareness campaign that highlight the barriers that average Americans, including the 47 million who do not have health insurance and the countless others who have inadequate insurance confront when facing cancer…"
A study released in the Lancet Oncology Journal in February 2008 pointed to some of those barriers by taking into account 3.7 million patients who received diagnoses from 1988 to 2004. Researchers took the information from a national cancer database started in the late 1990s. From that they learned, of twelve different cancers the worst cases showed up in patients who were uninsured or underinsured.
Those patients were often diagnosed with cancers that could be detected early through routine screening or simple assessment of symptoms, like colon, breast or lung. For each, uninsured patients were two to three times more likely to be diagnosed in stage three or stage four when symptoms became unbearable rather than stage one.
"There's evidence that not having insurance increases suffering," said Dr. Otis Brawley, ACS' chief medical officer.
Brawley said it was clear that some patients with possible cancer symptoms- say a persistent cough that could indicate lung cancer- were delaying doctor visits because they were uninsured. Those barriers often create a twofold job for Gasterenterologist Dr. Donald Henderson of Centinela Hospital in Inglewood. He accepts almost all insurance, he said, but is frequently inundated with patients who have none or who have policies that don't cover what they need. Advocating for them has become routine in his 30 years of practice.
"It's impossible not to get involved," Henderson told the Sentinel
"It's unlawful for [insurance companies] to make unreasonable decisions when it comes to patient care but there are often circumstances when I have to interact with them and force their hand. Sometimes I have to call and find out why an insurance company won't pay for something like an X ray when I know they really need one."
Organizations like the Stennis Foundation do step in and help patients get access to care beyond their reach but as the nation's economic environment gets tougher, their ability to assist is reaching a limit.
"We're not able to do it anymore but we have in the past funded colonoscopies for individuals who do not have insurance," said Erin Stennis who founded the Stennis foundation after her husband died of colon cancer and who is also an ACS volunteer.
"It's so unfortunate that, that many individuals out there have no or limited [health] insurance. I know often times these individuals… they may have issues, they'll go to a clinic and they have to go to a county facility. In going to a county facility, unless they go to emergency, the wait for tests that could properly diagnose them is so long. It could be months long… as a volunteer I see these individuals become very frustrated."
But a lot of them do end up in emergency where:
¥ The expenses are passed on to others through
higher medical fees and insurance premiums.
¥ there is overburdening of the local
¥ the finances and ability of emergency
rooms to handle trauma are significantly impacted
¥the overuse of an emergency department can
even lead to increased local taxes.
"Encouraging people is sometimes difficult,"said Stennis who focuses more on making people aware of prevention and support resources in the community.
"People expect that their insurance will be sufficient should they be faced with a major illness," said Richard C. Wender, M.D. and ACS' national volunteer president.
"Unfortunately, millions of Americans think they are covered, but find out too late that their insurance is inadequate, and as a consequence they often face substantial financial burdens, including being denied the care they need. No one should have to choose between taking care of their health and paying their bills."
Stennis has seen it first hand in her line of work, she said. One gentleman who did his own research was "lucky" enough to discover that he had more choices to care than he was told by physicians. He wasn't told, she said–as it was relayed to her–that his insurance payout limited his options.
"The American Cancer Society believes that, after tobacco use, lack of access to quality health care in the United States could be the biggest barrier to continued progress in the fight against cancer," said Wender.
"Cancer is the number one personal health concern of Americans. Reducing suffering and death from cancer may only truly be possible if all Americans are able to visit their doctor for regular check ups, early detection screening tests and prompt, quality cancer treatment if and when they need it."
Those who need more information on ACS' ongoing campaign and on how to get involved can visit www.cancer.org.