Cancer costs highest for individually insured

One of every seven cancer patients spends more than 20 percent of his income on health care and insurance, according to a new study from federal researchers.

Among these patients, those who buy private insurance on their own - instead of through an employer - pay the most out-of-pocket for their health care, compared to patients who have other forms of insurance or none at all.

"Looking at this," patients insured privately, and not through a group plan, have "an underinsured problem," said Dr. Didem Bernard, a senior economist at the Agency for Healthcare Research and Quality, and the lead author of the study.

Using surveys of about 4,200 people with cancer and roughly 149,000 people without, Bernard and her colleagues looked at incomes and out-of-pocket health care spending - including the cost of insurance premiums - among adults under the age of 65.

"It turns out that (people with cancer) have significantly higher burdens than not only people without cancer, but other chronic conditions," Bernard told Reuters Health.

The researchers found that 13 percent of cancer patients spent at least a fifth of their income on health care and insurance, compared to roughly 10 percent of people with chronic conditions and four percent of people without cancer or chronic diseases.

"This paper confirms previous reports that the out-of-pocket burden of cancer care can be substantial," said Dr. Neal Meropol, the chief of the division of hematology and oncology at University Hospitals Case Medical Center and Case Western Reserve University.

Meropol said that newer cancer-fighting agents can be extremely expensive.

Bernard also said that expenses for cancer patients might be higher than for people who have chronic diseases because of the myriad other issues that can be associated with cancer treatment.

For example, some patients might require plastic surgery after a procedure to remove cancerous tissue, or a patient might be treated for depression, sparked by the stress of dealing with cancer. However, the study did not dig into the causes of cancer patients' higher out-of-pocket burdens.

The study, which is published in the Journal of Clinical Oncology, included health care spending from 2001 to 2008.

Within the group of cancer patients, the research team also compared spending between people with different types of health coverage, including employer-sponsored group insurance, non-group insurance paid for by the individual or family, government-funded insurance for the poor (Medicaid), and no insurance.

Of people who had non-group health insurance, 43 out of every 100 spent more than 20 percent of their income on cancer treatment and insurance premiums.

In comparison, 26 out of every 100 people without insurance had high out-of-pocket costs, as did nine out of every 100 people whose employer paid for their insurance.