The cost of cancer care is substantially impacting the lives of patients with cancer and survivors, forcing them to make significant lifestyle changes and causing some to incur long-term medical debt. According to a new Survivor Views survey from the American Cancer Society Cancer Action Network (ACS CAN), a majority of patients and survivors say they were unprepared for the costs of their care both in terms of their ability to pay for it (54%) and in what they thought it would cost (64%).
Additionally, more than 70% of respondents said they made significant lifestyle changes in order to afford care, including delaying major purchases (36%), depleting most or all of their savings (28%), going into more credit card debt (28%), and borrowing money from relatives and friends (20%). Eleven percent reported taking out another type of loan, borrowing from a payday lender or refinancing their homes to afford care.
Survey Details
The poll of 1,218 patients with cancer and survivors was conducted from February 9 to 23, 2022. Roughly half (51%) of patients surveyed say they have incurred cancer-related medical debt, the majority of whom (53%) report having their debt go into collections, and 46% of whom say the debt has negatively impacted their credit. Among those with medical debt, about half (51%) said they had balances of more than $5,000 and nearly a quarter (22%) had debt of more than $10,000.
Women were far more likely to report medical debt (57%) than men (36%), and Black patients (62%) were more likely to incur such debt than White patients (52%). Additionally, those who lived in states where Medicaid has not been expanded were more likely to report medical debt (58%) than their counterparts in expansion states (49%). Overall, nearly three-quarters (73%) of respondents said they are worried about affording the cost of their current or future cancer care.
“Patients with cancer are clearly suffering the financial fallout from a disease that is incredibly expensive to diagnose, treat, and survive,” said Lisa Lacasse, President of ACS CAN. “No patient should have to zero out their savings or take out a loan with long-term consequences to save their lives. We need lawmakers to pass policies that make health care more affordable, and we need them to do so now.”
Risks of Inaction
Policies that could improve patient affordability include making increased subsidies to purchase marketplace health coverage permanent, expanding Medicaid in the 12 states that have yet to do so, and capping Medicare prescription drug costs, among others. The risks of inaction are reflected in the survey, with 62% of respondents with medical debt saying they’ve delayed or avoided medical care for minor issues due to their debt and nearly half (45%) who say they’ve delayed care for serious issues. While nearly 8 in 10 (78%) patients say their cancer-related medical debt was accumulated during active treatment, 52% also incurred debt posttreatment for costs such as ongoing screening, monitoring, surveillance, or rehabilitation, and 39% began to go into debt at the point of diagnosis.
“We can’t have patients and survivors delaying or forgoing necessary care because they’re worried about costs and debt collections,” said Ms. Lacasse. “Patients need to know they can get and afford care from the point of diagnosis through long-term survivorship, especially at a time when patients and survivors may already be delaying screening and appointments due to pandemic-related risks and backlogs.”
According to the survey, more than a quarter (26%) of respondents with debt say the pandemic is at least partially responsible for their financial struggle, due to changes in income, employment, or health-care coverage caused by the pandemic.
“Patients, survivors, and their families need financial relief—not mounting bills and collections calls. Congress should act swiftly to pass policies that begin addressing this issue before more patients find themselves unable to overcome their medical debt,” said Ms. Lacasse.
