Uninsured Cancer Patients Receive Less Care But Spend More Out Of
Pocket Than Privately Insured Patients, Health Affairs Article Says

More Than One-Tenth Of All Cancer Patients Under 65 Lack Coverage;
One-Fifth of Hispanics With Cancer Are Without Insurance

BETHESDA, Md.—Uninsured cancer patients incurred health care costs that were little more than half of the costs of treating privately insured patients over a six-month period, and were admitted to hospitals and seen by physicians less frequently, according to a new study published today as a Health Affairs Web exclusive.

In a Commonwealth Fund-supported analysis of federal health spending data, Emory University scholars Kenneth E. Thorpe and David Howard estimated that 200,000 of the four million cancer patients undergoing treatment each year had no health insurance coverage.

While uninsured cancer patients receive far less health care than their insured counterparts do, the authors find that their out-of-pocket spending is nearly two and a half times that of privately insured patients.

In addition, the authors identify a disparity in health care coverage between Hispanics and cancer patients from all other ethnic groups. Twenty percent of Hispanic cancer patients under age sixty-five lacked health insurance coverage, while 10 percent of whites and 14 percent of blacks in the same age group lacked coverage.

Having health insurance coverage appeared to be the key to better treatment, however, as the authors identified no differences in health spending by race or ethnicity among those with coverage. But they documented a stark difference in spending between those with coverage and those without. Among their findings:

• Uninsured cancer patients incurred $3,606 in health care costs in a six-month window studied by the authors, compared to $6,550 for privately insured patients
• Among those under age sixty-five, uninsured patients incurred $4,806 in health care costs over six months, compared to $8,419 incurred by the privately insured patients
• Uninsured patients under age 65 incurred just $1,454 in inpatient treatment costs over six months, compared to $5,643 incurred by privately insured patients
• Uninsured patients under age 65 paid $1,343 out of pocket, compared to the $549 paid out of pocket by privately insured patients

The authors say that Congress made some effort toward addressing the differences in treatment when it passed a law allowing states to extend Medicaid coverage to some women with breast or cervical cancer. "However, although it is an important first step, breast and cervical cancer account for only 15 percent of newly diagnosed patients with cancer. Extending health insurance to the remaining cancer patients without health insurance could result in earlier treatment and improved survival."

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.

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©2003 Project HOPE–The People-to-People Health Foundation, Inc.