"Certainly, having access to health insurance is better than not, because, unsurprisingly, you're much more likely to forego care if you have no access," Weaver said. "But clinicians need to be aware that a relatively substantial proportion of survivors -- including those with insurance -- are not getting the care they need because of cost and try to identify sources of care that are available for their patients at a lower fee."
Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School in Boston and co-author of a medical bankruptcy paper from the Consumer Bankruptcy Project, described the findings as unsurprising but "nonetheless appalling."
"In my own hospital, I was recently involved with a gentleman who refused chemotherapy for Hodgkin's -- a potentially curable disease -- because he couldn't afford the co-pay," she noted. "So, we have many people who have private insurance but find that there are so many gaps in their coverage that, even so, they can't afford the care they need."
"Of course, unfortunately, most of the mainstream health-care reform proposals in Washington right now talk only about covering the uninsured," Woolhandler added. "And that's important. We certainly support that. But what's not being discussed is that already insured people can't afford the health care they need. So we need changes in policy that ensure that insured people get the health care they need."
The National Coalition on Health Care has more on the economics of health care.
SOURCES: Kathryn E. Weaver, Ph.D., cancer prevention fellow, Office of Cancer Survivorship, U.S. National Cancer Institute, Bethesda, Md.; Steffie Woolhandler, M.D., associate professor, medicine, Harvard Medical S
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