Medical debt is one of the leading causes of bankruptcy, according to a study published online today in the journal Health Affairs. There are plenty of anecdotes of people who have used up their savings, borrowed from friends or filed for bankruptcy following a serious illness like cancer. Now researchers at the Fred Hutchinson Cancer Research Center in Seattle have documented exactly how great the risk of bankruptcy is for cancer patients.
When we think of cancer, we think of the clinical side of the disease: the treatment, the side effects, and the prognosis. But there’s a financial toll to consider, too, said Dr. Scott Ramsey, an internist and health economist at the Hutch, who led the study.
“There is a financial toxicity to cancer treatment and we’re trying to get our arms around how big of a problem that is," he said. "And the next step is treat that toxicity like other side effects of cancer.”
Ramsey found that people diagnosed with cancer are two and a half times more likely to file for bankruptcy, compared with those without cancer.
Cancer is a very, very expensive condition, said Ramsey. Surgery and hospital bills for the initial treatment can run up to $200,000. Then there are chemotherapy treatments—the price tag for that can go up to $15,000 a month.
“And to make it worse, patients with cancer are often very sick and can’t work, so they have the double whammy of having high out-of-pocket costs, and not being able to work," he said. "So that can be a severe strain on families.”
To determine the bankruptcy rate for cancer patients, Ramsey analyzed data from the cancer registry in Western Washington. He compared that with records from federal bankruptcy court.
Ramsey also found two types of cancer that put people at even higher risk for financial ruin: lung cancer and thyroid cancer. “Thyroid surprised us because it’s usually a cancer that’s treated fairly quickly,” he said. "But it turns out that affects a lot of younger women more often.”
And younger women often don’t have the financial resources. In fact, younger, unmarried people have higher bankruptcy rates compared with older groups.
For people who’ve been recently diagnosed with cancer, Ramsey said there are things that can be done. Assess your finances and your insurance coverage. Talk to a financial counselor, and talk to your doctor to see whether there are less expensive treatment options.
“They should at least have that option and be given the choice to choose the less expensive,” said Ramsey. “Because it’s not helpful to be treated for cancer, but, then have your family be financially devastated.”