The American Cancer Society has released data indicating that uninsured Americans are 2.1 times as likely as those with private health insurance to have cancer initially diagnosed at an advanced stage. This shouldn’t come as much of a surprise, since people without health insurance tend to put off going to the doctor out of concern over the expense. With 47 million people living without health insurance in this country, this cancer diagnosis data is significant for a lot of people.
The study also looked at how people with Medicaid fared when compared with people covered by private health insurance. Those with Medicaid were 80% more likely to have advanced-stage cancer when diagnosed. While this is not as bad as the uninsured group, it’s still a troubling number. Medicaid is health insurance. It’s provided by the government for low-income individuals who are unable to afford private health insurance. So if these people are insured, why are they almost twice as likely as privately insured people to have cancer that progresses to an advanced stage prior to diagnosis? One in six Americans is covered by Medicaid – nearly the same as the number of uninsured Americans – so the late-stage cancer diagnosis with this group is also a significant number. Here in Colorado, 1 in 12 residents is covered by Medicaid, although among Colorado children, 1 in 6 gets health insurance from Medicaid.
So why are people who are covered by Medicaid not getting diagnosed with cancer at an early – more curable – stage? We support the idea of a universal health insurance program, which would most realistically be funded by tax dollars. But for low-income people, that’s what Medicaid is. So why is it not as effective as private health insurance with regards to early diagnosis of cancer? More research would need to be done in order to get a clear picture of what is going on here. Every state has different eligibility requirements for Medicaid, and different rules as to what is covered under the plan and what is not. A good first step would be to make sure that basic cancer screening tests are included in every state’s Medicaid programs. But then we have to look beyond the nuts and bolts of the health insurance coverage and look at the people who are being covered. Does education level or social status have anything to do with delaying a medical check up? Perhaps Medicaid recipients as a group are less educated about things like colon cancer and breast cancer than their more affluent, privately insured neighbors.
Whatever the cause, it’s a whole lot more expensive to treat advanced cancer than a cancer that is caught at an early stage. Colon cancer caught early averages $30,000 to treat, compared with $120,000 if it’s diagnosed at an advanced stage. And of course you’re more likely to die if it’s not caught early. It’s in the best interest of health insurance carriers – including the government-run Medicaid program – to figure out ways to get more people in compliance with cancer screening recommendations. And if we’re ever going to get a universal health insurance system in place in this country, we need to make sure that it fares as least as well as private health insurance in future studies of preventive care outcomes.
{ 3 comments… read them below or add one }
I’m sure that education and social status play a part in the delayed diagnosis of Medicaid patients, but even more, I believe the clinic system in most cities is at fault. Medicaid is often not accepted in private physician offices because of low reimbursement, so Medicaid patients are shunted off to clinic settings. Since most clinics don’t take appointments (and even those that do take appointments are overbooked and understaffed), going to the doctor means spending an entire day waiting to be seen. For Medicaid recipients with jobs, it means taking a day off from work, usually unpaid. So despite the fact that they “have health insurance,” most Medicaid recipients can’t actually afford to see a doctor until they are very sick.
That is a great point K.K. — I wish I would have said it like that!
I’m thinking it’s probably because Medicare/Medicaid only covers the bare minimums, and reimbursement rates for certain diagnostics are very low to zero. There’s also a culture problem in some communities with trusting doctors and modern medicine, and it’s not like cancer has only one set of blatantly-obvious symptoms. By the time some people finally break down and go see a doctor, it’s too late for the Medicare/Medicaid system to help them effectively.