Bankruptcy’s bite felt 2-5 times more by cancer patients

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Cancer patients are more than twice as likely to file for bankruptcy than people without cancer, according to a study of Washington state patients published in the May issue of Health Affairs.

Bankruptcy rates varied across cancer types and age groups, with younger patients having up to five times higher rates of bankruptcy than cancer patients age 65 or older, according to Scott Ramsey MD, PhD, of the Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, and colleagues.

“Although the risk of bankruptcy for cancer patients is relatively low in absolute terms, bankruptcy represents an extreme manifestation of what is probably a larger picture of economic hardship for cancer patients,” they wrote.

Findings were based on a retrospective cohort analysis of Surveillance Epidemiology and End Results (SEER) data and federal bankruptcy records covering the Western District of Washington State in U.S. Bankruptcy Court from 1995 to 2009. Patients newly diagnosed with cancer were linked with matched samples of those without cancer.

Ramsey and colleagues reported that cancer patients were 2.65 times more likely to go bankrupt than those without cancer, with thyroid cancer patients at the greatest risk for bankruptcy. The authors speculated this was because thyroid cancer affects younger women more than most cancer and they more likely to live in single-income households, have a lower wage and have less access to high-quality health insurance.

Younger cancer patients succumbed to bankruptcy more often than older patients likely due to higher debt loads (from student loans) and limited assets, according to Ramsey and colleagues. Medicare and Social Security also probably heavily contributed the older patients’ financial stability.

“As a policy issue, there may be a role for employers and governments in creating programs or incentives to reduce the likelihood of financial insolvency, given that bankruptcies are ‘lose-lose’ events for debtors and creditors alike,” wrote the authors. “An example would be tax incentives to encourage employers to provide supplemental insurance policies with fixed sums to cover household and out-of-pocket expenses in the first year following a cancer diagnosis.”

In the study background information, the authors noted that $1.3 billion of the $20.1 billion spent annually in the nonelderly cancer patient population comes directly from patients, while between 40-85 percent of cancer patients stop working during initial treatment.

Ramsey and colleagues called for future studies that include information on financial and insurance status of patients at the time of diagnosis to better understand the associations with bankruptcy. They wrote that cancer care facilities should assess the financial health of their patients, and families should be encouraged to make financial preparations if possible.