Access to Care: Essential to Winning the Fight Against Cancer Ruth Parriott MWD Government Relations Director

The Case for Health Insurance Reform The good news… –Cancer death rates started dropping in 1991 and continue to fall. –We know that prevention and early detection save lives. –Scientists are continually developing new, effective treatments for cancer. –Medically, we know what we need to do to win the fight against cancer.

The Case for Health Insurance Reform The bad news… –An estimated 1.44 million cancer diagnoses in 2007 –An estimated 560,000 cancer deaths in 2007 –Significant gaps in access to care –The health care system fails millions of people with cancer and other chronic life-threatening diseases.

Reform Through the Cancer Lens The Uninsured and Underinsured million uninsured Americans can face having to pay enormous medical costs out of pocket at the time of a major diagnosis. -- Millions more underinsured Americans face great difficulty paying costly medical bills because of inadequate coverage.

The Link: Cancer & Insurance Coverage Peer-reviewed studies have shown: -- Uninsured breast cancer patients are almost 2.5 times more likely than patients with private insurance or Medicare to be diagnosed with advanced stages of the disease. -- Uninsured patients with oropharyngeal (tongue/tonsil) cancer are more than 2.8 times more likely than patients with private insurance or Medicare to be diagnosed with advanced tumors. -- Uninsured patients with laryngeal (voicebox) cancer are 4 times more likely than patients with private insurance or Medicare to be diagnosed with advanced stages of the disease.

Problems Paying Medical Bills Source: USA Today/Kaiser Family Foundation/ Harvard School of Public Health Health Care Costs Survey (conducted April 25 – June 9, 2005) % of families reporting a problem:

Cost Problems in Families With a Major Diagnosis No chronic health condition % reporting in last year skipped treatment, cut pills or didn’t fill prescription due to cost: Heart disease Cancer Source: USA Today/Kaiser Family Foundation/ Harvard School of Public Health Health Care Costs Survey (conducted April 25 – June 9, 2005) Asthma

Reported Problems with Insurance in Paying Cancer Bills Were turned away or unable to get a specific treatment because of insurance issues Plan would not pay anything for care they received that they thought was covered Reached the limit of what insurance would pay for cancer treatment Plan paid less than expected for a medical bill Among those with insurance, % saying they/their family member had these the following problems during cancer treatment: Source: USA Today/Kaiser Family Foundation/Harvard School of Public Health Cancer Survey (conducted August 1 – September 14, 2006) 23% 13% 10% 8%

What is Meaningful Insurance? The Four A’s: A – Adequacy A – Affordability A – Availability A – Administrative simplicity

The 4 As Essential components of any health care reform proposal Represent the minimum standards that must be met for ACS support

Adequacy Access to the full range of cancer care without imposing a financial burden Complete continuum of evidence- based cancer care

Availability Available to everyone –Renewable –Portable –Continuous Must not be constrained by health status –Pre-existing condition exclusion period

Affordability Premiums based on ability to pay Premiums should not be based on health status Reasonable out-of-pocket costs –Including co-pays and deductibles

Administrative Simplicity Transparency and simplicity in health insurance products Can the policy be understood? –By the patient? –By the provider?

Threshold Questions 1. Does the proposal contain the essential ingredients: availability, adequacy, affordability and administrative simplicity? 2. Does the reform plan reduce or eliminate the ability of insurers to “cherry pick” among applicants? 3. Is the overall proposed financing realistic and adequate to sustain the proposed reforms?

More Policy Tools Evaluative Tool –A detailed list of questions ACS will ask about any reform proposal –Provide the basis for developing practical and more specific evaluative criteria in the four areas –The Society is not currently offering its own plan, but rather will evaluate proposals and decide whether to support them

Public Education Campaign

Access to Care Petition

ACS CAN Cancer Promise

THE COLLABORATION Five powerful partners…

The Message…

ACS CAN 2008 Election Bus

Thank you.