Debt Crisis: Coping with Cancer's Financial Aftermath

Coping with cancer’s financial aftermath calls for creative solutions.

In 2010, while leading a focus group in Knoxville, Tenn., Joanne Buzaglo looked around the room and saw a group of people who appeared highly educated, well-dressed and comfortably middle class. She had been helping people with cancer cope with the social fallout of the disease for 20 years. By that time, she thought she’d seen and heard it all. But Buzaglo found herself speechless as, one by one, the people around the table described their struggles with one of cancer’s most toxic side effects: medical debt so crushing that it cost patients everything.

“It was the most poignant moment I’ve ever felt,” says Buzaglo, vice president of research and training for the Cancer Support Community. “People felt shame and worry, and they were often too overwhelmed to take action.” Buzaglo and her team convened similar groups across the country to update Frankly Speaking About Cancer: Coping with the Cost of Care, a program aimed at helping people manage the cost of cancer treatment.

Health care is generally expensive, but cancer care tends to rack up the largest of medical bills—at precisely a time when people are least able to cope. Medical insurance cannot cover all the costs. Debt piles up quickly, and soon patients can find themselves fighting not only for their physical lives but for their fiscal lives, as well. To make matters worse, patients often have little or no control over the cost of services. Even when they are vigilant about choosing network providers, they soon learn that hospitals contract with providers who may be out of their network, triggering penalties on top of hefty expenses. And newly released data from the Centers for Medicare and Medicaid Services show that hospitals— even facilities in close vicinity—charge vastly different prices for the most common medical procedures. With so much out of a patient’s control, it’s more important than ever to craft a plan for managing debt from the cost of cancer care.

Early in their cancer experience, patients should develop an action plan for managing medical debt— one that includes evaluating their insurance and asking their healthcare providers if they provide financial assistance, discounts and extended payment plans, says Mark Rukavina, of Community Health Advisors. He urges patients to contact a social worker to get started identifying places that offer assistance, and then meet with a patient accounts representative and ask for help in assessing finances and applying for aid.

The worst thing anyone can do is to ignore a bill, Rukavina says, because it may be sent to a collection agency, triggering another set of complications, such as ruined credit. Reaching out to government leaders can sometimes help in identifying local, state or community services. “If people don’t ask for help, they’re not likely to get it,” Rukavina says.

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