What Role does Private Insurance Play in Cancer Care?

Two completely separate events have me thinking about private insurance and the role it plays for Canadians in our healthcare system. For kidney cancer patients, whether or not you have private medical insurance plays a huge role in your treatment decisions, and very likely in your overall survival.

“Good Job, with Benefits”

First this week, someone close to me was offered a new position in a good company that has over 100 employees. On closer inspection, the medical coverage (including dental, vision, and pharmaceutical coverage) would cap at $2,000 per year. As many of you reading this know, $2,000 would not even cover 2 weeks’ worth of cancer drugs for kidney cancer. Perhaps having this kind of coverage is worse than not having any at all. (At least if you have none, you know you have none and can make a conscious decision to find private coverage somehow on your own.)

At Kidney Cancer Canada, we often get calls from patients or families who thought they had private insurance that would cover them. Many of us are capable of covering the odd $50 prescription for antibiotics, so we’re not prepared for drug costs of over $6,000 per month.

Your employer’s group plan depends upon where in Canada you live, the insurance carrier, and most importantly how much coverage your employer has purchased. We encourage anyone denied coverage to work through their employer’s HR department first because ultimately the employer is the client of the insurance company. As employees though, we might all want to keep an eye on our benefits programs and changes being made by our employers to reduce the growing cost of these plans. It’s worth finding out what you would be covered for. If you leave your job (willingly or not) or retire, can you continue coverage even at cost to you?

Globe Article: Catastrophic Injury Without Insurance

The second prompt this week was an excellent article in today’s Globe & Mail that focuses on catastrophic injury and how our healthcare system covers the acute care in the hospital setting, but leaves a patient without insurance completely in the lurch once they are discharged:

http://www.theglobeandmail.com/life/health/medicares-no-match-for-catastrophic-injury/article2234387/

 

Disclaimer here: I don’t work for the insurance industry and no family member does either, but my proverbial bacon has been saved by some young whipper snapper (thank you Ian) who once told me to purchase private disability insurance even though I had a decent job at the time AND by an employer plan that (at least currently) pays 100% of my prescription drug costs.

If I was young, or if I had the chance to speak to young Canadians, I would urge them to purchase private insurance now while they are young and healthy. Don’t expect your Canadian public healthcare system to pick up the costs of a catastrophic injury or illness. And don’t expect your employer’s plan to cover everything like in the “good old days” of lifetime employment. Unfortunately, the trends are just not heading in that direction. For reference, see the Cancer Advocacy Coalition’s excellent article on trends in private insurance in their 2009 Report Card.

For some relatively neutral information about private insurance, you can check out the Canadian Life and Health Insurance Association’s website:

A Guide to Supplementary Insurance
A Guide to Disability Insurance

We’ll continue fighting for access for all Canadian patients to all proven therapies for kidney cancer, but until the Canada Health Act is reworked to include medications outside of a hospital setting, we might all want to buy or hang on to whatever insurance we can afford.  As we get closer to renewing the Health Accord in 2014, it will be important for all Canadians to make cancer drug access a priority for our Federal Government.

Comments? Sad but true?

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