Why the government shouldn't be in the health care business

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Study Finds Cancer Diagnosis Linked to Insurance

By KEVIN SACK

Published: February 18, 2008

ATLANTA — A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival.

The study by researchers with the American Cancer Society also found that blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured. The study’s authors speculated that the disparity might be caused by a lack of health literacy and an inadequate supply of providers in minority communities. The study is to be published online Monday in The Lancet Oncology.

Previous studies have shown a correlation between insurance status and the stage of diagnosis for particular cancers. The new research is the first to examine a dozen major cancer types and to do so nationally with the most current data. It mined the National Cancer Data Base, which began collecting information about insurance in the late 1990s, to analyze 3.7 million patients who received diagnoses from 1998 to 2004.

The widest disparities were noted in cancers that could be detected early through standard screening or assessment of symptoms, like breast cancer, lung cancer, colon cancer and melanoma. For each, uninsured patients were two to three times more likely to be diagnosed in Stage III or Stage IV rather than Stage I. Smaller disparities were found for non-Hodgkins lymphoma and cancers of the bladder, kidney, prostate, thyroid, uterus, ovary and pancreas.

When comparing blacks to whites, the disparities in late-stage diagnosis were statistically significant for 10 of the 12 cancers. Hispanics also had a higher risk but less so than blacks.

The study’s authors concluded that “individuals without private insurance are not receiving optimum care in terms of cancer screening or timely diagnosis and follow-up with health care providers.” Advanced-stage diagnosis, they wrote, “leads to increased morbidity, decreased quality of life and survival and, often, increased costs.”

The study cites previous research that shows patients receiving a diagnosis of colon cancer in Stage I have a five-year survival rate of 93 percent, compared with 44 percent at Stage III and 8 percent at Stage IV.

“There’s evidence that not having insurance increases suffering,” said Dr. Otis W. Brawley, the American Cancer Society’s chief medical officer.

Not all cancer researchers believe that comprehensive screening and early detection is universally constructive. They argue that with certain cancers, like melanoma and prostate cancer, it can lead to misdiagnosis and overdiagnosis, with doctors identifying and treating tumors that may never cause serious problems. In some of those cases, surgery and drug therapies may actually shorten lives.

“Do these findings mean that patients without insurance are being diagnosed too late, or that insured patients are being excessively diagnosed?” said Dr. H. Gilbert Welch, a professor at Dartmouth who studies the usefulness of medical procedures. “And if it does mean that too many are being diagnosed late, we don’t know if it’s the problem of not being insured or a problem of cultural norms and patient education.”

Dr. Brawley said that the cancer society, the largest and wealthiest of the disease-centered philanthropies, received no more than 5 percent of its $1 billion in revenues from corporate donations, including some from medical suppliers and drug-makers that stood to profit from expanded screening. He said the group had rejected contributions from companies it considered directly connected to its research, and that he saw no conflict in the study on cancer and insurance.

The cancer society, Dr. Brawley said, has been conservative in its screening recommendations, which vary by cancer type and age. The study’s results, he said, would encourage broader screening for breast, colon and cervical cancers, where early detection has reduced death rates, but not necessarily for other cancers.

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Just another in a long line of fluff pieces about how we rich bastards of America are killing off our poor. Does anybody think that if we get universal health care that the outcome will be any different? There will always be a certain percentage of people getting cancer and dying until we find a cure. Why don't we throw more money to cancer research and we will come closer to preventing this than going to universal health care. Oh wait, we already throw billions of dollars at cancer research. What have we gotten form it? Who regulates it? How do you measure success and/or progress? And what is the incentive for finding a cure...unemployment?

Every time I see a study like this, I see more tainted information insinuating that the government can SAVE these folks. I imagine achmed Obama will be citing this study soon.

[Auburn85 432]

Don't we have a shortage of nurses and doctors as it is? Who on here has an appointment time at a doc. office only to never be called back on the appointment time? Usually have to wait a few to several minutes. Then, we may end up throwing millions of more into the system. How are we to sustain it?

How do we get an influx of doctors and nurses? Do we have our friend Government offer more funding for scholarships for those who want to be doctors and nurses? Do we lower the bar?

It's amazing how some are sick of the government and it's handling of the war, the handling of Katrina, "giving tax breaks ONLY TO THE WEALTHY", deficit spending, a big national debt. Then, all in the same breath, people are looking to this SAME GOVERNMENT to provide them healthcare?! What makes people think they'll handle this any better than the other reasons I stated?