(Reuters Health) - Even cancer patients who seemingly have health insurance are seeking donations online to help with medical bills, travel, drug costs and sometimes living expenses while they undergo treatment, a U.S. study suggests.
More than one quarter of campaigns were on behalf of a patient who was described as under-insured, researchers note in JAMA Internal Medicine.
Based on a sample of more than 1,000 GoFundMe campaigns seeking money for a U.S. cancer patient, the researchers found that patients only received, on average, one quarter of the funding goal they set. Half the goals were US$10,000 or higher.
"The use of GoFundMe (and other sites) fits into the national conversation about insurance coverage, drug costs and the value of care patients receive in the U.S.," said Dr. Benjamin Breyer of the University of California, San Francisco, the study's senior author.
"There are a lot of great things we can do in medicine here, but all stakeholders need to work harder to make care less expensive and a better value," he told Reuters Health by email.
To get a sense of the types of expenses for which cancer patients were seeking help, Breyer and colleagues searched in October 2018 on the GoFundMe website for mentions of the 20 most common cancers in the U.S. They identified 37,344 campaigns and selected a random sample of 1,035 for detailed analysis.
They found that the average fundraising goal was US$21,000, and the average raised was about US$5,000. More than 85per cent of patients were adults. About 40per cent of campaigns asked for funds to pay medical bills, followed by 25per cent for medical travel and 23per cent for nonmedical bills. Less than 2per cent mentioned alternative treatments.
Campaigns for under-insured patients made up 26per cent of the total and were more likely to ask for money for unpaid medical bills. They also requested an average of US$10,000 more than campaigns that didn't mention a lack of insurance. The under-insured were also more likely to describe unstable employment and previous surgery.
"The use of GoFundMe shows us a lot of what we already know: that for many, the present safety net is inadequate and can create financial ruin," Breyer said. "Getting sick shouldn't create financial devastation, and patients should have access to affordable, high value care."
This study is part of a larger research project, Breyer noted. His team is examining the influence of the Affordable Care Act on a state level and use of GoFundMe for cancer care. They're also looking at the role that traveling to a cancer center plays in medical costs and how using GoFundMe allows patients to obtain alternative treatments.
"Medical debt has become an all-too-common phenomenon in our country, and the costs continue to rise more than wages," said Matthew Banegas of the Kaiser Permanente Center for Health Research in Portland, Oregon, who wasn't involved in the study.
"Research shows the widespread sacrifices that patients and families have to make following a diagnosis, which is important because we often focus strictly on medical costs," he said in a phone interview. "So many areas of day-to-day life need attention, and patients don't have the financial resources to keep up."
Banegas is part of a team that has a National Cancer Institute grant to test a Cancer Financial Experience program that guides patients and families through the medical financial planning process.
"I encourage patients and families to ask about their costs of medical care, including cost of treatment, travel costs, insurance coverage, out-of-pocket expenses and payment plans," he said. "This is all information that patients should know, be able to obtain and know what to expect."
SOURCE: https://bit.ly/2m6jxU6 JAMA Internal Medicine, online September 9, 2019.