Early cancer diagnosis depends on health coverage too!

Press Release:

“Essentially we showed there is a big jump in cancer diagnoses as people turn 65 and are thus Medicare-eligible,” said Shrager, the senior author of the study. The study’s lead author is Deven Patel, MD, a surgical resident at Cedars-Sinai Medical Center in Los Angeles who spent a year as a research fellow at Stanford. “This suggests that many people are delaying their care for financial reasons until they get health insurance through Medicare.

“Collectively, these results demonstrate that Medicare eligibility, an event coincident with becoming 65 years old, is associated with a rise in early-stage cancer diagnoses and a resulting survival benefit,” the study concluded.”

I was concerned about this finding-are patients delaying their treatment (and hence the chances of curing) for insufficient health coverage? If yes, it is disturbing news because it skews the statistics towards worse outcomes.I have argued for the “payer-pays” principle with adequate “co-payments” and in that regard, Singapore has hit the nail on the head through well administered and efficient system. I wonder why they don’t export that out because it has profound implications for other systems as well.

There is a huge amount of moral hazard built in the system. It is inevitable as people will inevitably clog the healthcare systems and the hospitals will execute the necessary testing “just to be sure”. How do you weed out the ones who genuinely require care versus the ones committing the fraud? These are thorny issues and under-researched due to ethical constraints. However, unless hospitals are weaned off from the episodic acute model of care, mechanisms won’t change with overcrowding and worse experience for everyone involved.

I couldn’t access the linked study (it’s behind a paywall!) However, I think it deserves a mention.