Even more on skin in the game and Cancer

Yousuf Zafar, my colleague here at Duke presented today at the American Society of Clinical Oncology annual meeting on a study showing out of pocket costs for moderate-to-low income Cancer patients averaged $712 per month (I am a co-author). The study shows a variety of mechanisms that patients use to cope with these costs, including not filling prescriptions, cutting pills in half, and going into debt. I cannot share more details on the blog at this time because the paper has not yet been accepted for publication.

However, the role of out of pocket costs and its role in health care and health reform has gotten a great deal of attention of late. Austin and Aaron have been writing a great deal about skin in the game, including more today from Austin where he usefully points out that premiums are a large part of health care expenditures for Medicare beneficiaries. I wrote last week on a recent study showing that 1 in 10 Cancer patients didn’t fill their initial anti-Cancer medication due to out of pocket costs. Yousuf’s new study helps to further demonstrate that sick people (Cancer in these studies) pay quite a lot out of pocket for health care in our current system. Such cost sharing lessens the amount of care received by sick people, and it is unclear if the blunt tool of out of pocket costs does a good job of prioritizing wasteful from productive spending. As I said last week, if you are worried about costs and rationing of care, high deductibles for sick people should have you worried.

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