Coping With The Financial Fallout of Cancer

"It's a huge issue [loss of income and costs related to cancer care]. For middle-class Canadians and working-class Canadians a cancer diagnosis is like standing on thin ice, and you only hope you can get back to work and cover your bills before you go under."
"Those [government] benefits just expire too soon for a lot of people."
Gabriel Miller, Canadian Cancer Society

"It's something I'm not proud of [filing for personal bankruptcy], something I never thought I'd do. I've always been a proud, stand-up individual. But I had no alternative ..."
"You're not bringing in income, bills are mounting, [creditors] are not compassionate and understanding. They want their money."
Lawrence, (last name withheld),Toronto real estate agent, 56

"The thing that keeps me up at night is, if I do need a drug or some treatment of some sort, will we have the funds to cover it?"
"And if we have to sell our house, is that even a reasonable thing to do? Probably, I would just go quietly."
Deb Maskens, advanced kidney cancer patient, Guelph, Ontario

"People will deal with different stresses, they will have financial stress or problems with health."
"When you throw everything together all at once, there comes a point where you say 'I just can't do it any more'."
"You need to be able to breathe."
Monica Pope, 51, breast cancer patient

In Canada, a growing body of research, along with interviews with patients, point to the fact that despite universal health care coverage for everyone, a diagnosis of cancer has an enormous drag on anyone's future. Going beyond the dread diagnosis and the accompanying psychological stress and physical pain of surgery and treatment, there is the looming threat of financial insolvency caused by the inevitable prolonged income loss and costs related to cancer treatment.

Drugs required on an ongoing basis, not administered in a hospital, are paid for by the patient. If there are expenses related to travel on top of the drug costs the end result is a devastating financial burden at the very time when fear rules while the cancer is being treated and the final outcome remains unknown. An estimated one in six bankruptcies are caused by the fall-out of health problems, and many of them relate to cancer.

If there are economic options that come into play they are the draining of savings for retirement for example, the re-mortgaging of homes, and the base alternative of going on welfare. Undergoing cancer drug treatment at home, not in hospital, means it is patients who personally must pay the cost of expensive medications in some provinces. Once the fear of a dramatically shortened lifespan reflected reality, now however, patients live longer post-treatment and federal and provincial income support programs prove inadequate.

Some people have disability insurance that they rely upon to help them with their growing health-related expenses while there is a hiatus from their work, yet some insurance companies if they can prove a pre-existing condition is involved, refuse to honour the policy. Even though in Canada oncology treatment comes without a personal charge under the universal health care system, all other costs associated with treatment are at the patient's expense.

According to a 2002 survey by the Canadian Partnership Against Cancer, two of every five people diagnosed with cancer go off their work schedules for a minimum of six months while receiving treatment. The diagnosis of  cancer and its after-effects impact on caregivers, some 60 percent of whom must cut work hours or leave their employment, according to a Lung Cancer Canada Survey. Canadian patients' families experience incomes plummeting by 26 percent according to a 2010 McMaster University study.

While some employees in Canada have access to workplace disability benefits, an estimated seven million Canadians have none. Those who qualify can count on Employment Insurance kicking in, but sickness benefits last for fifteen weeks at most, providing 55% of normal salary. As for the Canada Pension Plan, cancer patients run into problems qualifying for disability benefits to people under 65 under CPP which kicks in at a rate of $1,300 monthly. And welfare provides less than that figure, as an alternative.

According to Ilene Shiller, a manager at Wellspring, a Toronto-based cancer charity, some people are so "shocked" at the prospect of their income falling so dramatically they delay treatment so they can remain at work longer. Quebec, Alberta and British Columbia pay for all cancer medications, Ontario and the Atlantic provinces provide less coverage for home medications typically costing thousands monthly. Ontario does have a catastrophic drug coverage program for patients under 65 with no workplace drug plan but patients are required to contribute four percent of their income yearly.

The nightmare for people facing a cancer diagnosis and attempting to balance all their needs as a patient with a drug protocol will continue to become an acute social problem as cancer drugs by 2020 taken at home are expected to impact 60 percent of patients. And while the Canada Health Act requires hospital-administered drugs to be covered by medicare, provinces are not expected to fund those medications self-administered in the home.