I learned a great deal from a recent webinar entitled “Managing Financial Toxicity: Addressing the Hidden Costs of Cancer” hosted by our colleague and supporter Shareshet, the national organization for the U.S. Jewish Breast & Ovarian Cancer community. There were lots of facts and figures, up-to-date research, and as expected from such a wonderful organization, a lot of encouragement and positive support. But the most important takeaway for me, as the founder of the Lemonade Fund, was this: Israel’s national health service is a blessing.
Of course, our public system has no shortage of challenges and problems. Long waiting lists, painfully inefficient bureaucracy. And a bedside manner that often leaves much to be desired.
But the safety net it provides, and that has been protected so adamantly by every government since Israel’s founding, is testimony to the inherent values that inspire and maintain it.
The webinar highlighted some very disturbing trends. In the U.S., financial toxicity affects one in four cancer patients. Most of the immediate causes are from upfront medical bills and treatment costs. These are followed closely by monetary and time costs: like loss of income, utility costs, childcare and transportation to treatments.
The presenters highlighted another even more worrying fact: the direct causal relationship between financial distress and adverse health outcomes.
On the flip side, the experts shared initiatives designed to reduce the risk of financial toxicity. A Senior Director from the Patient Advocate Foundation shared a wealth of available resources and programs to help patients in the U.S. Dr. Margaret Liang, Associate Professor at Cedars-Sinai Medical Center in Los Angeles shared research on new systems and screening tools that are in actual clinical trials to learn how to reduce this very significant risk factor.
Dr. Liang’s work reinforced what we at the Lemonade Fund, and the social workers we work closely with, have believed for a long time, based on our work with thousands of patients since 2011.
While our excellent national healthcare system goes a long long way in alleviating the risk of serious financial toxicity, it is a mistake for physicians and healthcare policy makers to think that this eliminates the problem altogether. Or that this problem is not a genuine medical concern.
Thankfully Israeli cancer patients do not have to make heart-wrenching decisions to forgo paying rent to get life-saving drugs or treatments. But screening tools for distress, financial toxicity, and financial needs can and need to be implemented in Israel’s public healthcare system to reduce the risks of financial distress from monetary and time costs to improve outcomes and ease the burden on social welfare agencies.