they finally see a doctor many underinsured patients are given fewer treatment options and receive less aggressive, and therefore less expensive, treatment compared to whites. When blacks are diagnosed early enough to improve survival rates, studies have shown that even after accounting for socioeconomic factors blacks diagnosed with early-stage lung cancer are less likely than whites to receive surgery, the only treatment which can result in long-term cure. Similarly, socioeconomic statuses aside black women with breast cancer still have poorer outcomes then white women.
For example, Newsweek reported that 7% of black women with breast cancer get no treatment and 35% do not receive radiation after mastectomy compared with 26% of white women who do not.
Insurance-Rich, Coverage-Poor, Medically Bankrupt
Low-income people are not the only ones who are medically underinsured. There are two definitions of underinsured widely used by experts, reports a study by the Commonwealth Fund, a private foundation working toward a high performance health system. According to the first definition, the underinsured are those whose out-of-pocket expense associated with a catastrophic illness would be greater than 10% of their annual family income. According to the second, the under-insured are people whose healthcare plans cover less than 71% of their average total covered medical expenses. The authors of the Commonwealth study explain that small businesses in particular have moved to plans with higher front-end deductibles and average deductibles tripled between 2000 and 2007.
According to the Kauffman Family Foundation, the percentage of firms offering coverage dropped from 69% in 2000 to 60% in 2007, which was in part due to rising premiums. From 2000 to 2007, there was a 91% cumulative increase in premiums, compared with a 24% increase in wages In 2007, the annual employer group premium for a family of four was $12,106, nearly double what it was in 2000.
The climate created by the high cost of insurance may be leading to what the AARP and the nonpartisan group Dividewefail.com describes as “medical bankruptcy,” a serious concern that may have led countless Americans down the road to foreclosure.
The Kaiser network estimates that about 100,000 families went bankrupt last year because of a cancer diagnosis and lack of adequate coverage.
A Forward Look at Funding
The good news is that the health disparities of African Americans have been acknowledged and money is being funneled into programs to lesson these gaps. The National Center on Minority Health and Health Disparities (NCMHD) received $213.8 million (an additional $13.8 million) for fiscal year 2008 and announced that awards totaling $32 million have been made to 33 new eligible biomedical and behavioral research institutions under the Centers of Excellence in Partnerships for Community Outreach Research on Health Disparities and Training.
On the other hand, the National Institute of Health received $30.81 billion for the fiscal year of 2008, which means the NCMHD’s portion is less than 0.1%. Even worse, money allocated to the NCMHD is not dedicated solely for cancer prevention and detection, but will also go toward researching the combined health disparities that minorities face, which