Implications of Cancer Survivorship on Financial Assets, Work Productivity and Employment Circumstances
Nellis, Rebecca V.
The key question this thesis is exploring is whether cancer is a career setback. My hypothesis is that cancer--whether current, in remission, or recurrent--will have a negative impact on someone from a work standpoint as compared to those individuals who have not had cancer. Given that there isn't one single proxy for career setback, this paper approaches this question by looking at the implications of cancer on financial assets, work productivity and employment circumstances. The Medical Expenditures Panel Survey (MEPS) household component is designed to offer a nationally representative estimate of healthcare use and spending, types of insurance coverage and health status in the United States. The MEPS data contains information on any current cancer a person may have. To obtain data on past cancer, MEPS is linked to the National Health Interview Survey (NHIS). For the purposes of this paper, the linked MEPS-NHIS data offer a national sample that includes current cancer patients--including people with new or recurring cancers--people in remission and people who have never been diagnosed as well as employment and socioeconomic indicators for everyone in the sample. Of the thirteen outcomes chosen to test cancer's negative impact on employment, eleven indicate a statistically significant relationship with at least one category of cancer. For people with a repeat cancer the impact appears to be most pronounced with nine indicators, while the other two cancer categories had statistical significance with seven each (though not the same seven).With regards to policy implications, cancer survivors are negatively impacted by pre-existing conditions exclusionary clauses in group health insurance plans, where they often have a waiting period. For underemployed and unemployed people, a cancer history makes it nearly impossible to acquire health insurance on the open market and simultaneously, the qualifying criteria for attaining Social Security Disability Insurance and Supplemental Security Income can be difficult to meet and requires that the person not work more than a set amount in order to continue to receive the benefits.Many chemotherapy drugs are covered in Medicare Part B so co-pay support policies need to better address cancer treatment costs. In addition, oral chemotherapies tend to fall under prescription drug benefits and require higher co-pays whereas intravenous chemotherapy tends to be a medical expense and generally covered at a larger amount. States have begun passing legislation to require both treatment protocols to be covered the same, the federal government needs to follow suit so patients and their healthcare teams can determine the best path to recovery.Finally, incentivizing flexible work models is an area not currently being addressed legislatively but that would increase cancer survivors' ability to stay in or return to the workforce. These would likely follow from the ADA's reasonable accommodations model requiring that it not create an undue hardship for the employer. They might include telecommuting all or some of the work week or allowing employees to work forty hours a week however they choose (e.g. four ten hour days per week).
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