Faces of Americans flash across the television screen as a narrator says, “This is what a health care crisis looks like to the American Cancer Society: People with cancer but without insurance, countless others with insurance, just not enough to cover something as devastating as cancer.”
The American Cancer Society’s (ACS) fall advertising campaign isn’t about the dangers of smoking or the importance of mammograms. Instead, the society is spending its entire $15 million budget on TV, Internet, and print ads targeting what its leaders say is the primary reason Americans die from cancer each year–lack of or inadequate health insurance coverage.
“From our evidence-based perspectives, without question … adequate access to health care is among the biggest obstacles to eradicating cancer as a major health problem in the United States,” said Greg Donaldson, national vice president of corporate communications for the Atlanta-based group. “We felt compelled to do our part to raise a national conversation about access to care, but we do not believe we have a role in the policy solution.”
Entering Politics
Donaldson noted ACS continues its support of other educational initiatives, such as Breast Cancer Awareness Month in October and the Great American Smoke-out in November.
The ads, running from September to nearly the end of November, marked a major shift in how disease-fighting organizations address the public, Donaldson admitted. Generally, they have focused on educational messages about prevention or early detection. The 94-year-old cancer society’s campaign may reflect an emerging trend for medical organizations and other nonprofits–urging policymakers and the public to take political action on health questions.
The ads marked the first time a disease-fighting organization has focused its entire budget on a policy issue, but others recently have done so to a lesser degree.
In August, for example, the American Medical Association launched a program called “Voice for the Uninsured,” which proposes to expand health insurance by giving employees choices about which health insurance plans they want; establishing tax credits for the purchase of insurance, with bigger credits for lower-income families; and increasing competition among health insurance companies.
Similarly, this summer the American Association of Retired Persons (AARP), the Business Roundtable, and the Service Employees International Union (SEIU) introduced an effort called “Divided We Fail,” a drive to increase Social Security and press for more access to “affordable, quality health care,” among other initiatives, according to AARP’s Web site.
Care, Not Coverage
Some analysts note the ACS advertisements imply health insurance coverage means access to care.
“Just because you don’t have coverage doesn’t mean you don’t have care,” said Twila Brase, a public health nurse and president of the St. Paul-based Citizens’ Council on Health Care, a nonprofit organization that promotes health care choice. “There are several scenarios here. Some people receive charity care, and some people apply for Medicaid, which is often retroactive. And other patients are paying for medical services out of pocket.”
The reverse is also true–health coverage does not guarantee access to care, Brase said.
“Look at nations that have universal health insurance, like Canada,” Brase said. “They have plenty of citizens who have coverage but can’t get access to care.”
Misguided Politics
Betsy McCaughey, former lieutenant governor of New York and now chairman of the Committee to Reduce Infection Deaths, expressed similar sentiments in a September 14 op-ed published in The Wall Street Journal.
“Despite the large number of uninsured, cancer patients in the U.S. are most likely to be screened regularly, have the fastest access to treatment once they are diagnosed with the disease, and can get new, effective drugs long before they’re available in most other countries,” McCaughey wrote.
McCaughey cited several studies, including what she identified as “the largest international survey of cancer survival rates.” The study, published this year in the medical journal Lancet Oncology, showed that under Great Britain’s universal, government-run health care system–in which all citizens have coverage–the five-year cancer survival rate for women is 53 percent, compared with 63 percent for American women. British men fare even worse: Only 45 percent survive five years after diagnosis, compared with 66 percent of American men.
“[Cancer patients] do better in the U.S. than anywhere else on the globe,” McCaughey concluded. “With a track record like that, the American Cancer Society should continue its lifesaving messages about prevention and screening instead of switching to a political agenda.”
Hilary Masell Oswald ([email protected]) writes from Colorado.
For more information …
“Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data,” by Arduino Verdecchia et al., The Lancet Oncology, online August 21, 2007: http://www.thelancet.com/journals/lanonc/article/PIIS1470204507702450/abstract
