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The American Cancer Society, the largest US voluntary health organisation, will devote its entire advertising budget for 2008 to telling Americans and presidential candidates that lack of health insurance or inadequate insurance prevents many people receiving early detection, treatment, and cure of cancer.
US residents with chronic diseases such as heart problems and diabetes face similar problems, said Richard Wender, national president of the society.
The society will spend $15m (£7m; €11m) on what it calls an aggressive and emotive advertising campaign on television, in magazines and newspapers, and online. The society found that previous public service announcements didn't attract attention but that paid-for aggressive advertising did.
The cancer society is joining forces with AARP (formerly the American Association of Retired Persons), which has 38 million members, the Alzheimer's Association, the American Diabetes Association, and the American Heart Association as the election approaches to publicise the problem of access to quality health care. To keep the matter in the news, the associations sent their chief executive officers to speak in states that hold early primary elections to nominate presidential candidates.
Dr Wender said that the cancer society decided on the campaign because only by improving patients' access to care can the society meet its goal to cut mortality from cancer in half by 2015. Otherwise, this mortality will fall by only 25%.
Access to care, he told the BMJ, was a problem that he sees every day in practice as chairman of the department of family and community medicine at Thomas Jefferson University, Philadelphia. He is the first primary care doctor to head the cancer society.
Recent studies have shown that people who were uninsured or had inadequate insurance were twice as likely as people with private insurance to be given a diagnosis of advanced rather than early cancer (Cancer 2007;110:396-402, 403-11, and 231-3).
The society says that, second to use of tobacco, lack of access to quality care is the biggest barrier to reducing deaths from cancer. It has set four principles for health insurance—it should be adequate, affordable, available, and administratively simple.
The society has developed a list of desirable proposals for health insurance. The checklist will be available to state and federal legislators and to the public to evaluate proposals by presidential candidates.
One of the society's television advertisements features a woman who had no insurance when she was diagnosed as having breast cancer. Another advert shows a woman who had insurance when she had thyroid cancer but still faced costs that resulted in her medical bills being handed to debt collection agencies.
Americans with health insurance may find that insurance doesn't cover all the care they need or the hospitals or doctors who are most experienced in their problem, and insurance plans may require patients to pay for a large part of the care.
Groups such as the diabetes and heart associations “can tell the story from different perspectives,” Dr Wender said.
The cancer society joined with Georgetown University Health Policy Institute to track health coverage for patients with cancer through a call-in service to help patients navigate the healthcare system and get care. The service has been able to help only one out of five callers. “The problem is with the system,” said a spokeswoman for the cancer society.