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Access to Care 101
Learn more about the access to health care issue, why it matters, and what the Society is doing about the problem.


Access to Care 201
This video illustrates the importance of providing access to health care for the uninsured and undersinsured and what the American Cancer Society is doing to help. It addresses some of the questions that have arisen since the organization's campaign began in September 2007.

Frequently Asked Questions

Initiative Background

What is the Access to Care initiative?

The Access to Care initiative is the nationwide effort of the Society and ACS CAN to elevate the issue of access to affordable, quality health care to a state and national priority and to contribute to improving the health care system for all Americans. From passing laws improving access to lifesaving screenings to ensuring the ongoing development of new cancer treatments, the Society and ACS CAN are dedicated to making meaningful access to health care a reality in this country. The initiative cuts across national and Division efforts and involves science, policy, mission delivery programs, legislative advocacy, and communications. By examining the system through the “cancer lens,” the Society and ACS CAN are highlighting health care challenges encountered by the more than 1.4 million Americans who are diagnosed with cancer each year.

Why are the American Cancer Society and ACS CAN involved in access to health care?

Winning the fight against cancer depends on improving access to quality health care. We’re making progress in the fight against cancer, but millions of Americans aren’t benefiting because they don’t have access to quality cancer prevention, early detection, and treatment services. Nearly 46 million people in America are uninsured, and 25 million more are underinsured – meaning their insurance fails to provide adequate coverage if they are diagnosed with cancer (Schoen C, Collins SR, Kriss JL, Doty MM. How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007. Health Aff. 2008; w298-w309). Meanwhile, though about 50 percent of cancer deaths can be prevented, our current health care system focuses on treating people when they are sick rather than on keeping them well. We need to transform health care to emphasize wellness and prevention.

What U.S. health care system improvements do the American Cancer Society and ACS CAN support?

The American Cancer Society and ACS CAN envision a health care system in which all Americans have access to health insurance that is adequate, affordable, available, and administratively simple – what we have dubbed the “four A’s.” We also want to transform the health care system from one that treats people when they are sick to one that focuses on keeping them well through disease prevention and early detection. Our health care system should also reduce suffering from cancer by offering quality, evidenced-based care delivered in a humane manner from diagnosis through survivorship and until the end of life. If we improve the health care system through these means for cancer patients, we will improve it for millions of people with other life-threatening diseases as well.

What is the Society doing to address access to care?

The American Cancer Society has been working to help people gain access to quality health care through a number of initiatives for many years, including but not limited to:

  • Offering assistance to patients struggling with insurance issues through the Society’s Health Insurance Assistance Service (HIAS) at the National Cancer Information Center (NCIC)
  • Building Hope Lodge® facilities near major cancer centers to offer patients and their families a place to stay free of charge when their treatment is far from home
  • Placing trained patient navigators in hospitals to help patients navigate the health care system

What is ACS CAN doing to improve access to care?

  • Developing policy on critical health principles
  • Collaborating with key stakeholders in the health care reform debate to find common ground on improving the health care system
  • Sharing the concerns of cancer patients and their families with legislators at the state and federal levels, and telling them that health care reform needs to be a legislative priority
  • Securing a “seat at the table” for legislative discussions on health care reform
  • Advocating for programs such as the Center for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program, which offers free mammograms and follow-up care to low income, underinsured, and uninsured women
  • Advocating against legislation that threatens insurance coverage requirements

Isn’t the Society really advocating for “socialized medicine”?

The Society and ACS CAN are not advocating for “socialized medicine.” When we say that everyone deserves access to affordable, quality health care, we mean that every American should be able to obtain adequate and affordable health coverage, whether through a private system, a public system, or some combination of the two. The solution is up to the American people and policymakers, which is why we are educating the public about the issue and giving concerned citizens the tools they need to make informed decisions. ACS CAN does reserve the right, as in all its advocacy priorities, to weigh in on the merits of actual legislative proposals.

Wouldn’t the Society’s money be better spent on research to find a cure than on this campaign?

The American Cancer Society is and will continue to be the largest source of private cancer research funds in our country. Thanks in large part to Society-funded research, there are currently many proven ways to save lives from cancer, such as early detection tests that find cancer at its earliest, most treatable stages and cancer treatments that offer a cure for many people. Tragically, too many people do not have access to these lifesaving measures because of lack of insurance or costs not covered by insurance. With the current state of our health care system, the same will happen with any innovative new cancer discoveries that may result from the cancer research that the Society funds today.

Why does the American Cancer Society spend money on advertising?

The American Cancer Society has long history of educating the public on important cancer issues such as the dangers of smoking, the importance of healthy lifestyles and early detection tests in reducing cancer risk, and the availability of services that help patients and their families. Advertising helps ensure that the Society reaches the intended target audiences with these important messages. In 2007, the Society engaged the public through a landmark paid media campaign in a discussion about access to care. When polled about their response to the advertising, 98 percent of the viewing public felt the campaign either confirmed their positive impressions of the Society or even improved their perceptions. Only two percent expressed feeling “less favorable.”

Will you continue to educate people about cancer prevention and early detection?

The American Cancer Society will never stop encouraging people to take advantage of all of the measures proven to reduce cancer risk. The Society offers extensive information on cancer prevention and early detection through its National Cancer Information Center, on its Web site, and through its local offices. It offers cancer prevention and early detection guidelines to help people make informed decisions about the best ways to reduce cancer risk. The Society conducts proactive public education campaigns to encourage people to embrace healthy lifestyles and seek the appropriate early detection tests. The Access to Care initiative is intended to ensure that all Americans gain access to the very lifesaving cancer prevention and early detection measures the Society promotes.

Is the American Cancer Society or ACS CAN going to provide insurance coverage or financial assistance to people who are un- or under-insured?

No. The American Cancer Society and ACS CAN do not offer health care insurance, and don’t have the means to provide all the people who need it with financial assistance. To address the health care crisis in America, the American Cancer Society and ACS CAN are working to educate Americans about the access to care issue, offering opportunities to speak up and share their experiences, and encouraging them to take action and advocate for changes in our health care system. In addition, the Society will continue to do what it does best to address the problems created by lack of access to quality cancer care: provide information about cancer prevention, early detection, and treatment; offer answers to financial and insurance questions; help with transportation and lodging; offer hope and support from others who have “been there”; and fund researchers in the quest to understand the causes of cancer and its potential prevention and treatment. ACS CAN will support legislation and policies at the federal, state, and local levels that ensure more people have access to cancer prevention, early detection, and treatment.

The Role of Advocacy in Access to Care

Why are the American Cancer Society and ACS CAN engaged in politics and policy?

Our nation’s lawmakers play a critical role in reducing death from cancer. In the last two decades, the American Cancer Society and ACS CAN have made enormous strides in the fight against cancer by advocating for increased government investment in cancer research, strong tobacco control policies that are proven to decrease smoking rates, screening and treatment programs that give low-income people access to prevention and early detection services, and other lifesaving policies. The Society created its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), in 2001 to build a nationwide grassroots movement of cancer advocates who call upon government officials to support policies like these that help people prevent and fight cancer.

What is the difference between what the American Cancer Society and ACS CAN are doing about access to care?

The American Cancer Society is a charitable organization. Its purpose is to educate the public about key issues that relate to its lifesaving mission of eliminating cancer as a major public health problem. The American Cancer Society has been working to help people gain access to quality health care through a number of initiatives for many years, including but not limited to:

  • Offering assistance to patients struggling with insurance issues through the Society’s Health Insurance Assistance Service (HIAS) at the National Cancer Information Center (NCIC)
  • Building Hope Lodge® facilities near major cancer centers to offer patients and their families a place to stay free of charge when their treatment is far from home
  • Placing trained patient navigators in hospitals to help patients navigate the health care system

The American Cancer Society Cancer Action Network (ACS CAN) is a grassroots advocacy organization that supports laws and policies that help people fight cancer, and holds lawmakers accountable for their votes through comprehensive public education campaigns. Legislative advocacy for health care reform at the federal and state levels is a component of the overall access to care initiative.

Did the Society or ACS CAN endorse any of the presidential candidate health plans?

No. The American Cancer Society and ACS CAN are nonpartisan organizations. More specifically, ACS CAN is prohibited in its articles of incorporation from endorsing candidates. Because both organizations are unable to endorse or fund any candidates or political parties, they did not endorse or oppose a health care plan offered by any of the presidential candidates.

Will the Society or ACS CAN endorse legislative proposals for health care reform?

The Society or ACS CAN may choose to endorse or oppose legislative proposals for health care reform. Health care reform in 2009 presents a tremendous opportunity to enact real change in the way health care is delivered, and for the first time to make sure that all Americans have access to quality health insurance. Critical decisions about health care reform will impact cancer patients and survivors, and that is why ACS CAN is participating in the legislative and policy development discussions now taking place in Congress. ACS CAN will evaluate system-wide and incremental reform proposals through the “cancer lens” for their adherence to Society principles on health coverage, cost, and prevention. If such review shows that a legislative plan would clearly honor or violate those principles, ACS CAN may decide to endorse or oppose that plan accordingly.

How do the Society and ACS CAN plan to engage the public on this issue?

Our primary goal for our ongoing public education efforts remains to educate Americans about the lack of access to affordable, quality health care; to encourage them to speak out about their experiences in the health care system; and to motivate them to take action in support of change. We want Americans to research their own health care plans to determine the extent of their coverage should they be diagnosed with cancer. We also want Americans to ask tough questions of the new president and Congress about whether their health care reform proposals would adequately cover people with cancer. We want Americans to join us in urging that the new president and our lawmakers make this issue a top priority.

The first phase of this public education campaign was intended to create an environment in which the newly elected president will be compelled to address the access to care problem as the first order of business in his administration. The second phase of our work is focused on encouraging the new president, the new Congress, groups representing the nonprofit and for-profit sectors, and the public to seize the opportunity to make dramatic improvements in the health care system with emphasis on preventive measures and services.

What grassroots efforts have been conducted in support of this campaign?

ACS CAN’s grassroots efforts have included:
  • ACS CAN Fight Back Express – ACS CAN launched a six-month nationwide bus tour in May 2008 that called attention to the need to improve access to quality health care. The bus visited every state in the continental United Stated, educating citizens about the critical need to take action and encourage lawmakers to find a solution to the health care crisis.
  • ACS CAN Access to Care Petition – Visitors to www.acscan.org and participants in ACS CAN Fight Back Express events were invited to sign ACS CAN’s petition urging the presidential candidates to make access to health care the top priority of their administration.
  • Candidate tracking – During the presidential campaign, ACS CAN advocates informed the candidates about our principles for quality health care and encouraged an open and explicit conversation about the candidates’ plans to improve the health care system.
  • Voter Guides –ACS CAN asked the presidential candidates and state legislative candidates from around the country to tell us where they stood on high priority cancer issues, including access to care. These voter guides will also be critical post-election as hundreds of thousands of ACS CAN volunteers in congressional districts across the nation will hold our elected officials accountable, asking if their votes were consistent with their answers on the ACS CAN voter guide.
  • ACS CAN Cancer Promise – Advocates encouraged their federal elected officials to sign the ACS CAN Cancer Promise, which outlines short-term steps, such as adequate funding for cancer prevention, early detection, and treatment programs, that must be taken to get our country back on track toward winning the war on cancer.
  • Are You Covered? – ACS CAN collaborated on grassroots activities with the nation’s leading volunteer health advocacy organizations to highlight the importance of giving all Americans access to quality health care. Together with these groups – AARP, the Alzheimer’s Association, the American Diabetes Association, and the American Heart Association – ACS CAN held nonpartisan advocacy events in May 2007 in four key early primary/caucus states and urged the 2008 presidential candidates to make access to health care a central part of their platforms.

What advocacy activities are the Society and ACS CAN currently engaged in relating to access to care?

In addition to our public education, research, and patient services addressing access to health care, the Society and ACS CAN are continuing their ongoing work in support of specific legislative priorities that address the access to health care crisis, such as:

  • Increasing the federal investment in medical research at the National Institutes of Health and the National Cancer Institute at a pace that at a minimum keeps up with medical inflation.
  • Implementation of the 2009 legislation providing the US Food and Drug Administration the broad authority to regulate the sale, advertising, manufacture, and distribution of tobacco products. Passage of this legislation was a major priority for the last decade and its implementation will help us in our smoking prevention efforts. Prevention is a major focus of our access to care efforts.
  • Ongoing work to boost state tobacco excise taxes and calling for Congress to increase the federal tobacco tax to enhance federal prevention and access to care initiatives.
  • Fully funding the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program and related treatment programs at the state level, so uninsured and underinsured women have access to lifesaving cancer screenings.
  • Supporting similar early detection and treatment programs at the federal and state levels for colorectal cancer.
  • Supporting legislation that would create a National Cancer Fund, which would serve as a dedicated funding source for cancer research, and for prevention and early detection programs.

During 2008, the Society and ACS CAN succeeded in helping pass federal and state legislation aimed at improving access to care, including:

  • Michelle's Law – This legislation, which requires health insurance companies to cover full-time college students who must take medical leave for up to 12 months, passed the House and Senate this year with strong support from ACS CAN and President Bush signed it into law in September 2008.
  • Welcome to Medicare Improvements – Congress overrode a presidential veto in June 2008 to enact Medicare legislation that eliminated the co-pay and deductibles for the “Welcome to Medicare” visit, and extended eligibility for the benefit from six months to a year. The new law also allows the secretary of the US Department of Health and Human Services to approve new Medicare preventive services without having to seek congressional authorization, meaning that Medicare beneficiaries will have increased access to the full range of available screening tests in a timely fashion.
  • Colon Cancer Screening Coverage Laws – Colorado, Kentucky, Maine, and Pennsylvania passed legislation in 2008 that requires private insurers to cover colon cancer screening tests in accordance with Society guidelines. Twenty seven states and the District of Columbia now have such laws. Kentucky and Maine also passed legislation that establishes statewide colorectal screening and treatment programs for the uninsured.

Our public education campaign on access to care adds to the urgency of all of these efforts. Our message to the public is that they have a critical role to play in improving the health care system, and we invite them to join us in the effort.

General Questions About Access to Care

Health care reform was attempted in the early 1990s and failed. Why is this point in time any different?

Improving health care is hugely important to our country. Nearly 46 million people do not have coverage, 25 million more have inadequate coverage, and many who do have good coverage do not obtain quality care because of excessive costs. If we want to succeed in saving lives from cancer, we have to improve the access and delivery of care for all Americans. The fact that reform has been tried before and failed is no reason to quit. People told us we could never change Americans’ views on tobacco – but we have, and over time, smoking rates have fallen dramatically. We believe that by educating the public and elevating the debate on this issue, the Society and ACS CAN will help to define clear goals for reforming the system and set the stage for real action. We are working to bring all of the health care stakeholders together to make real progress on improving our health care system. We recognize that everyone must come to the table to find a solution because we can no longer afford to do nothing.

I’m healthy. Why should this issue matter to me?

Access to quality health care is an issue that should matter to everyone – no matter their health status. In addition to the obvious human and economic toll cancer takes on our nation, it is also the health care issue of greatest personal concern for most Americans.

To stay healthy, even the healthiest person needs to know what they can do to reduce their risk of cancer and other diseases, and to be able to get the recommended tests to detect cancer and other diseases early. Based on your age and other risk factors, the American Cancer Society and other medical experts recommend a specific regimen of screening tests that can help detect any potential cancer problems early, and in some cases prevent them altogether. Adequate health insurance that covers the full range of prevention and early detection services is crucial to your ability to maintain your good health.

How many people are uninsured or underinsured?

According to US Census Bureau data, nearly 46 million people in America are uninsured. At least 25 million adults are underinsured, meaning their insurance does not adequately protect them against catastrophic health care expenses. In addition, one in ten cancer patients under age 65 do not have health insurance (Thorpe KE, Howard D. Health insurance and spending among cancer patients. Health Aff. 2003; W3-189).

What are the effects of inadequate health insurance on people’s lives?

Lack of adequate insurance coverage puts many healthy people at higher risk for being diagnosed with cancer at a later stage. Too many people – including many who are insured but not adequately covered – are foregoing early detection testing. In addition, the inadequately insured may experience limits to their benefits, which can interrupt or delay treatment, or force terrible financial choices including bankruptcy. Financially, they experience high or multiple co-pays and limits on number of treatments, visits to the doctors, and prescriptions, to name a few.

For those diagnosed with cancer, the financial repercussions can be catastrophic. Among those who were insured during their illness, 22 percent reported having used up all or most of their savings to pay for treatments; 7 percent were unable to pay for basic necessities like food, heat, or housing; and 3 percent declared bankruptcy. Among uninsured cancer patients, 46 percent reported having used up all or most of their savings to pay for treatments; 41 percent have been unable to pay for basic necessities, including food, heat, or housing; and 6 percent declared bankruptcy.

How do I know if my insurance is adequate?

The best way to determine if you’re adequately insured is to become familiar with your health plan. Contact the plan administrator and ask for the “summary plan description” to learn about your policy. Are the premiums affordable? Consider lifetime maximums, deductibles, and prescription coverage.

Why don’t people have access to health care?

People have inadequate access to quality health care for a variety of reasons:

  • Some are uninsured because they are unemployed, their employer doesn’t offer health benefits, or they simply can’t afford costly premiums (such as small business owners).
  • Others have insurance that doesn’t cover the full range of prevention, early detection, and treatment options that should be available to everyone.
  • Still others are deemed “uninsurable” and denied coverage because of pre-existing health conditions.
  • And finally, many people face yearly and lifetime caps on their health insurance, and/or limits on the number of their doctor visits, especially to specialists.

Call 1-800-ACS-2345 or visit www.cancer.org or www.acscan.org to learn more.