Paying For Chronic Illness W/ Dina A Hospital Social Worker

When people get diagnosed with chronic illness, their worlds are turned upside down. As a hospital social worker, I often hear reactions like “I did not see this coming,” “I’m not financially ready for this” or “I’m the main breadwinner, how can I provide for my family now that I’m sick?”

When facing a chronic illness, your energy should be focused on recovery and not on the financial strain caused by your inability to work.

In the world of health care, the term “social determinants of health” refers to the well-established relationship between financial well-being and overall prognosis. This means that the more financially stable you are, the better your chances are to overcome your health issues.

The good news is that people with chronic illnesses are living longer thanks to advances in all areas of medicine. However, being sick takes a significant toll on people’s finances over time.

While the social insurance programs in place are a good foundation to ease the financial burden that comes with being sick (see the For Patients section below for more), they must be improved to ensure they reflect the needs of patients living with chronic diseases. Here’s how:

LONGER EMPLOYMENT INSURANCE (EI) SICKNESS BENEFITS. Medical EI for patients is only 15 weeks in duration. This urgently needs to be adjusted to meet the needs of patients who have longer treatments in the context of chronic illnesses. For example, most treatment protocols for breast cancer or leukemia are 2 years long, so 15 weeks of benefits is clearly insufficient.
FINANCIAL SUPPORT PROGRAMS FOR YOUNG ADULTS WITH CANCER. These individuals are just about to launch into the workforce and haven’t had the time to build their safety nets yet. This makes them especially vulnerable since they are often ineligible for EI or Canada Pension Plan (CPP)/Quebec Pension Plan (QPP) since they haven’t worked enough years to qualify for these programs.
FASTER APPROVAL FOR DISABILITY BENEFITS FOR CHRONICALLY ILL PATIENTS. The current criteria for CPP disability pension is that an illness must be both severe and permanent. However many illnesses are severe and prolonged but not permanent. Patients who need chronic treatments, 1-2 year long treatment protocols or relapsed diseases should get special consideration for quicker access to a disability pension. Patients who are not yet deemed permanently disabled but have already exhausted all their EI benefits are sometimes forced to deplete their savings, declare bankruptcy or sell their homes.
EXTENSION OF COMPASSIONATE CARE BENEFITS BEYOND THE PATIENT’S DEATH. At present, caregivers stop receiving benefits when the patient dies. This means caregivers are expected to immediately return to work, which is unrealistic in the context of grief and the responsibilities of settling an estate. Ideally, Compassionate care benefits should extend 2-4 weeks beyond the patient’s date of death.
LESS COSTLY EI DEDUCTIONS FOR SELF-EMPLOYED PEOPLE. Currently, most self-employed Canadians cannot afford EI contributions so they are not covered by this program, which makes them particularly vulnerable.
MORE FLEXIBLE EI AND DISABILITY BENEFITS. As it stands, if patients want to work part time during their treatments, they are penalized. It is important for some patients’ financial well-being and self-worth to be able to contribute in a meaningful way even when they are sick.
TRANSPORT FUNDING FOR CHRONIC MEDICAL PATIENTS. Transportation costs represent a huge out of pocket expense for patients undergoing chronic treatments, who are especially vulnerable if they are living on fixed incomes. We need to increase funding to communities to help them improve transport resources for all chronic medical patients.
MORE AFFORDABLE NUTRITIONAL SUPPLEMENTS. Many patients have food aversions while undergoing chemotherapy but they need to keep their nutritional intake stable. This presents yet another financial burden on chronically ill patients. Nutritional supplements should be more affordable.
FINANCIAL LITERACY EDUCATION IN HIGH SCHOOL. We have a social and moral responsibility as a society to sensitize people to the importance of taking out life and mortgage insurance while they are healthy and young. These insurance policies are much cheaper if bought earlier in people’s lives when they have fewer risk factors, which can save them from losing their homes and assets if they get sick.

FOR PATIENTS

Where do you start as a patient and you’re wondering how you’ll make ends meet when you’re sick? Speak to your social worker, nurse or medical doctor about your concerns. You can also check with your province’s branch of the Canadian Cancer Society to explore financial assistance for travel expenses and medical supplies.

Here are some government programs that can help you are living in Canada and get sick: