Health brief – A double punishment for cancer survivors – EURACTIV.com

Many cancer survivors in long-term remission often experience unfair treatment in accessing financial services because of their medical history. While the right to be forgotten is a way to solve this issue, it is implemented in only a handful of EU countries.

One Lithuanian woman, Justina Gustė, recently got a call from an insurance company. “I can save you some time by saying that I had an oncological disease,” Gustė said to the insurance company’s representative. After an “uncomfortable silence”, she was told that in that case, there was nothing that the company could offer. 

Justina spoke about her experience at a recent press conference in the Lithuanian parliament. Her story is just one example of how cancer survivors struggle with health insurance, mortgages or bank loans — things that many Europeans take for granted – despite being cancer-free.

The number of cancer survivors is growing every year and is now estimated at over 12 million in Europe, as stated in Europe’s Beating Cancer plan. This figure includes around 300,000 childhood cancer survivors, a number expected to rise substantially in the years to come. 

Progress in science and medicine has dramatically increased survival rates. For example, between 2010 and 2020, there was a 45% increase in the successful treatment rate for cancer patients.

But, as Health Commissioner Stella Kyriakides pointed out during a webinar on Monday (30 May), this medical progress and progress in science “has unfortunately not appeared to filter down to many commercial practices”.

“For myself, it is unacceptable that still today, persons with a history of cancer face numerous social and financial challenges, including limited access to mortgages and loans,” she added.

For John Ryan, director of the Unit Public Health at DG Sante, this situation is “a double punishment”. “People who have already suffered with and successfully dealt with cancer, and then a second punishment, which is the financial discrimination point,” he said. 

One option to address this issue is a ‘right to be forgotten’. This is not about General Data Protection Regulation (GDPR) but a right to be forgotten for former cancer patients seeking financial services, such as loans, mortgages, credit, travel, insurance or health insurance.

Kyriakides explained that the right to be forgotten is “about equality, and addressing stigma and discrimination”.  

Avoid reinventing the wheel 

In a handful of EU countries, the right to be forgotten is already implemented, with France leading the way as the first country to introduce it back in 2016.

“France has played a leading role and could serve as a model in order for other countries not to reinvent the wheel because we know that it is effective,” said Françoise Meunier, a member of the Belgian Royal Academy of Medicine and the scientific committee of the European cancer patients coalition. 

Moreover, in February this year, France went a step further when it decreased the delay from 10 to five years regarding the right to be forgotten. 

“They are confident enough to convince the insurer to decrease the delay of the penalty of 10 years to five years, and moreover, they even abandoned the medical questionnaire, which is a crucial step for loans up to €200,000 to be reimbursed at 60,” Meunier highlighted.

The right to be forgotten has also been introduced in Belgium, Netherlands, Luxembourg and Portugal, with Italy and Romania expected to follow suit shortly. Several other countries are also looking at this option. 

As Johan Hansen, a researcher at Netherlands Institute for Health Services Research, explained while presenting the findings of a report on access to financial products for persons with a history of cancer, “most countries made a distinction to look at cancer survivors who have successfully received the treatment at least 10 years ago, with no relapse”.

But as we see from France’s example, there are signs of change. In the case of childhood cancer survivors, the distinction is often made at the five-year remission mark.

Hansen also mentioned that most countries use reference lists to ensure a more “tailored approach” as there are specific types of cancer and particular circumstances.

Regarding financial products, there are differences between countries, mostly linked to varying financial situations. “All in all, across the board, you can see there, there’s a lot of commonality between the countries with some minor differences,” Hansen said.

Meunier called for getting “the same common principle” for financial services across the EU while respecting some national specificity.  

“The right to be forgotten should not be based on postcode,” she said. 

Getting all member states on board

To avoid financial discrimination based on nationality, the EU’s beating cancer plan addresses economic discrimination and unfair obstacles and the right to be forgotten.

During Monday’s webinar, Kyriakides announced that, as per the Commission’s Beating Cancer Plan, the EU executive is “launching an EU-wide process to address the right to be forgotten’ in all member states”.

She said that the Commission was working with the insurance and financial sector to find “common ground”.

“We will provide them with trustworthy research outcomes and solid evidence about cancer risks,” she said, adding that “ultimately, we want to help insurers and banks better assess the creditworthiness or insurance risk of cancer survivors”.

The second step this year is the launch of the first-ever EU Code of Conduct for addressing fair access for cancer survivors to financial services, ensuring that cancer survivors only need to share necessary and vital information. The code of conduct should be adopted by early 2024.

Meunier called the code of conduct a first step. “We should find the basis on the national legislation of EU member states which perhaps will not be achievable only by the code of conduct, but it’s the starting point,” she said.

Insurance companies reluctant 

In their communication dated last year November, the European insurance and reinsurance federation Insurance Europe warned that a right to be forgotten that disregards how private insurance works (i.e., the pooling of risks) would have a “negative effect on the availability of insurance, its price, and the choice of benefits that insurers could offer for all consumers”.

“Right to be forgotten is actually at odds with the basic insurance principles,” William Vidonja, head of conduct of business at Insurance Europe, said on Monday (30 May). 

He continued by explaining that the basic principle of insurance is risk-based.

“And the problem with the right to be forgotten is that it is forcing insurers to ignore the possible additional mortality rates, which could be associated with a prior cancer diagnosis, at least for a number of different types of cancers after a certain cutoff period, which can be 10 years or five years,” he explained. 

This could “have also detrimental impacts on the availability of insurance products and the affordability of the insurance products for the other clients’ groups, and for the design of our products,” he added.

Meanwhile, Peter Eichler, a member of the management board at UNIQA insurance group, added that getting rid of medical questionnaires would place “the voluntary insurance industry is at risk itself”.