The loss of a firefighter to cancer is always a cost that’s too high a price to pay—but cancer is also now costing fire departments millions of dollars. Cancer is the second most common cause of death in the United States, accounting for nearly one out of every four deaths, exceeded only by heart disease. Yet the cost of cancer has quickly escalated and now far exceeds that of heart disease.
According to the National Cancer Institute (NCI), cancer is one of the most expensive diseases to treat, with 2010 costs in the United States topping $124 billion. That number is expected to rise; the NCI projects those costs to reach at least $158 billion by 2020.
Yet the rising cost of cancer research and care, which thankfully has helped reduce death rates by 16% over 40 years, is something just now impacting the fire service. The workers-comp data of a large metropolitan fire department indicate cancer costs are increasing at a faster rate than overall medical expenditures. So even if cancer rates remain constant or even decrease somewhat, the associated medical costs are expected to increase as new, more-advanced, expensive treatments are adopted as standards of care.
Direct medical expenditures are only one component of the total economic burden of cancer. Improved survival rates resulting from a combination of early detection, better treatments and improved supportive care increase indirect costs of extended losses in time, backfill costs and other economic productivity.
The IAFF/IAFC Wellness-Fitness Initiative (WFI) has already proven it can save lives and money. When comparing incurred cost from 1996 (pre-WFI) to 2009 incurred costs for WFI-compliant departments (as compared to a non-WFI compliant department), the data speaks for itself.
Incurred Medical Costs 1996 vs. 2009
Figures don't include backfill costs.
Comparison of
Three Departments |
Total
Incurred Costs |
Average Cost
per Claim |
| Dept 1 – Non-WFI |
167% |
108% |
| Dept 2 – WFI-Compliant |
0% |
10% |
| Dept 3 – WFI-Compliant |
-35% |
-69% |
For those departments that still have barriers to fire service-specific annual medicals based on cost, maybe looking at the increasing cost of cancers will bring a paradigm shift in their reluctance to spend a little money to save a lot of money. Finding precancers or early-stage cancers can save lives and drastically reduce the costs per claim. The medical cost of one advanced case of cancer is estimated at $1,350,000, with low survival outcomes.
Just a few cancer claims can catastrophically increase your medical costs. With the associated backfill costs, since recovery from treatments can be lengthy, the total costs could easily destroy budgets very quickly.
Non-WFI Incurred Medical Cost with Four New Cancer Cases Added in 2010
| Year |
# of Claims |
Incurred Costs |
| 2008 |
346 |
$3,195,015 |
| 2009 |
345 |
$3,765,248 |
| 2010 |
274 |
$8,343,382 |
Clearly, fire service-specific annual medicals are critical in the fight to control the escalating costs associated with cancers and so much more so in the fight to eliminate the needless suffering and—far too often lately—the death of a firefighter.
Kim C. Favorite is the occupational health & fitness coordinator for the Seattle Fire Department. She’s a member of the IAFC’s Safety, Health and Survival Section and has been a technical advisor for the Fire Service Joint Labor-Management Wellness-Fitness Initiative since 1996.