The Good News
So the good news is that America is winning the war against cancer, slowly but surely, especially for the so-called “Big Four” – lung, breast, prostate, and colo-rectal cancer. Dr. Julie Vose, the current president of the American Society of Clinical Oncology, commented in her society’s recent report entitled “The State of Cancer Care in America, 2016”. Dr. Vose said last week “We have seen mortality rates decline on the average of 1.5% annually over the past decade, even greater declines for the 4 most common cancers. Additionally, the number of survivors is expected to grow from 14.5 million to 19 million in 2024.”
The Bad News
Despite President Obama’s recent announcement of a near billion dollar “Moon-Shot” against cancer, Dr. Vose went on to say “However, all of the advances are set against the backdrop of unsustainable cost and a volatile practice environment.”
So what does that mean in plain English? The cost of cancer care is skyrocketing, especially the cost of chemotherapy drugs. And so many patients simply cannot afford to pay. In fact, medical bills represent one of the single biggest causes of a family’s financial stress. Dr. Blase Polite, the immediate past chair of the American Society of Clinical Oncology’s government relations committee, said “It is the cost of cancer drugs themselves as well as the increased burden the patient’s face with rising deductibles and higher cost sharing by insurance companies.”
So in plain English again, insurance premiums are going up and deductibles are going up even faster-all costing the cancer patient more money.
The Ugly News
Whatever your politics, ObamaCare has dramatically changed the landscape of cancer care in America. Independent community practices-once the mainstay of cancer care only a decade ago-are vanishing. The independent cancer clinics are either closing or being bought out by hospitals where the cost of cancer care is much more.
Despite the passage of ObamaCare, 35 million non-elderly people remain uninsured, and 31 million more are “underinsured” because their deductibles, the actual out-of-pocket costs, are many thousands of dollars. A $5,000-$6,500 deductible with an ObamaCare insurance policy simply cannot be paid by many Americans.
And for our senior patients, Medicare Advantage programs that now comprise 30% of all Medicare patients can be problematic. For example, our own senior men with prostate cancer are shocked when I tell them that I provide 3 different types of radiation for their prostate cancer, but their insurance companies will decide on whether or not they undergo Cyber Knife, IMRT, or implants. So access to the right treatment is now a major concern. Often times insurance carriers ignore which treatment actually costs less and which is more effective.
So with more pressure on cost and access, can quality be far behind? Are we setting ourselves up for insurance carriers making your medical decisions? Simply put, I never thought I would be posing that question. I wonder whether President Obama’s Moon Shot has already missed its target?
If you have any questions about your cancer, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.