© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 2, 84-85,
January 16, 2002
© 2002 Oxford University Press
NEWS |
Presidential Panel Calls for Overhaul in Cancer Care
The President’s Cancer Panel concluded in December that the U.S. health care system is failing people with cancer.
Its report, Voices of a Broken System: Real People, Real Problems, is the product of a series of nationwide hearings held in response to the President’s Cancer Panel’s 1999 report, which concluded that many proven cancer interventions resulting from the National Cancer Act were not reaching the general public.
The new report is a collection of testimony from 393 Americans affected by cancer—from those living with the disease to their health administrators, caregivers, and volunteers. These people all voiced the same basic message: The nation’s health care system is filled with barriers preventing them from getting the care they need.
"No person in America should spend more time fighting the system than fighting their cancer," said Harold P. Freeman, M.D., chairman of the President’s Cancer Panel. "America’s health care system is broken. As a nation, we have a moral and ethical responsibility to take action."
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Based on the testimonies (see box, p. 85), the panel made several recommendations including: Providing immediate medical insurance for those diagnosed with cancer who are uninsured; reimbursing for cancer medications; supporting community-based programs that provide cancer information, screening, treatment, and support; reaching rural areas using telemedicine and other technologies; training health care providers, and encouraging more minorities to enter cancer care professions.
In testimony before the panel, one colorectal cancer survivor and Vietnam veteran recalled being denied state medical coverage and having to pay $600 a month for treatments. Another person, a prostate and colon cancer survivor, said he had to refinance his house and sell his car before he could become eligible for Medicaid. "It just bankrupted us," he said.
Gerardo Midence, M.D., an oncologist from Montana, described a number of scenarios cancer patients face in trying to get through the health care system, "You make too much for Medicaid. You have not had the disease [long] enough to get disability or [supplemental security income]. You are not old enough for Medicare. You are not insurable because you have a pre-existing condition. So you’re in a hole."
The report also revealed patients’ frustrations about health plan restrictions, lack of transportation to cancer care facilities, and poor communication of information and options from health care providers.
The President’s Cancer Panel presented the report and its recommendations to President George W. Bush, Congressional leaders, the Secretary of Health and Human Services, and the directors of the National Institutes of Health and the National Cancer Institute.
"It’s hard to say what’s going to happen to such a report and its recommendations," Freeman admitted. "I think when you describe an American problem of this depth and magnitude, what the panel can do is make people understand the depth of this problem. What will be done about it is a huge question."
This report is the latest in a succession of reports scrutinizing the quality of cancer care. Most recently, the Institute of Medicine’s National Cancer Policy Board issued a report in 1999 called Ensuring Quality of Cancer Care, which concluded that the quality of cancer care is not equal throughout the country. (See News, Dec. 6, 2000, p. 1871.)
Other studies are ongoing to address the problem of inadequate cancer care. In May, the American Society of Clinical Oncology will release results from its National Initiative on Cancer Care Quality. This goal of this study is to help put into place a national system to monitor the quality of cancer treatment.
And the National Cancer Institute has begun an initiative called the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) that is looking at the quality of care among people with colorectal and lung cancer.
Despite these efforts, results are slow in coming. For example, people who are poor and uninsured are still struggling with the health care system—12 years after the ACS’s report and recommendations. "[The poor and uninsured] are having essentially the same tragic problems that they were having [in 1989]," said Freeman.
John Seffrin, Ph.D., chief executive officer of the American Cancer Society said that America needs to reshape public policy to make sure that once a diagnosis of cancer occurs, all people have access to state-of-the-art care.
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Seffrin said he believes the latest recommendations are a step in the right direction: "If [the recommendations] are taken seriously, and if there is follow-up action, there will be some very favorable results obtained."
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