By Jill Zorn |
I am thinking a lot about the fact that many Americans can’t afford to get cancer.
I attended a conference last week, The Policy, Politics and Law of Cancer, hosted by Yale Law School’s Solomon Center for Health Law and Policy. The conference brought together over 40 speakers from the fields of cancer treatment, research, government regulation and funding, academia, advocacy, and health policy. Those attending heard a lot about the complexities of this terrible disease and the ever-evolving, ongoing effort to combat it.
New approaches to research are underway. Advocacy groups like Kids v Cancer and Friends of Cancer Research, are making sure that the voices of patients and their families are heard, and that research and treatment are responsive to patient needs. Government regulators and funders try to work in collaboration, to provide the right amount of oversight as well as support. As new cancer treatments are developed, cancer centers, like Yale New Haven Health’s Smilow Cancer Hospital, implement complex treatment protocols to patients across the country.
While the conference showcased the many advances in cancer research and treatment, two panel discussions highlighted where the system is failing us.
Cancer Health Justice and Disparities
One of the ironies highlighted by the conference is that, even as huge progress is being made, cancer health disparities are widening. As some people are benefiting from advances, others are falling further and further behind.
Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society, asked THE question, “How can we provide adequate high quality care (to include preventive services) to populations that so often do not receive it?” He and the speakers that followed him then shared many sobering statistics about how people of color have less access to care, receive lower quality of care and have higher mortality rates, when compared to white Americans.
It is clear that income level and access to coverage are also relevant. One speaker showed two maps side by side. One was of cancer death rates and one of the states that haven’t expanded Medicaid. Death rates were generally higher in non-expansion states. While other factors contribute, high rates of uninsurance certainly matter.
Drug development and the cost of researching and treating cancer
The cruel reality is that the cost of treatment is too high for many Americans, even those WITH insurance coverage. As one speaker pointed out, there are financial constraints throughout the system, but no stakeholder is being squeezed more than the patient.
Cancer treatment costs are the top reason of health-related bankruptcy. And cancer patients who declare bankruptcy are more likely to die.
As the previous section on disparities explained, many people go untreated or undertreated in our current system.
With new gene therapies costing close to $500 million, and patients receiving treatment requiring weeks in the hospital and other follow up care, the price tag could easily be above $1 million per patient. Even if prices come down somewhat over time, who is going to pay for treatment costs like this?
On a panel devoted to drug development and cost, two speakers zeroed in on the cost part of the discussion: Professor Amy Kapczynski of Yale Law School’s Global Health Justice Partnership (GHJP) and Dr. Peter Bach, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center. (Note: GHJP partnered with Universal Health Care Foundation and the National Physicians Alliance on the paper, Curbing Unfair Drug Prices, A Primer for States.)
Dr. Bach’s remarks really struck home with me. He questioned what the goal of our system is. Is our goal to deliver care to patients, and the side benefit is that we can financially sustain pharmaceutical corporations to develop new drugs and hospitals, physicians and nurses to provide that treatment? Or is our goal to transfer wealth to the health care system and a side benefit is that some patients will get care? He made the stark assessment that right now we are clearly going down this second, very wrong path. Cancer care and really much of health care, is becoming a luxury good only for the “haves”.
I don’t believe that is the path we want to be on. We need to take action now to get back on the right path.
Go HERE to see the agenda for conference
Go HERE to see videos of the conference sessions