Panel: System Fails Cancer Patients
By Randolph E. Schmid, Associated Press Writer
Originally published by The Associated Press, December 3, 2001
WASHINGTON (AP) — The nation's health care system is failing cancer patients, who often find themselves battling the system in addition to their disease, a presidential commission contended Monday.
"For people who don't have resources there are great difficulties and many barriers in trying to get through the health care system,'' Dr. Harold P. Freeman, chairman of the President's Cancer Panel, said in an interview.
Every day 34,000 Americans are diagnosed with some form of cancer and 1,500 die from the disease, the panel said in a report. Yet 44 million Americans lack health insurance and millions more are underinsured and face hardships in paying out-of-pocket costs of cancer care.
In addition, the panel found that restrictions on who is eligible for assistance eliminate many people who need help; others live far from the sources of care and lack transportation and few patients receive full and accurate information about their disease.
Among the examples cited in the report:
- Catherine Danielson, a single mother of four in Arizona, said she was unable to get help for treatment of throat cancer because her $900-a-month income was too high.
- "It just bankrupted us. I didn't have any more money,'' said Alan Hebert, a colon cancer patient in Louisiana who had to sell his house and car to pay for treatment.
- Pamela Rutherford of West Virginia said she and her husband considered separating so she could get assistance in treating her cervical cancer after being told their combined income of $22,000 was too high.
The report summarizes the findings from a series of seven public hearings held across the country over two years.
Freeman said the findings are similar to those of a study of cancer among the poor that he was involved in 12 years ago as then-president of the American Cancer Society.
"The difference is this time we did not target the poor, but heard from all American people,'' he said. "And we found it doesn't matter whether you are rich or poor, educated or not. The system is so complex and fragmented for people who have serious diseases like cancer, they are likely to have difficulties getting through the system.''
"We found that many people had to fight their way through the system while they were trying to fight their cancer,'' Freeman said.
The panel said the health care system under emphasizes cancer prevention, with education and screening efforts varying widely from area to area.
When people are diagnosed, coordination is poor among public agencies providing assistance and patients often are not informed of all benefits for which they may be eligible, the report said.
"Numerous patients recounted having to fight their insurers to get the care they needed to save their lives,'' it said.
Many self-employed people such as farmers, ranchers and small business operators are able to support their families but cannot afford health insurance. And they often avoid cancer screening and try to treat symptoms themselves because they know they cannot afford proper care, the report said.
The panel issued a series of recommendations, including immediate cancer coverage for the uninsured.
Asked if he thought such a broad measure could win political approval Freeman replied: "I'm a hopeful person … you never know what the political will may be.''
Other recommendations include:
- Provide reimbursement for anticancer medications and proven preventive agents.
- Within two years, public and private insurers should implement a standard health benefit package for cancer care. This should be updated regularly.
- Provide money to assist community programs providing cancer screening, information, treatment and support.
- Establish systems to monitor treatment fairness and expand research into quality of care.
The three-member panel was established under the National Cancer Act of 1971 and issues periodic reports to the president. Besides Freeman, of Columbia University's College of Physicians and Surgeons, it includes Frances M. Visco, president of the National Breast Cancer Coalition; and Dr. Dennis J. Slamon of the University of California at Los Angeles School of Medicine.
The report is based on data collected at hearings in Omaha, Neb.; Burlington, Vt.; Billings, Mont.; Nashville, Tenn.; Los Angeles; Albuquerque, N.M.; and Washington.
