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Cancerous

Well I reckon if there's one common denominator between Conservative and Liberal it's cancer-phobia. While cancer is no longer the automatic death sentence it used to be, it'll still strike the fear of God into even a devout atheist. The debilitating chemo treatments, the hair loss, the nausea, the pain, the uncertainty...all compounded by worries over the astronomical cost of cancer treatment. Bills so large the survivors envy the deceased.

That's the perception we get anyway. Of course, for somebody without health insurance it's probably a little closer to the truth than those of us who do what it takes to remain insured. Either way you can be sure cancer care was high in the minds of many in Washington as they undertook "reform" of the world's best health care system.

So it's a good thing they rushed the bill through before a new study was released. Check it:

US cancer costs double in nearly 20 years

By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer - Mon May 10, 9:45 am ET

ATLANTA - The cost of treating cancer in the United States nearly doubled over the past two decades, but expensive cancer drugs may not be the main reason why, according to a surprising new study.

The study confounds conventional wisdom in several respects. The soaring price of new cancer treatments has received widespread attention, but the researchers conclude that rising costs were mainly driven by the growing number of cancer patients.

The study also finds cancer accounts for only 5 percent of total U.S. medical costs, and that has not changed in the last few decades.

For those of you that don't remember your "Rule of 72" from college (which is about all I remember...) that doubling happened at a 3.6% annual rate. Maybe more than inflation, but not unexpected considering cancer is for the most part a disease of aging. People are living longer and they've got to die from something.

Raise your hand if you thought cancer care was only 5% of total medical costs. Keep it up if you thought that percentage of cost had remained unchanged for decades.

"I will say I'm a bit surprised," said Dr. Len Lichtenfeld of the American Cancer Society, who said he would have expected the proportion of cancer costs to rise.

The researchers also found that private insurers now cover a greater share of cancer treatment costs -- about 50 percent -- while patients' out-of-pocket costs have fallen over the past two decades.

Though taken aback by some of the findings, Lichtenfeld and other experts did not dispute the study, which compared medical cost data from the late 1980s to that of the early 2000s. But they said the picture surely has changed in the last several years.

Just like the global warming skeptics thinking they're going to find absolution from decades of established data with a short term vacillation from the long term trend.

You can almost hear Dr. Lichtenfeld's teeth grinding while you're reading it. I've got no beef with him and it's not like I'm out there volunteering at the Dick Cheney Walk for Cancer Mortality. But they've digressed into a bunch of scientific busy-bodies lobbying ignorant and more-than-willing politicians into nanny-stating us Americans. The American Cancer Society threw its weight behind Obamacare. Why not? Yeah, like the government having more control over our health care choices and dollars is going to be a bad thing for the ACS.

The study did not offer precise estimates of how the number of people treated for cancer changed from the late 1980s to the early 2000s. But it showed dramatic increases in the number of cancer cases covered by the government's Medicare and Medicaid programs. Medicare, which covers the elderly and disabled, has consistently covered about a third of the nation's cancer costs. Medicaid accounts for only 3 percent.

The U.S. population is aging, and older people tend to get cancer at higher rates, Tangka noted.

Better and more advanced treatments mean more people with cancer are remaining alive, so the spending increases represent money well spent, said Kenneth Thorpe, a health policy researcher at Emory University who has focused on the cost of health care.

"It seems like we're buying increases in survival," Thorpe said.

Some people might call that an investment in keeping patients alive longer so their doctors can milk the system by unnecessarily removing their tonsils and lopping off their lower extremities.
The researchers also found:

_The percentage of cancer costs from inpatient hospital care fell from 64 percent to about 27 percent. A shift to less expensive outpatient care, along with cost containment efforts by large health insurers, helped keep down increases in the costs per patient, the authors said.

_The proportion of cancer costs paid by private insurance rose from 42 to 50 percent.

_The proportion of costs paid out of pocket by patients -- including copayments and deductibles -- dropped from 17 percent to 8 percent.

Those last two findings surprised some experts.

Recent government reports have found that the percentage of Americans with private health insurance has been shrinking and recently hit its lowest mark in 50 years. Yet the study found that the proportion of cancer treatment costs paid by private insurance rose.

And companies have been tightening or cutting employee benefits, causing out-of-pocket costs to go up for many patients. Yet the study found that the proportion of bills paid by patients declined.

What they're saying is that anecdotal evidence aside, everything you thought you knew about the economics of cancer care is mistaken. This would have been interesting information to have during the rush to make history. It needs to be front and center in the repeal debate.

The US is number one in cancer survival rates. Do we really want to be more like Europe?

Access to Treatments and Drugs. Early diagnosis is important, but survival also depends on getting effective treatment quickly. However, long waits for treatment are "common devices used to restrict access to care in countries with universal health insurance," according to a report in Health Affairs . 5 The British National Health Service has set a target for reducing waits to no more than 18 weeks between the time their general practitioner refers them to a specialist and they actually begin treatment. A study by the Royal College of Radiologists showed that such long waits are typical, and 13 percent of patients who need radiation never get it due to shortages of equipment and staff. 6

Another reason for the higher cancer survival rates in the United States is that Americans can get new, effective drugs long before they are available in most other countries. A report in the Annals of Oncology by two Swedish scientists found: 7

* Cancer patients have the most access to 67 new drugs in France, the United States, Switzerland and Austria.
* Erlotinib, a new lung cancer therapy, was 10 times more likely to be prescribed for a patient in the United States than in Europe.

One of the report's authors, Nils Wilking, from the Karolinska Institute in Stockholm, explained that nearly half the improvement in survival rates in the United States in the 1990s was due to "the introduction of new oncology drugs," and he urged other countries to make new drugs available faster.

Conclusion. International comparisons establish that the most important factors in cancer survival are early diagnosis, time to treatment and access to the most effective drugs. Some uninsured cancer patients in the United States encounter problems with timely treatment and access, but a far larger proportion of cancer patients in Europe face these troubles. No country on the globe does as good a job overall as the United States. Thus, the U.S. government should focus on ensuring that all cancer patients receive timely care, rather than radically overhauling the current system.

Early detection. We've diagnosed the Democrats' cancer on our health care system, now let's make with the treatment. I don't want them Interferon with the world's best cancer care system.


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Comments (10)

I propose we cut out the de... (Below threshold)
914:

I propose we cut out the democratic malignancy and proceed with a bright and sunny December.

Interfere? Hell, they want... (Below threshold)
GarandFan:

Interfere? Hell, they want to dismantle it!

One advantage that the US h... (Below threshold)

One advantage that the US has over nations like Great Britain is that our entire health care infrastructure has been privately built. In the UK, the government health service has been in charge of health care since 1946 or so, and because the British built their modern health care infrastructure with only the kind of limited resources, inefficiency, waste, and bureaucratic stalling that the government can master, their health care infrastructure (treatment facilities, diagnostic machinery etc.) has never rivaled that of the US. Canada also has the same problem.

We should be wary of the rationing of resources that always accompanies government management via public dollars, but it would be a scandal far beyond acceptability to the American people if a good portion of our existing health care infrastructure sat unused because of government rationing. If American cancer patients were waiting four months for treatment because formerly private cancer treatment centers were shuttered do to lack of government funds and personnel, there would be a public backlash the likes of which our generation has never seen.

That is at least something to be hopeful about.

And yet, that's the norm un... (Below threshold)
bobdog:

And yet, that's the norm under the British National Health Service, if I read it right, and it's a bloody outrage. I don't know what the comparable statistics are for Canada, but I would be surprised if they were any different.

If my GP suspected cancer, both of us would expect to be under a specialist's care the next morning, and I would not accept no for an answer.

Far from being hopeful, I'm afraid that's exactly where we'll be in 10 or 20 years. Expect it to impact the oldest seniors first.

Sarah Palin was right, and I have no doubt about it.

Several things:The... (Below threshold)
epador:

Several things:

The core to effective treatment of cancer in most patients is surgery. Then radiotherapy. Then chemotherapy. Many more patients are cured surgically in the US than those treated with chemotherapy. While a lot of people receive adjuvant chemotherapy (for breast and colon cancer) in an effort to improve cure and survival, a veto-proof majority don't benefit - usually 10-30 % improvement in survival.

Chemotherapy treatment regimens have also been shortened in the past 10 years for most of the common solid tumors. Fewer months treatment means cheaper treatment.

Newer drugs do not necessarily mean significantly lengthened survival - improved treatment regimens and techniques are generally the big improvements.

Testing - PET, MRI, CT, and labs - has also evolved, and has a huge impact on the cost of treatment (perhaps negating some cost savings with shorter treatments).

Institutionalized cancer treatment and research has a vested interest in maintaining government funding. Medicare has made cancer treatment in the US what it is today both in expertise and skill, as well as a cash cow. Without it, much of the money that spurred the rapid growth of cancer treatment in the 70's to 90's would not have happened. It's no surprise they would knee-jerk support to ObamaCare.

As you can see, they didn't look at the evidence closely or make an evidence-based decision.

Hmm, I hear Steppenwolf's Monster in the background.

BTW, Tarceva isn't all that... (Below threshold)
epador:

BTW, Tarceva isn't all that great a drug, If it prolongs survival in NSCLC by 2 to 4 months its a miracle. And miracles do happen, but not often. BUT it sounds cool, its expensive, and insurance pays for it, so what the hell.

The epantsipation is on the... (Below threshold)
914:

The epantsipation is on the way! Just ask Barry.

A dew of my colleges from U... (Below threshold)
hcddbz:

A dew of my colleges from UK were in town and they were saying that the UK system is improving.

It seems that they are allowing more private clinics and insurance.
You just have to stay private all the way through the process.


My mother is 82 and just un... (Below threshold)
Oyster:

My mother is 82 and just underwent chemo and radiation for almost 6 months. Her doctor just gave her the results of a biopsy and scan and has said the cancer is gone. I get to keep her for a while longer and I'm very grateful for that. I see improvement in her every day. But I wonder, if we had a system like the UK, would I have had to bury her by now? When she was diagnosed she was undergoing treatment within days. In another system she would possibly still be waiting.

Bobdog - Your expectation i... (Below threshold)
Imhotep:

Bobdog - Your expectation is not based in reality (seeing a specialist the day after suspecting cancer), especially if you are a Medicare patient.

Epador is partially correct in that Medicare/Medicaid paid well for cancer treatment in the previous 3 decades, but that reimbursement has been cut drastically in the last 5 years and peaking with a 21% cut this last April 1. No physician in my current area sees cancer patients as a "cash cow" and most are viewed as a money loser, because of the time it takes to treat them and the reimbursement paid doesn't cover the overhead.

Epador is right about this being a huge MONSTER.

Peace to all and stay cancer free!!!




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