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Gambling With American Medicine

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An e-mail from my friend Tim, with whom I did a lot fo radio in late 2007 and 2008 as he battled bladder cancer:

I’m depressed to hear that the House just reached an agreement on health care legislation. I guess we keep fighting, but the numbers in the House and Senate are not encouraging.

For what it’s worth, allow me to share a story of my personal experience with my cancer diagnosis and subsequent treatment. My initial diagnostic procedure was performed on a Monday. On Friday, my treating physicians received the lab results verifying the diagnosis of Stage II cancer. The following Monday, one business day and three calendar days later, I had an appointment with a highly experienced oncologist who outlined my chemotherapy treatment plan. A few days later I had an appointment with the highly skilled surgeon who ultimately performed my cancer surgery. No delays, no need for the approval of a government bureaucrat, no insurance roadblocks. In fact, throughout the entire chemotherapy and surgery regimen, my insurance carrier never objected, obstructed, or in any way interfered with any of my diagnostic tests, treatments, or surgery. We paid all of the copays and surgical amounts called for in our insurance policy, but we fully expected to. [# More #]

As you know, I obtained a second opinion about the chemotherapy and surgical proceeding from a highly regarded National Health Care institute (also paid for by my insurance carrier). In the course of receiving the second opinion, an oncologist on staff there noted “in Europe and other parts of the world, your treatment options for this diagnosis would be much different.” He cited statistics from outside the United States where a much smaller percentage of patients afflicted with this kind of Stage II cancer received chemotherapy and surgery. Rather, he stated that a much higher percentage of patients outside the U.S. received radiation therapy. This was disconcerting to my wife and me, as it caused us to question if the treatment paradigm my doctors prescribed was the right option for me.

I asked my local oncologist about the statement by the oncologist from this national health care institute. He asked me if the staff oncologist was trained outside the United States; in fact, the physician was from South America. My local oncologist then commented that he wasn’t surprised by his statement, and agreed that he was probably right — outside the U.S. the percentage of patients diagnosed with this type of Stage II cancer who were treated with a regimen of chemotherapy and surgery was lower than those who were treated with a regimen of radiation therapy. When I asked him why, he had a one word reply: “rationing.” He went on to explain that the majority of patients afflicted with this kind of Stage II cancer are older — I was 49 when diagnosed — and outside the U.S. the government apportionment bodies who authorize care and treatment plans conclude that older patients do not merit the more expensive chemo/surgery regimen, and instead authorize only a regimen of radiation therapy.

Thankfully, everything worked out for the best and, God willing, I am fully cured. I am very grateful for the highly skilled physicians, nurses, technicians and other health care personnel who guided me through my cancer diagnosis, chemotherapy, and surgery. I am also grateful for the insurance company and their agents who reviewed and authorized my treatment, and my employer who supported me through this process. I am very concerned that if the public option becomes available, my and other very rational employers will make a reasonable financial analysis of the costs associated with maintaining private plan sponsorship against the costs of rolling their employees into the public plan, and conclude that it simply makes economic sense to give up private sponsorship in lieu of enrolling their employees in the public option. It won’t be long for the public option to overwhelm private insurance plans, and the expert care I was so blessed to receive may not be provided to people who receive a similar diagnosis. Of course, this gives lie to the Administration’s repeated claim that “if you like your present insurance and your present doctor, you can keep them.”


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