More than 1.6 million people in the United States are expected to be diagnosed with cancer this year. This would be discouraging news if not for the fact that cancer deaths have been steadily declining due to our increased understanding of and ability to treat this devastating disease. In fact, cancer death rates have dropped by 23 percent since 1991. That’s more than 1.7 million cancer deaths averted as we slowly turn what was once a death sentence into more of a chronic condition. Unfortunately, we risk reversing these successes if the misguided Centers for Medicare & Medicaid Services experiment on cancer care is allowed to become a reality.
The proposed CMS experiment involves Medicare Part B drugs, which are complex therapies such as chemotherapy, that need to be administered to patients under close physician supervision. With absolutely no evidence, CMS is going to test its belief that oncologists’ treatment decisions are incorrect and based not on patients’ personalized medical needs but instead on physicians’ economic interests. CMS will use a financial stick to pressure treatment choices to lower cost, and potentially less effective, cancer therapy.
CMS is clearly setting this up as a clinical experiment, involving test and control groups, and randomly putting patients based on zip codes into one or the other. The problem is that seniors cannot opt out of this Medicare experiment and, unlike established ethical rules for research, will receive no “informed consent” that the government is experimenting on their cancer care.
Despite advances in knowledge and technology, cancer is still an incredibly complex disease. Developing and administering effective treatments to patients, especially vulnerable seniors, is an intricate process. There are more than 200 different types of cancers and each patient responds differently to medications, making a personalized treatment plan critical. Every cancer patient is unique, and oncologists frequently have to try different treatment options until they find a medicine, or combination of drugs, that works best for them. And it’s an inconvenient truth to CMS that sometimes the best drugs are the newest, most expensive drugs available, such as the immunotherapy that helped put President Carter’s brain tumors into remission.
There is no doubt about it: personalization is key to winning the fight against cancer. Unfortunately, this ill-conceived government experiment is in line with a bureaucratic, one-size-fits-all approach to cancer care. And worse yet, it has the government – not oncologists in close consultation with their patients – defining what cancer care is “right” and what care is “wrong” based simply on what saves the most money, not the most lives. The treatment President Carter received? The government experiment would pressure doctors not to use it.
In addition to imperiling personalized cancer care, CMS’s experiment would also push more community cancer clinics to close their doors, as more than 300 have already done. And as the primary providers of both cancer care and clinical trials in America, every community cancer clinic closure puts us leaps and bounds backwards in finding the cure for cancer.
There is a significant gap between the lip service the government pays to its key health goals and the reality of the policies it wants to put in place. By repeatedly changing the way doctors provide cancer care, the government is slowly and methodically inserting itself in exam rooms and treatment decisions that are best left to doctors and patients.
Community oncologists wake up every day committed to our nation’s war on cancer, despite feeling like the government is waging a war on their cancer care. Meanwhile, the launch of the vice president’s “moonshot” to cure cancer will not get off the ground if we dismantle the cancer care system as we know it. In fact, it will be left a dud on the launch pad, another victim of bad policymaking separated from the reality oncologists face every day on the ground caring for their patients.
Lofty goals alone will not cure cancer, particularly not when paired with harmful government experiments. That is why Congress must listen to patients and providers before it is too late: Step up and stop CMS’s misguided experiment on cancer care.
Ted Okon is Executive Director of the Community Oncology Alliance (COA).