Will Healthcare Reform Help or Hurt Breast Cancer Diagnosis and Treatment?

BlogHer Original Post

Where do you stand on healthcare reform?  It's a hot-button political issue that has strong opinions on both sides.  And with October being Breast Cancer Awareness Month, it seems appropriate to address how healthcare reform could affect the diagnosis and treatment of breast cancer.

The question is...Will it help or hurt?

From The American Cancer Society...

Continued progress in the fight against cancer requires early diagnosis and timely access to medical care that gives all cancer patients an equal opportunity to battle this disease. Meaningful health care reform that promotes prevention and wellness and ensures quality of life throughout disease-directed treatment into survivorship will help change these statistics.

“We believe that a health system that works well for cancer patients, survivors and those at risk for cancer, will also work well for all Americans who may one day be faced with a serious medical condition,” Brawley said. “Continued progress in the fight against cancer requires early diagnosis and timely access to medical care that gives all cancer patients an equal opportunity to battle this disease. To help accomplish this, health care reform must happen now.”

It seems hard for me to believe that insuring the uninsured could hurt breast cancer treatment or diagnosis.  But that is exactly what some would like us to believe.

Breast Cancer Awareness - Will More Women Die of Breast Cancer with Health Care Reform?

Three hundred thousand more women will die of breast cancer each year in the US if proposed health care reform takes place, according to a multi-million dollar television ad campaign running in several states this week. The ads, sponsored by the Independent Women’s Forum, cite as evidence a report from Lancet Oncology that shows “England’s breast cancer survival rate is much lower than in the US.”

What’s the truth? The truth is LESS women will die of breast cancer in the US if every woman has access to screening and treatment for breast cancer. The American Cancer Society looked at insurance status and cancer outcomes in 2005 and 2006. Not surprisingly, only 38% of women between 40-64 years with no insurance had had a mammogram in the previous two years, compared to 75% of those with private insurance. More importantly, patients with no insurance were more likely to be diagnosed with Stage III or Stage IV breast cancer, and less likely to be diagnosed with a Stage I cancer.

And survival from breast cancer? The 5-year survival rate was 76% for all uninsured patients, and 65% for uninsured African American women, compared to 89% for White women with private insurance. We may have some of the best breast cancer care available in the world, but unfortunately, it’s just not universally available to all US women.

From The Examiner - We Want A System That Will Cure Breast Cancer...

The Obama administration’s plans call for the establishment of a Health Benefits Advisory Committee to determine the coverage that Americans must have, creating a one-size-fits-all health insurance marketplace. The government’s “Center for Comparative Effectiveness Research” would be charged with analyzing available treatments to determine which are “efficient” and which are not.

As government tries to reduce health care costs, it will do more than just limit the treatments available. Officials will also limit what doctors, hospitals and companies get paid. This means that, as is the case with Medicare and Medicaid, many reimbursement rates will be below cost. As a result, many people will leave (or never enter) the medical profession, again damaging the quality of care.

From Physicians News (with video) - What Obama Isn't Saying About Breast Cancer Success in America...

As a women’s health specialist, I have many patients like Tracy Walsh who are 10, 20, and 30 year survivors of breast cancer because they had the benefits of the American health care system: early diagnosis, cutting edge treatments, and continued state of the art monitoring for recurrence. None of my patients have even considered going to England, Canada, or Cuba for treatment! I can confidently say that if I were facing breast cancer, the United States is where I would want to be.

Studies clearly show that breast cancer survival rates are higher for the earliest stages of cancer. In the United States, mammograms are typically done annually, and consequently breast cancers are detected earlier. Women in the United Kingdom under the National Health Service guidelines are only allowed a mammogram every 3 years. Britain’s death rate from breast cancer is consequently much higher than in the U.S.

From the Wellsphere Breast Cancer Community - Breast Cancer Reconstruction and Healthcare Reform...

In an enormous break with tradition, such cost considerations based on averages will be factored into medical practice guidelines. These will function as an invisible hand that puts a brake on the more expensive procedures even though they benefit certain patients.

Standardized practice guidelines will be evident everywhere, even embedded into your doctor's government-certified computer: as described in the Obama budget, computer pop-ups will appear to help your doctor make decisions. (And through the same systems, his or her choices can be monitored for consistency with the guidelines.)

What do you think?  Will healthcare reform help or hurt breast cancer treatment and diagnosis?  Let us know in comments.

Also See:

Contributing Editor Catherine Morgan
at Catherine-Morgan.com and Women4Hope

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