Insurance plays a role

One of the greatest issues that are facing our country today is the issue of paying for healthcare costs.  It is an issue that has been well publicized in the presidential campaigns. The talk of universal healthcare has been debated extensively and will likely play a role in the upcoming presidential election.  I have always, in my practice, tried to practice with blinders on ignoring a patient’s insurance.  Whether a patient has Medicare, private insurance or Medicaid, I have always tried to treat them each with the same standards.  However, this is a somewhat of a naïve sediment.  Unfortunately, a patient’s insurance does matter on what treatments they will and will not get. It will also matter on how timely and how easy getting these treatments will be.  Patients with Medicaid have an extremely hard time of getting good care. Many surgeons, urologists and other specialists don’t accept Medicaid. Trying to get patients proper care is sometimes difficult, if not almost impossible.  There are different private insurance companies that take a much more difficult stance in terms of covering patients for certain therapies.  This is especially true with oral chemotherapy agents.  Some of the newer and most exciting drugs that have come onto the market in the last 3 years have been oral chemotherapy drugs. Drugs such as Sudent, Xeloda, Tarceva and Nexovar have been found to be effective in multiple malignancies; however, most oral chemotherapy is handled like any prescription drug.  This sometimes leaves patients with no coverage or huge copays that prevent them from being able to afford these kinds of drugs, Medicare part D also, in many cases, prevents patients from being able to afford these drugs.  These Financial situations have sometimes changed what a therapy a patient might get, and have at times influenced a patient’s decision of whether to proceed with therapy or be admitted to hospice.

As a practicing oncologist, I find it difficult to truly know what the best answer for our country is.  It concerns me that our country is already struggling to pay for the advanced heath care that we have. New drugs and new therapies will continue to put pressure on our country’s ability to pay.  It will certainly be interesting to see how the presidential campaigns go.  I think healthcare and how to pay for healthcare should be one of major topics discussed between now and November. I encourage everyone to think long and hard about this issue.