Brendan Sullivan, Star Tribune
An affront to cancer sufferers
- Article by: IRV LERNER
- March 11, 2012 - 7:20 PM
After nearly 40 years of attending cancer patients as a practicing oncologist, the most important lesson I learned is that patients need all the help they can get. So I'm absolutely baffled that the Minnesota Legislature would choose to increase the burden on our fellow citizens afflicted with cancer.
This burden is imposed by legislation that places a moratorium on the construction of any new cancer radiation facilities in a 14-county area encompassing the entire metro area and other populous counties.
The moratorium, which took effect in 2007, is in place until 2014; efforts are underway to extend it to 2017 and even to make it a "permanent moratorium."
It makes no more sense as a concept than it does linguistically. The only clear results of this legislation are to make life tougher for cancer patients and likely increase the future cost of medical care.
Cancer patients are sick people suffering serious symptoms from their disease and, unfortunately, often serious side effects from their treatment. Most require radiation therapy, usually delivered in a series of daily treatments over five to six weeks.
The burden of making these daily trips is very substantial and could be minimized by making the facilities as close to patients' homes as possible. But this legislation ensures that can't happen.
It strikes me as extraordinarily presumptuous that anyone who hasn't experienced cancer patients' travails would legislate barriers to treatment for them. In fact this is the only form of medical practice the Legislature restricts in this manner, and no other state does so.
Moreover, the moratorium effectively puts a stop to the development of additional "integrated cancer centers." This model is a one- stop shop in which all the cancer specialties are housed under one roof, as is the case at the St. Paul and Maplewood Cancer Centers, the Mayo Clinic and the University of Minnesota.
At these locations, cancer care is completely integrated, representing an enormous benefit to the patient. The moratorium deprives Minnesota patients who don't live near one of these facilities the opportunity of receiving this recognized state-of-the-art treatment.
The moratorium also ignores demographic realities. Without question, additional radiation therapy centers are needed in the near future to meet the increased cancer diagnoses in our aging population and the increasingly sophisticated use of radiation technologies.
The American Cancer Society, which opposes an extension of the moratorium without reliable data indicating adequate capacity, pointed to its projection of a 13.6 percent increase in radiation services needed statewide by 2015.
That translates into an even higher need in the metro area and a significantly greater need beyond 2015. Given these statistics, it should be no surprise that the Mayo Clinic recently built a new facility just outside the moratorium in Northfield, as did Health Partners in New Richmond, Wis.
The argument has been made that restricting the construction of these very expensive radiation facilities will reduce health care costs. But there is simply no evidence supporting this, and it makes no sense. I believe the opposite is true.
Unlike sports stadiums, no public funds are used in the construction of these facilities. On the other hand, as the increased need for these services becomes more apparent we will be forced to play "catch up" and build at the higher costs of that time.
Patient utilization, based on exacting medical indications rather than arbitrary judgment, will not be increased. To suggest there would be overutilization of cancer radiation not only has no basis in fact, but is truly offensive.
Moreover, the cost per treatment is either fixed by Medicare or determined by sophisticated negotiation between providers and private health insurance payers.
There is surely an upside for some to the moratorium. It is a terrific benefit to the business interests of the overwhelmingly largest provider of radiation services in the metro area, Minneapolis Radiation Oncology (MRO).
One has to wonder if there might be a connection between the passage of the moratorium and the push to extend it and the fact that MRO had the sixth-largest lobbying expenditures in the entire state in 2010.
Somehow I'd like to believe the interests of Minnesota cancer patients and those of us who will be paying for health care in the future should trump high-priced lobbying.
Irv Lerner, of St. Paul, is a retired oncologist. He is on the board of the America Cancer Society and serves as a consultant to Minnesota Oncology.
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