Cancer Care Public Policy

As anyone knows who has had to see a doctor, the health-care system in the United States is becoming increasingly complex and expensive. At the same time, scientists are developing new and better prevention strategies and treatments for most of the world’s common diseases. This situation is obviously ripe with frustration for not only are our expectations of the medical system high, but the barriers to getting that care are high, too.

There are many barriers to excellent oncology and hematology care. While some are personal, many are financial, or due to the structure of our society.

Payment for medical care is a mixture of federal, state and private insurance programs. If one is more than 65 years old, Medicare is probably the primary source of insurance. Americans pay into the Medicare system through our federal income and withholding taxes. Those less than 65 years old generally have private insurance, or are covered by Medicaid.

Premiums for private insurance are usually paid as an employee benefit, but because these premiums are becoming increasingly expensive, some employers no longer provide complete insurance coverage. Consequently, some people – employed and unemployed –are uninsured.

For individuals with low or no incomes, insurance coverage is often provided through Medicaid, a state-run, federally funded program. Most of these programs pay for a portion of hospital care and office care costs. Some portion of the bill will still fall on the patient individually.

The Federal Government sets the regulations for Medicare. Theoretically, we have control over what this system will pay for and what it will not pay for. Obviously, influencing the policies of the federal government is complex and difficult. Our U.S. Senators and U.S. Representatives are there to hear our voices on these issues.

NHOH’s staff is actively involved in communicating with our New Hampshire Senators and Congressmen. We also work with many state and national patient advocacy groups, which seek to make sure that funds are provided for cancer care. Links to these groups can be found at InnisfreeCancerHelp.org.

The policies of most of the private insurance companies are regulated by the states in which they do business. Again, NHOH has sought to have a good working relationship with the private carriers, as well as the New Hampshire Insurance Commissioner and our state legislature on these issues. The New Hampshire Medical Society is also very active in this area.

The public fight to find a cure for cancer is largely funded by the National Cancer Institute. Over the past several years the budget for the NCI has not increased, and given inflation, that means the funds to fight cancer have been decreasing. Again NHOH has been working with local and national advocacy groups to try to improve this situation.

Lastly a variety of State, Federal and voluntary agencies have oversight and regulatory authority over medical care in general in the US and oncology care specifically. These include the Center for Medicare and Medicaid Services (CMS), {the organization that runs Medicare and Medicaid}, the NCI, the National Institute of Occupational Safety and Health (NIOSH), the Occupational Safety and Health Administration (OSHA), the Food and Drug Administration (FDA), the Drug Enforcement Administration (DEA), the NH Board of Pharmacy, and the NH Boards of Registration in Medicine and the NH Board of Nursing. This is only a partial list, but will give you an idea of number and complexity of the regulatory agencies with which we work.

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