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Insurers: Fight Cancer, Not Me

October 9, 2017

Insurance is a major consideration when seeking treatment with proton therapy. Most centers have an energetic staff with expertise in squeezing out every last drop of coverage. Any innovative new technology faces an uphill battle for government approval and insurance acceptance. Medicare said yes long ago, but insurance companies balk at high payments, seeking alternatives by claiming x-rays are as effective as proton therapy. (See my blog about criminal activity on the part of insurance companies who deny coverage: blog.InsuranceCriminals.html.)

Now, a new organization has been formed to advocate for insurance coverage: The Alliance for Proton Therapy Access. Their motto is the title of this blog: "Insurers: Fight Cancer, Not Me". The organization is financed by the leading providers of proton therapy, including Varian, Hitachi, Mevion and IBA. Daniel E. Smith, executive director, and Molly Daniels, Advocacy Director, have impeccable credentials and thirty years of experience in advocacy of this type. On the Alliance website, you can tell your story, sign a petition, and sign a banner. So far, I don’t find any direct information for the patient. It seems their main job is to lobby insurance companies. Providing our stories will give them a body of evidence to use in their fight. The website is: www.allianceforprotontherapy.org.

Here is the text of a petition that you can sign:

TO INSURANCE COMPANIES: Cancer patients deserve fair and timely access to the best available treatment recommended by their doctors. When it comes to cancer, patients don’t have time to waste on unnecessary bureaucracy – they need quick answers to life-threatening problems.
 
Today, too many people fighting cancer are also battling restrictive, complex insurance policies and processes that make it difficult or even impossible to receive proton radiation therapy that their doctors prescribe. They shouldn’t have to struggle through senseless appeals and delays or denials, but too often that’s exactly what happens.
 
I’m joining with patients, families, physicians, and other advocates who all want to know how insurers are deciding who gets proton therapy treatment and who doesn’t.

We are asking insurers to make their review process timely, transparent, and fair for cancer patients in need of proton therapy! 

Here is further text from the Alliance website:

When it comes to cancer, patients don’t have time to waste on unnecessary bureaucracy – they need quick answers to life-threatening problems.
Today, too many people fighting cancer are also battling restrictive, complex insurance policies and processes that make it difficult or even impossible to receive proton radiation therapy that their doctors prescribe.
While some patients enjoy a smooth insurance approval process for proton therapy, others – even with the same disease and treatment recommendation – are subjected to delays and in some cases, denial of treatment. As a result, patients are suffering undue health risks, anxiety, and financial hardship when they are already struggling to survive cancer.
All cancer patients deserve timely access to the best available treatment recommended by their physicians. And they deserve an insurance process that is fast, fair and transparent.
That’s why the Alliance launched a national advocacy campaign, Tell Insurers: Fight Cancer, Not Me, to advocate on behalf of cancer patients in need of proton therapy. We’ve issued letters to hundreds of insurers across the country, demanding transparency and a commitment to a fair and fast proton therapy approval process.


Like every good pubic relations effort, a succinct motto has been devised: Insurers: Fight Cancer, Not Me. The Alliance supports the following patient’s rights:

Timeliness
Cancer patients deserve prompt answers about whether proton therapy treatment will be covered by their insurance provider.
Transparency
Cancer patients deserve a clear understanding of why their proton therapy is approved or denied by their insurer.
Fairness
Cancer patients deserve a fair determination of coverage for proton therapy, based on the recommendations and analysis of experts in the field, including the treating oncologist.

The last sentence asks for fairness from one’s oncologist, but it should add one’s urologist. My personal survey was 308 to 0, finding that no one I talked to was referred to proton therapy by their urologist. None. We need outreach to them, as well.

This is all quite new, but a definite step forward in putting pressure on insurance companies. In some cases, they are even breaking the law in order to avoid payment. I personally know someone who died because the insurance company delayed so long in agreeing to pay.

Did someone say single payer insurance system? This is the kind of insurance available in virtually every other industrialized country. Only the United States has a system depending on private insurance and profit motive (which costs more and provides less). When anyone suggests health care for everyone, conservatives cry “Socialism” as a knee-jerk response to a word they have learned to hate, even if they don’t really know what it is.

As I write this, the Senate is beginning debate on a tax cut for billionaires and corporations that will cost 1.4 trillion (that’s with a “T”) dollars, which is more than enough to pay for universal coverage for every man, woman, and child in our healthcare system. What would it look like? It would be administered just like Medicare, which is far more efficient than private insurance companies. It has about two percent overhead, whereas the industry, thanks to paying tens of millions of dollars to executives, has overhead around twenty-five percent.

The failed bill that would have replaced The Affordabe Care Act would have greatly reduced coverage in order to allow more profit for the insurers. This is just plain wrong. Healthcare should be available for everyone, as should proton therapy. Single payer insurance would pay for itself. Here’s why. My wife and I save every penny we can and put it aside against a future possibility that it will be needed for healthcare not covered sufficiently by our insurance. In addition, we pay high rates on long term care policies. If we knew that we could depend on our healthcare system, we would gladly pay some of this money for a tax that would fund the system. In addition, we would likely spend much of the rest of it, upgrading our lifestyle or contributing to nonprofit organizations, all of which would enrich and stimulate the economy (in a much better way than the ficticious trickle down effect from giving billionaires more money).

Besides the profit motive, there is the unwillingness to let go of deductions previously enjoyed. When I pay my self-insurance tax, I can deduct the cost of my health insurance premiums. If we did not have such a deduction, it would result in tens of billions of dollars in additional revenue that would pay for medical coverage. But politicians aren’t willing to touch that one, even though they are willing to cut Medicare and Medicaid by hundreds of billions of dollars. Huh?

So, here we are, with a new group to lobby insurance companies to hope for future coverage for the best cancer-fighting technology there is. Here’s the kicker. Although initially higher in cost, in the long run, proton therapy costs less than the x-rays or surger insurance companies are willing to cover, because of less recurrence, fewer side effects, and less secondary cancer. It’s short-sighted to try to save a few bucks today only to end up paying more in the long run.

Come on, insurers. Buck up. Do the right thing. Fight Cancer, Not Me.


I welcome your comments and suggestions. Please contact me at this address: robert@protontherapybook.com.

Here again are my other two related websites:

www.ProtonTherapyBook.com
This is for Best Prostate Cancer Treatment: Proton Beam Therapy and other books I have or soon will have written. It has updates and additional information, photos, and more.

www.proton-therapy-centers.com
This site has an up-to-date list of proton therapy centers in operation in the United States, as well as a number planned or under construction. Currently 27 centers listed as operational and 16 in the planning or construction stages.

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