There was a good op ed in the WSJ yesterday, but unfortunately it is in the subscriber-only section of the online edition. the link is below, along with excerpts, and anyone wanting the complete article can email me, and I will forward it.
Cancer Killers Cancer Killers - WSJ.com
The evidence shows that universal health coverage does not improve survival rates for cancer patients. Despite the large number of uninsured, cancer patients in the U.S. are most likely to be screened regularly, have the fastest access to treatment once they are diagnosed with the disease, and can get new, effective drugs long before they're available in most other countries.
Last month, the largest ever international survey of cancer survival rates showed that in the U.S., women have a 63% chance of living at least five years after diagnosis, and men have a 66% chance -- the highest survival rates in the world. These figures reflect the care available to all Americans, not just those with private health coverage. In Great Britain, which has had a government-run universal health-care system for half a century, the figures were 53% for women and 45% for men, near the bottom of the 23 countries surveyed.
A 2006 study in the journal Respiratory Medicine showed that lung cancer patients in the U.S. have the best chance of surviving five years -- about 16%. Patients in Austria and France fare almost as well, and patients in the United Kingdom do much worse with only 5% living five years. A report released in May from the Commonwealth Fund showed that women in the U.S. are more likely to get a PAP test every two years than women in Australia, Canada, New Zealand and the U.K., where health insurance is guaranteed by the government. In the U.S. 85% of women ages 25-64 have regular PAP smears, compared with 58% in the U.K.
The same is true for mammograms. In the U.S., 84% of women ages 50-64 get them regularly, a higher percentage than in Australia, Canada or New Zealand, and far higher than the 63% of women in the U.K. The high rate of screening in the U.S. reflects access as well as educational efforts by the American Cancer Society and others.
Early diagnosis is important, but survival also depends on getting effective treatment quickly. In the spring of 2007, 58-year-old Valerie Thorpe from Kent, England, went through the anguish of being diagnosed with cancer, and then was told she would have to wait four months before beginning radiation therapy. Her plight was reported in the newspaper because she appealed to her representative in Parliament. But her problem is not unusual. A study by the Royal College of Radiologists, published this June, showed that such waits are typical, and 13% of patients who need radiation never get it due to shortages of equipment and staff.
Long waits for treatment are "common devices used to restrict access to care in countries with universal health insurance," according to a report in Health Affairs (July/August 2007). The British National Health Service has set a target for reducing waits. The goal is that patients will not have to wait more than 18 weeks between the time their general practitioner refers them to a specialist and they actually begin treatment.
Access to new, better drugs also explains differences in survival rates. In May, a report in the Annals of Oncology by two Swedish scientists found that cancer patients have the most access to 67 new drugs in France, the U.S., Switzerland and Austria. For example, erlotinib, a new lung cancer therapy, was 10 times more likely to be prescribed for a patient in the U.S. than in Europe. One of the report's authors, Dr. Nils Wilking from the Karolinska Institute in Stockholm, explained that nearly half the improvement in survival rates in the U.S. in the 1990s was due to "the introduction of new oncology drugs," and he urged other countries to make new drugs available faster.