WASHINGTON--By the end of the century, cancer will surpass heart
disease as the leading cause of death in the United States. According
to a report to Congress from the National Cancer Advisory Board
(NCAB) Subcommittee to Evaluate the National Cancer Program, if
the nation fails to address six major issues (see table "the
resulting health-care costs, lost productivity, and personal tragedy
[will be] staggering."
The report from the subcommittee, chaired by Paul Calabresi, MD,
professor and chairman emeritus of the Department of Medicine,
Brown University School of Medicine, elaborated on these six issues,
stressing that they must be considered when any future health-care
reform legislation is written.
Too Many Cooks?
An absence of coordination of the National Cancer Program results
in research and service gaps and costly duplication of effort,
the report said. For example, 12 agencies in the Department of
Health and Human Services are involved in cancer-related research,
care, or regulation. Participation by hundreds of state, local,
and nongovernment agencies and organizations further confuses
The subcommittee found that many Americans receive inadequate
cancer care, especially the poor, elderly, and uninsured. It was
the opinion of the subcommittee that capitated delivery systems
often create a barrier to effective cancer care by pitting patients'
needs against providers' financial interests.
Problems With Current Laws
The report stressed that current laws, policies, and regulations
thwart the effort to eradicate cancer because cumbersome regulations
and excessive documentation requirements discourage industry from
developing new anticancer drugs and technology. In addition, laws,
policies, and regulations protecting tobacco companies worsen
the cancer problem and drive up health-care costs.