If he needed more encouragement than the California verdict, Sen.Wyden (D-Ore) got it a week later when the National Cancer Policy Board at the Institute of Medicine (IOM) released a report that said physicians are unprepared to help half or more of the 550,000 people each year who experience pain, depression, and breathing difficulties in the days before their death from cancer.
The report was critical of both the National Cancer Institute (NCI) and Medicare. The former spent only $26 million of its $2.9 billion budget in 1999 researching symptom control and palliative care. The IOM report recommended that the NCI require any health facility seeking to retain or achieve NCI recognition as a Comprehensive Cancer Center to do research on palliative care and symptom control. The Medicare hospice benefit allows enrollment of patients only if they are expected to survive 6 months or less, and it does not cover potentially life-prolonging treatment in addition to palliative carethereby making hospice enrollment tantamount to accepting death.
Richard Klausner, MD, NCI director, said an implementation group will recommend ways to make some or all of the changes sought by the report.