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 issue.
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.