A State of Healthcare in the USA
Answers submitted by Meghan Gutierrez, Chief Communications Officer, Lymphoma Research Foundation
What are the present day issues in healthcare in general in the USA today?
This is a busy and critical time in the United States regarding healthcare. In the coming months we will witness implementation of several major provisions of the Affordable Care Act (ACA);
Congress will consider future funding for the country’s biomedical research enterprise against a backdrop of fiscal cliffs and sequestration; and the entire healthcare community will continue to grapple with the concept of meaningful payment reform. In addition, there are several oncology-specific policies currently being considered by the United States Congress. Topics include oral chemotherapy parity; prescription drug shortages and tracking/ distribution security systems; and physician reimbursement for cancer care planning.
Is healthcare funding a priority in the USA?
Funding in terms of cost, value and affordability are all major priorities in the United States. It is well known that this country spends more on health care than any other, and these figures continue to grow. So the question becomes one of resource allocation and access. At present, there are numerous public and private entities studying these questions with no clear answer or solution in sight. Are blood cancer therapies well supported in the USA comparatively to other countries? In the United States, insurance coverage and personal income often dictate the quality of a patient’s cancer care. As such, an individual’s access to particular therapies is influenced by the amount and type of health care coverage they have. Those covered by government plans like Medicare (the federal health insurance program for people who are age 65 or older and certain younger people with specific disorders and disabilities) have access to the majority of blood cancer therapies. Individuals covered by private plans can gain access to some form of care, though there may be limitations or restrictions based upon the type of coverage they carry. Uninsured and underinsured individuals may encounter obstacles obtaining care and may have to utilize co-pay assistance programs, financial aid programs and/or charity in order to afford their care. This piecemeal approach can not only limit their treatment options but leave the patient with considerable financial liability as well.
How would you rate access to hematologists and pathologists specializing in Blood Cancers in USA today? Are there regional issues, geographic issues? Etc.
Most of the lymphoma specialists that the Lymphoma Research Foundation (LRF) works with are affiliated with major healthcare centers and academic institutions. This tends to be representative of the field all over the United States. While these centers and hospitals are located throughout the country, a patient’s ability to travel can be a limiting factor in whether or not they can gain access to these experts. More often than not, patients who cannot be seen or treated at a major medical center are treated in their local community by an oncologist who may or may not have specific training in hematologic malignancies. In an effort to engage these community oncologists and create a connection between them and the lymphoma specialists we work with, LRF created the Lymphoma Rounds program. Lymphoma Rounds provides a forum for local healthcare professionals to meet on a regular basis and address issues specific to the diagnosis and treatment of their lymphoma patients. Participants network, share best practices and learn the latest information on new therapies and advances in the management of lymphoma through interactive case studies presented by lymphoma experts from major medical institutions in the area.