COA President Dr. Patrick Cobb Responds to President Obama's Address to the AMA

Community Oncology Alliance (COA) president Dr. Patrick Cobb responds to President Obama’s speech to the American Medical Association today on health care reform.

We agree with and applaud President Obama for stating the simple truth “that health care reform should be guided by a simple principle: fix what's broken and build on what works.”

Where we diverge respectfully with President Obama is to approach the healthcare solution as a simple fix, in part because of the misperception that “Five of the costliest illnesses and conditions - cancer, cardiovascular disease, diabetes, lung disease, and strokes - can be prevented.”

Cancer and the treatment of it must be separated out and understood implicitly by its inherent threat to life as well as the catastrophic impact of cost. We hope that the President and Congress will work together with community oncologists to address and fix what is broken. Therefore COA is advocating for the passage of multiple bills that will address the broken system as well as deliver Best Practices recommendations to improve the current model. And, in fact, oncologists already use evidence-based treatment guidelines in their daily practice.

Patients are stricken with cancer for many reasons, and not all cancer is preventable. And the longer we live, the more of us suffer from it. Concurrently, the older the patient, the more frequently the treatment is through Medicare.

Already, Medicare has cut reimbursement for cancer treatment to such a low level that it negatively impacts the quality of care provided to seniors. Models just completed by several large community cancer clinics show that if Medicare rates become the standard, clinics would have to close their doors.

Oncologists continue to struggle to stay in business under the current cancer reimbursement system, which is failing. Medicare does not sufficiently pay for the costs of chemotherapy and related drugs. As a result, oncologists are increasingly financing these patients or being forced to turn them away and even close their practices. This is at the core of the crisis in cancer care, and our government must understand that as the broken system is analyzed and fixed, cancer care must be a primary consideration.

As it is now, Medicare accounts for approximately 45% of all cancer care payments. We have to fix the broken Medicare system before even considering expanding it. We face dire consequences if we break what is working and do not address what is already broken.

Statement by Dr. Patrick Cobb, president of the Community Oncology Alliance, regarding declining rates of cancer death

“The Community Oncology Alliance is encouraged by the recently released statistics from the American Cancer Society showing a decline in the number of cancer deaths in the U.S. It is important to recognize that the decreasing cancer death rates are a result of several factors, including the quality and accessibility of cancer care provided by community oncology practices throughout the country.

Yet, we cannot ignore that in this year alone there will be almost 1.5 million new cancer cases and 560,000 cancer deaths.

The U.S. cancer care delivery system is now in the first stage of a crisis because Medicare has substantially cut payment for cancer drugs and essential services. Increasingly Americans with inadequate or no insurance, including seniors unable to pay the Medicare 20% coinsurance, are foregoing cancer treatment. We are entering a second stage crisis as we lose oncologists relative to the increasing incidence of cancer.

The Community Oncology Alliance has been actively working on solutions, starting with the Quality Cancer Care Demonstration project (QCCD), a substantive program developed by community oncologists over the past year to enhance the delivery of quality cancer care. The project will focus on patients covered by Medicare (approximately 45% of all cancer patients) and involves collecting data and implementing a patient-centric program to enhance cancer care while controlling costs. The QCCD project is a means of moving forward immediately with real healthcare reform, and provides the foundation for a solution to the crises in cancer care.

The Community Oncology Alliance is actively working with the Congress in integrating the Quality Cancer Care Demonstration project into healthcare reform legislation.”