Oncologists endorse single-payer healthcare system

Two oncologists are calling on fellow oncologists and the American Society of Clinical Oncology (ASCO) to support a single-payer healthcare system, according to an article published in the January issue of the Journal of Oncology Practice.

The oncologists, Ray Drasga, MD, a community-based oncologist in Crown Point, Indiana, and Lawrence Einhorn, MD, professor of medicine at Indiana University Hospital in Indianapolis, said that the Affordable Care Act (ACA) will not solve the healthcare crisis that cancer patients face. The only solution is a single-payer system.

Dr. Drasga founded a free clinic in his own community of Crown Point, and Dr. Einhorn is a past president of ASCO and led the medical team that treated and saved Lance Armstrong's life in 1996.

“Oncologists face the dilemma of advising a treatment scheme that the patient can afford,” the authors wrote. “Therapies may need to be compromised as a result of the patient’s inability to pay. Patients often present with more advanced disease because they have never had cancer screenings because of a lack of insurance or concerns about cost. Meanwhile the prices of cancer-related drugs are rising sharply, prompting some oncologists to sound the alarm.”

Single-payer pros and cons

The single-payer system that Drs. Drasga and Einhorn are endorsing “is basically an improved Medicare for all,” resembling the current system in Canada. “It would provide universal comprehensive coverage with free choice of providers…Copayments, deductibles, insurance premiums, and out-of-pocket expenses would be eliminated.”

The single-payer insurance plan would be administered by a public agency to set healthcare policy, financing, benefits, drug formularies, and most importantly, the ability to negotiate drug prices and supplies with drug manufacturers and negotiate fees with healthcare providers and hospitals, they reported.

“Financing the system could be accomplished by a mix of payroll and income taxes. Funds from Medicare and Medicaid would be retained,” Drs. Drasga and Einhorn said.

People with cancer die sooner and suffer more under single-payer health systems, according to Robert M. Goldberg, PhD, founder, Value of Medical Innovation. “The claim that out-of-pocket costs for cancer drugs are nonexistent in single-payer systems is factually wrong,” Goldberg said. That would condemn their patients to the worst of all possible worlds: Slower and more limited access to targeted therapies and higher out-of-pocket costs for the medicines that they do get.”