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What Are the Plans from Both Candidates for Cancer Care

"Unfortunately, we are faced with some issues in healthcare, which from a political policy standpoint have very recently shifted," said John Akscin, vice president of government relations for McKesson Specialty. "If you had spoken with the Obama or McCain campaigns 6 months ago, healthcare was probably the number 3 item on their agenda. But considering what we've seen in the financial markets and mortgage industries recently, it has become obvious that finance and economics are the first priority."  Cancer death rates in the United States have declined by 18.4% in men and by 10.5% in women since mortality rates first started decreasing in the early 1990s, according to a recent report from the American Cancer Society.  The decline in cancer-related deaths is due to many factors, including effective tobacco-control strategies, effective screening strategies, and effective treatment strategies, explained Douglas W. Blayney, MD, president elect of the American Society of Clinical Oncologists. "But while it's clear that we have a good story to tell," Dr. Blayney said, "the momentum we have built in improving cancer survival may be in jeopardy."

Healthcare vs Economic Crisis:  Even before the financial crisis became full blown, Mr. Akscin pointed out that funding healthcare reform could prove problematic, and used the data from the Medicare Trustees Report of 2006 as an example. The report was an attempt by government to forecast what might happen in healthcare, specifically the Medicare environment, over the 10-year period from 2006 to 2015.  "It shows a 52.6% increase in the average cost of healthcare to a Medicare beneficiary," he said. "But as the baby boomers age, a large number of people will be entering the program, and there will be a 24% increase in the number of beneficiaries. The interesting part of the data shows about a 13% reduction in workers paying into Medicare during that same period." Funding for cancer research is another issue.  

Candidate Cancer Platforms:  Arizona senator John McCain, the candidate running on the Republican ticket, has had several brushes with malignant melanoma. Three other candidates who ran in Republican party primary also have a history of cancer: Kansas Senator Sam Brownback underwent 2 surgeries for melanoma in the mid-1990s; former New York City mayor Rudy Giuliani is a prostate cancer survivor; and former Tennessee senator Fred Thompson has non-Hodgkin's lymphoma, currently in remission. Cancer has also affected the families of the candidates: Elizabeth Edwards, wife of one-time Democratic candidate hopeful John Edwards (former senator from North Carolina), began treatment for metastatic breast cancer during her husband's campaign. Senator Hillary Clinton's mother-in-law died of breast cancer, and the mother of Senator Barack Obama, Democratic candidate for president, died of ovarian cancer when she was in her early 50s.   "Neither candidate is talking about drug reimportation, but both are interested in getting generics into the market sooner as a cost-saving measure."  Biologics is another issue. There is currently no US Food and Drug Administration (FDA) rule for follow-on biologic agents, he said. "Both candidates want an approved pathway for this class of drugs, and don't want to hold up the process for bringing them to market."  In addition to their comprehensive healthcare platforms, Senators Obama and McCain have released proposed agendas specifically for cancer care.    Key points of the Obama–Biden plan:   Commits to doubling the cancer-research budget within 5 years, stating that it is necessary to reverse the stagnation in funding of recent years.  Will ensure affordable health coverage for all Americans, but will maintain patient choice, and will establish a National Health Insurance Exchange (with a range of private insurance options) and a new public-health plan to allow individuals and small businesses to buy affordable and accessible health coverage similar to that available to federal employee.   Ends insurance discrimination for cancer patients and cancer survivors, with a guarantee that all people will be able to purchase any private insurance plan at an affordable and fair price.   Improves access to clinical trials.  Will strengthen the healthcare workforce by expanding funding for loan repayment, adequate reimbursement, grants for training curricula, the Nurse Reinvestment Act of Title VIII of the Public Health Act, and infrastructure support to improve working conditions.  Supports advances in personalized medicine by creating an interagency task force on genomics research, modernizing FDA review of genomics tests, and expanding support to genomics researchers.  Identifies the health effects of environmental impacts that may increase the risk for cancer.

 Key points of the McCain–Palin plan:  Will double the funding for the National Institutes of Health (NIH) and provide researchers "the necessary funding to defeat cancer once and for all."  Will better coordinate the efforts between the government sector (including the National Cancer Institute and NIH) and the private sector, especially in the area of translational research.  Has already cosponsored legislation that would create research centers to study environmental factors that may be related to the etiology of breast cancer.   Will focus on working with businesses and insurance companies to widely employ common-sense preventive approaches, like smoking-cessation programs, healthier eating habits, and a more active lifestyles, to reduce the incidence of cancer.   Improve access to cancer care by building on the current system of employer-based coverage, but also attempt to give consumers more control over their healthcare by offering tax credits directly to individuals and families for the purchase of the health insurance of their choice.   Proposed a Guaranteed Access Plan that will combine industry, state, and federal resources to help with the purchase of coverage for those hardest to insure, including patients with pre-existing conditions like cancer.  Will push for greater competition in the drug and biotechnology industries through faster introduction of generic drugs and by allowing safe and effective follow-on biologics to enter the marketplace, while ensuring that research and development is not hindered.

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