"One Cannot Measure What One Does Not Manage": Cancer-In Need of Reform (Part XIII-r)

So you thought healthcare reform is just a matter of political finesse, emulating other industrialized countries (docs making less, long queues and rationing [more on that aspect, next week]) or incentives realignment? For me, the cure is accountability, accessibility and appropriateness; the money available for healthcare is limited, measurement and management are key and patient care results matter.

Let's think of reform from a different vantage point—consider cancer; where is it going and how to we get there? Frances M. Visco, President, National Breast Cancer Coalition is an important lady and a friend you can count on in healthcare advocacy. She gives permission for us to reproduce her thoughts as she reminds us how deep and far reaching reform must go.

Discussing the granting process, she says we need a fair and egalitarian approach. Nevertheless, she feels the National Institutes of Health (NIH) is funding the Human Genome Project to the exclusion of the possible role that the environment may play in causing breast cancer. Indeed, when Dr. Francis S. Collins was nominated to head up the NIH, she stated, “The N.I.H. needs visionary leadership willing to challenge the present stagnation at the institute. It may be difficult for Francis, since he has been a part of the system.” (You can read between the lines).

"Pick to Lead Health Agency Draws Praise and Some Concern," the New York Times, July 8, 2009

From: "FMVisco" <fmvisco@stopbreastcancer.org> [with permission]

Date: July 15, 2009 5:48:27 PM EDT

To: "Dr. Jeff Kaplan" <fitdoc@sprintmail.com>

To the Editor:

It is no surprise that we have learned so little about how to prevent and treat cancer. Researchers and institutions have lost any sense of urgency about the goal of saving lives.

The bloated cancer research infrastructure is much too influenced by technology, patents and profit. Most research proposals focus on looking for the next cancer drugs, the majority of which bring incremental if any benefit to patients at great financial cost and increased health risks.

This happens through the National Institutes of Health, which spends billions of taxpayer dollars with no transparency, little accountability and even less external oversight. There is hope: We have seen a different result when informed; educated patients have a meaningful role in policy and research.

Perhaps now Congress and the White House will finally listen, drop their unwarranted deference to N.I.H. and force change.

Frances M. Visco

President, National Breast Cancer Coalition

Washington, June 29, 2009

Original Source: NY Times July 3, 2009 Letter to the Editor—"Medical Research: Which Approach Is Best?"

I think the same advice applies to healthcare—'Out with the status quo. It's about the patient. All the rest is pap.'