Re: Economic Scene - Plan to Cut MedicareWithout Stifling Innovation - NYTimes.comii

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I haven't looked at link but they are looking at CER. Need validated high level large clinical trials that justify higher charges. They say it has not been done. Looks like insurance maybe trying to limit treatment options. Looks like people will have to Sent from my Verizon Wireless BlackBerrySender: ProstateCancerSupport Date: Thu, 21 Oct 2010 13:14:42 -0400To: <ProstateCancerSupport >ReplyTo: ProstateCancerSupport Cc: 'Patient Advocates in Research'; 'VAPCACOALITION'<VAPCACOALITION >; 'Prostate Problems Mailing LIst'; ProstateCancerCommunityLeaders<ProstateCancerCommunityLeaders >; CircleSubject: Re: Economic Scene - Plan to Cut MedicareWithout Stifling Innovation - NYTimes.com Kathy,If you compensate for documented ASTRO versus 0.2 ng/ml measurementbias(+17% at 10 years), relative cohort disease levels (from 2% to 8% overRP) and then compare the best treatment results for each treatment typeyou might find some interesting information for a follow-on article. Almost no PCa treatments are equally good, although some are closerthan others. Acomparison of long term treatment effectiveness and seriousside effects that was assembled by six previous PCa patients can befound atwww.rcogpatients.com. For a quick review of the comparisons click on the "Snapshot" button atthe bottom ofthe first page.CarlKathy Meade wrote: The treatment of prostate cancer offers a good example of thetrouble withthe current system. I devoted a column to prostate cancer last year,and theHealth Affairs article - by Pearson of Massachusetts GeneralHospitaland B. Bach of Memorial Sloan-Kettering Cancer Center - uses itas acase study, too.The brief version is that the options for treating prostate cancerincludethree forms of radiation. One of them, three-dimensional radiation,costsMedicare about $10,000. Another treatment, a targeted form of radiationknown as I.M.R.T., came along a decade ago and initially cost about$42,000.Lately, Medicare has also started covering a third, proton radiationtherapy, for which it pays $50,000.No solid research has shown I.M.R.T. to be more effective at keepingpeoplealive, with minimum side effects, than three-dimensional radiation. Thebacking for proton therapy is weaker yet. As Dr. Pearson says, "There iseven less evidence on whether proton therapy is as good as otheralternatives than there was for I.M.R.T. when it was the new kid on theblock."But Medicare today doesn't pay for good outcomes. It pays for anytreatmentthat it deems reasonable and effective.http://www.nytimes.com/2010/10/20/business/economy/20leonhardt.html?_r=1 & ref=health