Since his announcement that he has prostate cancer, Senator Chris Dodd has been advocating health care reform using his own experience as an example:
“I didn’t wake up the morning of June 19th — when I found out I had prostate cancer — and worry about whether or not I have a health care plan or whether I would get access to good care,” he said. “I want every American to go wake up with that same sense of security.”
Thankfully, Mr. Dodd’s prostate cancer seems to have been caught early by a Prostate Specific Antigen (PSA) test. But the history of this test raises real questions about the health care reform plans that Mr. Dodd advocates.
The PSA test was developed by Dr. T. Ming Chu and a team of scientists at Roswell Park Cancer Institute in Buffalo, New York. It was, as you might imagine, a difficult task made more challenging by the circumstances:
“Finding a prostate-specific antigen wasn’t easy, especially in the face of the cancer community’s skepticism about tumor markers.”(The Man Behind the PSA Test).
But the facts speak for themselves. Thirty-five years ago, the cure rate for prostate cancer in the U.S. was just 4%. Today, it is better than 90%. And observed survival rates in the U.S. are even higher – 99.3%.
It isn’t that way everywhere. In Europe, observed survival rates are 77.5% – more than twenty percent lower than in the U.S. The reason?
“That in turn stems from the more intensive screening for cancer carried out in the United States, where a reported 70% of women aged 50 to 70 years have undergone a mammogram in the past 2 years, one-third of people have had sigmoidoscopy or colonoscopy in the past 5 years, and more than 80% of men aged 65 years or more have had a prostate-specific antigen (PSA) test. In fact, it is this PSA testing that probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment.” (Zosia Chustecka, “Cancer Survival Rates Improving Across Europe,” Accessed 7/31/09)
There is no doubt that America’s health care system is in need of reform. But it is in need of reform not because the overall quality of the medicine practiced is in question – it is because it costs far too much. Driving down the cost and expanding access should be the goal for reform – not stifling innovation.
But when proposals include a “Health Benefits Advisory Committee” designed to regulate medical procedures and choose only the most “cost-effective” ones to use, then it puts the innovative ability of America’s health care system at risk.
The PSA test still encounters criticism by medical professionals, even while early detection has the survival rate skyrocketing. Europe doesn’t use PSA tests as frequently because of the controversy over effectiveness – and government-managed innovations would likely face the same scrutiny here in the U.S. under the currently proposed reform plans.
So while Mr. Dodd champions health care reform, his own case should be Exhibit ‘A’ for caution about the current reform proposals.