The National Comprehensive Cancer Network® (NCCN®) opened its
17th Annual Conference with a roundtable discussion entitled,
Cancer and Corporate America: Business as Usual? ABC News veteran
and anchor, Sam Donaldson, moderated the opening session, as he has
for the past six years, telling the hundreds of conference
attendees that fifty-eight percent of non-elderly Americans rely on
their employers for their health insurance. He asked, “What is
business as usual when it comes to delivering cancer care?”
The panel, some of whom are cancer survivors, included experts
from business, industry, medicine, and public policy and addressed
a range of issues that businesses face today in defining quality
cancer care and developing the necessary methods to assure that
their employee populations have access to that care. They also
discussed both opportunities and barriers to delivering excellent
cancer care from a variety of perspectives and took on the
difficult issues related to health care reform. This year's topic
grew out of the ongoing collaboration between the National Business
Group on Health and NCCN which is working to develop standards and
tools to assist corporations in this increasingly complex area.
The panel included Robert W. Carlson, MD, an oncologist from
Stanford Cancer Institute; Helen Darling, President & Chief
Executive Officer of the National Business Group on Health; John S.
Greene, Director of Engineering from Salesforce.com, a survivor of
acute myeloid leukemia; Carole Klase, PhD, who survived merkel cell
carcinoma; J. Randall MacDonald, Senior Vice President of Human
Resources for IBM; Sheri S. McCoy, MSc, MBA, Vice Chairman of the
Executive Committee of Johnson & Johnson; Kavita Patel, MD,
MSHS, of the Brookings Institution’s Engelberg Center for Health
Care Reform; and J. Brent Pawlecki, MD, MMM, Chief Health Officer
of The Goodyear Tire & Rubber Company.
Sam Donaldson opened the discussion by asking the panel, “What
do companies owe their employees in terms of delivering
high-quality cancer care?”
Helen Darling addressed that question saying, “Great companies
believe in investing in their employees, and providing excellent
health care is central to that belief.” She noted that companies
who participate in the National Business Group on Health are
committed to assuring that their employees have the tools and
resources they need when they are diagnosed with cancer. She
emphasized that providing health navigators to support patients as
they navigate the complex pathways of the system is one example of
this commitment.
J. Randall MacDonald, who oversees medical benefits for IBM,
agreed but noted, “The reality is that this is a business
proposition. A healthy employee is a productive employee.” He
stressed, however, the need for evidence-based means of deciding
what is effective and not effective in delivering care.
J. Brent Pawlecki, MD, MMM, pointed to three factors that help
employers assure that their employees are “healthy, engaged and
productive.” These include an emphasis on preventive medicine,
obtaining the “right care at the right place at the right time” and
focusing more on end-of-life care.
“How will cancer change my life?” That’s the question that every
patient asks according to Robert W. Carlson, MD, and one area of
major concern is their ability to work. Patients worry about job
security, adequate health insurance, and the response that their
diagnosis will evoke from employers and co-workers.
John S. Greene pointed to the support he received from his
entire company following his diagnosis in November 2010 and noted
that Salesforce.com CEO Marc Benioff made it clear that “the
company is here for you; I am here for you.”
Sam Donaldson then pressed the panel to address the issue of
cost in providing excellent cancer care.
J. Randall MacDonald whose company employs over 500,000 people
and spends $1.2 billion a year on health care for its employees
stated, “Cost is an issue,” and noted that he constantly has to
balance individuals’ needs and requests with the larger issues of
running the business.
Helen Darling pointed to identifying and reducing waste within
the system as a key to controlling costs. “It's what you pay for,
not what you pay,” she said and that “by shifting wasted dollars to
more effective, evidence-based medicine, you create budget room to
pay for what works.”
“We need to take a step back,” Sheri S. McCoy agreed, “and make
sure that we invest in research and development. We need to know
who benefits from a treatment and who doesn't.”
Carol Klase, PhD, a mental health professional, stressed the
need to include mental health in benefits, reminding the panel that
“the psychological problems can be as big as the cancer
itself.”
Sam Donaldson’s final question focused on new health care
legislation, the Patient Protection and Affordable Care Act
(PPACA), that would guarantee access to health insurance for all
Americans. He noted that sixty million Americans currently do not
have health insurance and asked the group if the law helps patients
with cancer.
Kavita Patel, MD, MSHS, who was instrumental in developing the
legislation, answered in the affirmative, saying that the new law
“evens the playing field for cancer patients,” and pointed to
provisions that would make it impossible to exclude people with
pre-existing conditions from insurance plans as one
improvement.
Helen Darling noted the expanded coverage will make it even more
important to assure that medicine is evidence-based. She described
the work that her organization is doing with NCCN as a model for
solving problems. “If we have appropriate guidelines and we make
sure every patient gets an appropriate assessment, then the
benefits will be covered and the decisions will be driven by
evidence and research.”
Robert W. Carlson, MD, concluded the discussion with a strong
statement that summarized the complex issues that the panel
addressed during the session. “We need to make sure the system is
configured so that employees fight their cancers, so they don't
waste time fighting their insurance companies or being concerned
about their employment.”
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®), a
not-for-profit alliance of 21 of the world’s leading cancer
centers, is dedicated to improving the quality and effectiveness of
care provided to patients with cancer. Through the leadership and
expertise of clinical professionals at NCCN Member Institutions,
NCCN develops resources that present valuable information to the
numerous stakeholders in the health care delivery system. As the
arbiter of high-quality cancer care, NCCN promotes the importance
of continuous quality improvement and recognizes the significance
of creating clinical practice guidelines appropriate for use by
patients, clinicians, and other health care decision-makers. The
primary goal of all NCCN initiatives is to improve the quality,
effectiveness, and efficiency of oncology practice so patients can
live better lives.
The NCCN Member Institutions are: City of Hope Comprehensive
Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women’s
Cancer Center | Massachusetts General Hospital Cancer Center,
Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer
Center, Philadelphia, PA; Huntsman Cancer Institute at the
University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer
Research Center/Seattle Cancer Care Alliance, Seattle, WA; The
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins,
Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of
Northwestern University, Chicago, IL; Memorial Sloan-Kettering
Cancer Center, New York, NY; H. Lee Moffitt Cancer Center &
Research Institute, Tampa, FL; The Ohio State University
Comprehensive Cancer Center - James Cancer Hospital and Solove
Research Institute, Columbus, OH; Roswell Park Cancer Institute,
Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and
Washington University School of Medicine, St. Louis, MO; St. Jude
Children’s Research Hospital/University of Tennessee Cancer
Institute, Memphis, TN; Stanford Cancer Institute, Stanford, CA;
University of Alabama at Birmingham Comprehensive Cancer Center,
Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer
Center, San Francisco, CA; University of Michigan Comprehensive
Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The
Nebraska Medical Center, Omaha, NE; The University of Texas MD
Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer
Center, Nashville, TN.
Clinicians, visit NCCN.org. Patients and caregivers, visit
NCCN.com.