The Legislative Logic of Proton Therapy

Proton therapy delivers precise doses of radiation, resulting in fewer side effects and less damage to surrounding tissues.
Proton therapy delivers precise doses of radiation, resulting in fewer side effects and less damage to surrounding tissues.

I just love it when legislators tell insurance companies whose services they should insure. Lawmakers are obviously so much more qualified to judge the efficacy of different medical treatments — why shouldn’t we trust their judgment?

Pardon my snark. A bill has passed the House of Delegates and moved to the state Senate that would forbid insurance companies from holding proton therapy to a higher standard of clinical evidence than other radiation treatments.

Del. David Yancey, R-Newport News, submitted the bill on behalf of Hampton University (HU), which just happens to have a Proton Therapy Institute. HU complains that the procedure is still treated as experimental despite decades of research, explains Travis Fain with the Daily Press.

To tug at legislators’ heart strings, the bill’s supporters brought in Carolyn Lambert, wife of Benjamin Lambert, who served in the Senate more than 20 years and died in 2014. The Lamberts’ son is fighting prostate cancer now. Speaking in a halting voice, she said, the insurers “have abandoned him.”

Insurance lobbyists counter that they use blind studies to make coverage decisions, and that proton therapy makes the cut in some cases, such as pediatric and skull cancers, but not in others. “The bottom line is we don’t evaluate them differently,” said Doug Gray, executive director of the Virginia Association of Health Plans.

The Senate Commerce and Labor Committee passed the bill on what appeared to be a unanimous voice vote, reports Fain. Sen. John Cosgrove, R-Chesapeake, a motioned “as a cancer survivor” to send the bill to the floor.

Bacon’s bottom line: This illustrates the worst of everything about the way the General Assembly works. Anecdotal information and sentimentality demolish reason and empirical evidence. The legislature is well on its way to passing a law that could well nudge the cost of insurance policies higher. The prostate cancer of Sen. Lambert’s son is a tragedy. What we will never see is the tragedy of the “third man,” the invisible victim for whom the cost of medical insurance will be put just out of reach.

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7 responses to “The Legislative Logic of Proton Therapy”

  1. I believe I may have previously commented about legislatures doing the type of thing you cite.

    In the 60’s, legislatures throughout the country passed laws requiring hospitals to test newborns for PKU disease (Phenyketonuria), a very rare but unpleasant disease for kid and family. Kid would be prohibited from eating anything but a certain chalk like, extremely unpleasant milk shake from an early age, usually until puberty if I remember correctly. The problem was: there was a high level of false positives in the testing, relegating the kid and the parents to long bouts of unnecessary treatment during which many kids would become suicidal. Contrast the more gradual changes in law that take place as a result of case-by-case examination of the issues, particularly in life and death cases, of which the Karen Ann Quinlan case was at the forefront.

    Legislatures should stay the hell out of this stuff. They inevitably get it wrong.

  2. LarrytheG Avatar

    Shades of “death panels”!

  3. LarrytheG Avatar

    and to be honest – how does this differ from requiring insurance companies to cover “pre-existing” conditions in general?

  4. Do we have the bill number to send this article to those legislators who are voting on it?

  5. Steve Haner Avatar
    Steve Haner

    How does this differ from the General Assembly passing bill after bill to dictate your electric rates? It doesn’t. The legislature has quite a bit of power. That’s why it is a good idea to be paying attention. There are many ways to separate you from your dollars that are not taxes. Certainly I do not have total faith in the insurance companies, either.

    House Bill 1656 will be on third and final reading on the Senate floor tomorrow, VN. I watched the presentation in committee and the Lambert family put it over the top, for sure.

  6. LarrytheG Avatar

    I can understand the GA messing with electric rates for a regulated monopoly.

    but should the GA or Congress be telling insurance companies that they have to cover pre-existing conditions and/or some diseases that they’d not normally cover – if insurance is supposed to be something determined on a “if we cover it , it gets passed on to all subscribers” basis?

    that’s the essence of the current political argument about the young and healthy paying for the sick and old… right?

  7. Day-um, Larry. You may become a free-market capitalist yet. 😉

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