MEDICARE: Costly Lung Surgery Strictly Limited By HCFA
A study to determine whether Medicare should cover a new lung cancer procedure will force many low-income emphysema patients to wait as long as five years for the surgery, today's Wall Street Journal reports. The Health Care Financing Administration will pay for no more than 2,200 patients to receive "lung-volume reduction" as part of a National Institutes of Health controlled experiment aimed at determining the surgery's efficacy. Results will be used to decide whether Medicare will foot the bill for the $30,000 procedure. HCFA officials cited a 1994 mortality rate of 26% and surgeons who rashly performed the surgery "without fully understanding what they were doing" as reasons for conducting a cautious and thorough investigation. However, Dr. Joel Cooper, a St. Louis surgeon credited with bringing the surgery to the fore in 1993, decided that he could not "withhold the surgery from patients who would almost certainly benefit" and withdrew from the Medicare study. Other prominent thoracic surgeons followed suit. According to medical ethicists, the issue is a "flashpoint" in the debate about how to balance "limitless technological advancements ... [and] limited money to pay for them," and underscores the "unforeseen dilemmas" in conducting limited clinical trials for lifesaving surgeries in high demand (Gentry, 6/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.