Letter: Bill supports biomarker testing
This letter originally ran in the Lincoln Journal Star.
News
"If it is good enough for a Member of Congress..."
July 27, 2009
It has long been suggested that the American public should have access to the same health coverage as Members of Congress. So, ACS CAN decided to look at what Members get and see just how good it would be for someone who gets cancer, has a heart attack, or has diabetes. The answer is_ patients would do pretty well, though the coverage is certainly not Cadillac coverage.
ACS CAN commissioned Karen Pollitz at Georgetown University to conduct a study of the adequacy of coverage under the Blue Cross Blue Shield Standard plan offered to federal employees, including Members of Congress and their staff. The Blue Cross plan with approximately half of all federal employees covers more than 4 million people. Using very detailed scenarios that included treatment for a typical patient of breast cancer, colorectal cancer, heart attack, and diabetes, Pollitz found that all essential services were fully covered by the plan. In addition, the $7,000 annual out-of-pocket limit in this plan is hard meaning patient costs above the limit are fully covered for in-network and out-of-network care. For example, a woman with stage II breast cancer would have out-of-pocket costs of between $10,000-$13,000 (depending on how many services were out-of-network) over the course of two years. Likewise, a stage III colon cancer patient would have between $15,000 and $17,000 over a two and a half year period in out-of-pocket costs. What the study suggests is that a plan like the Blue Cross Blue Shield Standard plan would be a good starting point for coverage. It covers all essential services, and although the out-of-pocket costs would be high for many low and middle-income families, at least they are hard and could be made more affordable if sufficient subsidies are available. ACS CAN is using the study as part of its lobbying effort to educate Members of Congress and their staffs about the meaning and importance of adequacy. If it is good enough for Members of Congress, it should be available to all Americans.