A PBS Newshour segment, “Pediatric Cancer Survivors Face a Lifetime of Health Challenges,” discusses the late effects and potential secondary cancers that survivors of pediatric cancers face. The piece puts a human face on the challenges with its profiles of Laura Allaire, an adult survivor of pediatric cancer, and eleven-year-old Samantha Schwarz, who is being treated for a secondary cancer that resulted from treatment when she was a baby. Both are patients of the Survivors of Childhood Cancer Program at the University of California San Francisco (UCSF). Dr. Robert Goldsby, director of the program, said “The good news is, more people are surviving cancer. The bad news is those that survive, more than half have a long-term issue.”

“The good news is, more people are surviving cancer. The bad news is those that survive, more than half have a long-term issue.”
UCSF has developed a health “passport”, what we also call a Survivorship Care Plan, which provides a guide for pediatric cancer survivors. The passport is a unique approach to care plans – it is wallet-sized and includes a treatment summary on one side and recommended follow-up, based on specific risk factors resulting from the type of cancer and the treatment, on the back side.

The New England Journal of Medicine published, “Health Care Coverage under the Affordable Care Act — A Progress Report,” written by Drs. David Blumenthal and Sara Collins of The Commonwealth Fund, which also published a summary of the findings. The report finds that as of May 1, 2014, 20 million Americans have gained health coverage through various mechanisms of coverage expansion under the Affordable Care Act. The 20 million figure includes not only individuals who purchased policies through exchanges, but also young adults enrollment on parents’ plans, policies purchased directly from insurers, and Medicaid expansion.

“…the growth of premiums will continue as long as health care costs grow.”
The report also considered the impact of “narrow networks,” a tool used by insurers to keep premiums low by requiring enrollees to use low-cost providers or pay more for using out-of-network providers.  Insurers are likely to continue to use narrow networks as a strategy to keep premiums affordable. The question is how these restrictions on choice affect the actual or perceived value of the insurance products that are sold in the marketplaces.” The authors suggest that if consumers believe they cannot get the care they need, they may opt out of purchasing plans. Both the federal government and states are considering ways to address network adequacy.

The report concludes, “The unavoidable truth is that the growth of premiums will continue as long as health care costs grow.  Narrow networks are just one solution that health plans are likely to use. The long-term success of the ACA is linked inextricably to the affordability of health care in the United States, a larger problem that the law addresses through other provisions that have drawn far less attention than the enrollment numbers.”

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