'There's a gulf between coverage and real access'
Cancer is the second leading cause of death in
Yet while patients often need specialists, treatments and the chance to participate in clinical trials, that access is not equitable throughout the state. It typically depends on where they live, and sometimes on their health insurance.
Lower-income cancer patients — and especially those in rural places — tend to fare worse. Studies have shown that patients with
This disparity is at the crux of a
The new law, which goes into effect in January, requires
Authored by Democratic Sen.
The law also requires
Supporters say that even if limited, this law will be an important step in helping low-income cancer patients get specialized care.
"I think making incremental change has the ability to save lives and that's what we're trying to do here," Portantino said.
Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnosis, said Dr.
"The conversation begins with 'If I could only have gotten here sooner', or 'My family and I fought tooth and nail to get here,'" he said.
Alvarnas said that historically, City of Hope used to see more
"In managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices," Alvarnas said. "If you have high blood pressure or you've got a condition that can be cared for by many types of doctors, that's an OK model.
"But when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma."
Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope – as was the case for
"I think about how lucky I am," Nandy said. "Doctors said two more weeks and I probably would have been gone."
These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that's not always the case, Alvarnas said.
A 2015 analysis by the
The study also found
The law will apply to people with rare or complex cancers, including advanced stage brain cancer, lung cancer, colorectal cancer, leukemia and lymphoma, among others, Alvarnas said. The sought- after treatment and research centers include City of Hope,
While the law as passed had no registered opposition, it was watered down during negotiations involving providers, health plans and the
Health insurance plans initially opposed Portantino's bill because requiring plans to contract with centers, they warned, comes with new administrative hurdles that could disrupt or delay patient care.
The debate over cancer care equity shows the complexities of achieving true access even in a state that has expanded insurance coverage to more people.
"The state has worked very hard over the last decade to improve health care coverage," Alvarnas said. "The issue, though, is there's a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled."
While the bill fell short of what supporters initially aimed for, the work to make cancer care more easily accessible will continue, said
"If you pull up a map, you'll see these centers tend to cover certain areas:
Ana covers health policy and the COVID-19 pandemic. She joined CalMatters in 2020 after four years at
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