Editorial: New Jersey insurers act responsibly

Monday, Dec. 27, 1999 | 9:29 a.m.

For years cancer patients have met roadblocks in trying to get experimental treatments. Insurance companies for the most part have been reluctant to cover the medical costs of this type of care, claiming that since these treatments are unproven, they don't believe they should pay for them. But, as patient advocates have correctly pointed out, unless insurance companies consent to pay for cutting-edge treatments, then there is no way to find out what works best in fighting this disease.

State laws in Illinois, Maryland, Rhode Island and Virginia mandate some type of coverage by health insurers for these trials, but insurers have been reluctant to do so voluntarily. But last week health insurers in New Jersey became the first to voluntarily agree to pay for the medical costs for cancer patients who receive experimental treatments that are approved by U.S. government health agencies. The move was hailed by cancer patient advocates, the Associated Press reported. "If we continue to treat patients with the same standard therapies, we will get the same results," said Mary Todd, deputy director of the Cancer Institute of New Jersey. "In the treatment of cancer, it is not acceptable to follow the cookbook. We must write new recipes."

HMOs have done an excellent job when it comes to preventive medicine. They understand that taking early steps to head off potential diseases or catastrophic illnesses not only aids the patient's health, but it also means it costs the insurance companies less money in the long run. Unfortunately too many insurers have become obsessed with cost savings in all aspects of medicine, so that when it comes to paying for care involving expensive treatments, they often balk. So it is promising, then, to see health insurers in New Jersey take a responsible course in providing innovative care for cancer patients.

Now it's time for health insurers in other states to grab the baton and run with it. Congress, too, is expected to be lobbied, with cancer patient advocates seeking Medicare coverage of clinical trials. Managed care once brought innovative approaches to the delivery of health care, but lately it seems to have become static. It is hoped that the decision by New Jersey health insurers is a signal that some will start thinking "outside the box" when providing care for patients.