Should insurers be forced to pay for expensive new cancer treatments?

August 30th, 2013

If insurance companies won’t pay for expensive, but potentially life-saving treatments, will it stop hospitals from investing in them too?

Blue Shield of California has come under fire for refusing to pay for an expensive and controversial new radiation treatment for prostate cancer. Scripps Hospital in San Diego spent $230 million on a new proton beam therapy center set to open this fall.

Loma Linda University Medical Center was the first hospital-based proton treatment center in the nation. It’s invested millions in the technology and claims that it’s safer and healthier than traditional radiation treatments. Blue Shield claims there is no justification for spending $30,000 using the new machine when research shows that traditional radiation methods deliver similar results.

Insurers are under constant pressure to hold down costs but at the same time, patients and doctors are demanding they pay for pricey and often-controversial treatments. How do insurers decide which new treatments are worth spending top dollar? Will hospitals be willing to invest in potentially life saving new treatments if insurers won’t cover them?

Dr. Marcus Thygeson, Chief Health Officer, Blue Shield of California

Daniel Fontoura, senior vice president at Loma Linda University Medical Center

Dr. Steven Pearson, President of the Institute for Clinical and Economic Review at Massachusetts General Hospital in Boston.