Guest Column: We need to make health care affordable | SierraSun.com

Guest Column: We need to make health care affordable

Mark Spohr

In response to Dr. Heifetz's Sept. 29 guest column, "Cancer patients are getting state-of-the-art health care," Dr. Heifetz is rewriting the history of the cancer center and refers to documents which have been updated after the fact to justify the decision. You need to go back to the original documents to get the story.

Before Measure C, a consultant group, Aptium Oncology, prepared a Cancer Program Feasibility Study which was presented on Dec. 20, 2005. This feasibility study recommended proceeding with the development of an outpatient cancer program. This was proposed to include medical oncology and diagnostic services to be staffed by a part time (0.2 full time equivalent) oncologist and two nurses.

A Cancer Center Business Plan of May 2006 projected a capital expenditure of $134,000, utilizing approximately 1400 sq. ft. of an existing building. A later document, the Tahoe Forest Hospital Master Plan dated June 2006 includes $417,000 for cancer center offices within the existing building.

After the bond issue was passed, a February 2008 document laid out the grand new plan for the Cancer Center. The Cancer Center had to have Radiation Oncology as well as Surgical Oncology treatment. This meant that we needed a new building filled with expensive equipment. This equipment included a linear accelerator radiation therapy machine and a PET scan diagnostic machine.

In my 20 years experience advising governments on how to make cost-effective investments in health, this is one of the worst decisions I have seen. The district spent $32 million for a facility which could have been constructed to deliver the same high quality services for much less.

Yes, drug companies are partly to blame for the high cost of cancer chemotherapy. Our cancer center makes a bad situation much worse by charging patients a 500 percent markup on drugs. For example, a drug that costs the cancer center $2,000 could be billed to the patient at $10,000. This is unconscionable.

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Dr. Heifetz seems to be worried about the cancer center closing. Now that we have spent the money, it would be stupid to abandon it. However, the current high cost is driving patients away. We need to do as much as we can to attract as many patients as possible to the cancer center so that it will grow and prosper. We can do this by reducing the gross overcharges for drugs and making our charges for other services competitive.

The only way to move the hospital forward is to increase utilization of all services. Because the hospital has high fixed costs, it's possible to increase volume and revenue at very little incremental cost so even if you decrease prices, there can still be a net increase in revenue as hospitals in Arizona have proven.

We have an excellent staff and facilities. The Cancer Center is delivering quality care. We should do everything we can to make care at our hospital affordable for our taxpayers who will be paying for this facility for many years to come.

Mark Spohr, MD, is one of seven candidates for three seats on the Tahoe Forest Hospital District Board of Directors.