January 11, 2019 | USA Today
Zeke Emanuel & Justin Bekelman: Unproven medical treatments cost us lives and money. Let research tell us what works.
Late last year, an Oklahoma jury awarded $25.5 million to Orrana Cunningham's husband. In 2014, she had nasopharyngeal cancer growing behind her nose. Her doctors recommended proton therapy, a type of radiation treatment, but Aetna refused to pay. She created a GoFundMe campaign and mortgaged her home to pay $92,082. Unfortunately, Mrs. Cunningham died within months from complications of her cancer. Jurors condemned Aetna, saying it acted “recklessly” in its review and delay of her care, and that it “should’ve paid for the treatment.”
As oncologists we feel the heartbreak and tragedy of Mrs. Cunningham’s death at age 54. But her case raises an important societal question: Should Americans, through health insurance companies or government programs, pay for costly treatments that have not been shown to be more beneficial or less harmful than standard treatment, just because a physician prescribes them or a patient wants them? At stake are the health of millions of Americans with complex and debilitating illness, billions in health care costs, the affordability of health insurance, and data-driven medical care.