Kristine M. Conner
University of Pennsylvania Cancer Center
Last Modified: October 24, 2000
Speaking this morning before a nearly full ballroom of ASTRO attendees, Massachusetts senator Edward M. Kennedy asserted that he will continue to be a pro-patient, pro-physician, and pro-research voice in our nation's Congress. Kennedy first expressed pride in the important role that Massachusetts academic centers, biotechnology companies, and medical institutions have played in improving our understanding of cancer and its treatment. But with the presidential election less than two weeks away, the senator quickly turned his attention from state-level accomplishments to some of the more pressing health care-related issues affecting this nation as a whole, such as health insurance coverage, patients' rights, access to adequate health care services, and pending related legislation.
Kennedy has a long history of both supporting and even orchestrating legislation that widens citizens' access to health care and promotes the drive for more medical research. For instance, he was a major supporter of the National Cancer Act of 1971, which affirmed the nation's commitment to finding more answers about the disease, and more recently has been a vocal supporter of the Patients' Bill of Rights still pending in Congress.
The senator praised his audience for their role in the major accomplishments of the past three decades, noting that ?newer and more detailed cell imaging techniques? and "new ways to direct radiation therapy and spare healthy cells" are already making a real difference in patients' lives. Emphasizing that Boston institutions have received the most funding from the National Institutes of Health for the sixth year in a row, Kennedy said he feels that "the Massachusetts medical and bioimaging community is uniquely positioned to lead the way in cancer research."
"There are many who think that this will be the century of the life sciences," Kennedy said. "I do."
At the same time, he expressed concerns that too many people are being left behind even as terrific progress is being made. "Everyone should share in the benefits," Kennedy asserted. "In this economic situation, we should be able to guarantee access and coverage for all Americans."
Access to services is a major problem for many Americans, but especially for ethnic minorities and rural populations. Kennedy cited a litany of statistics to show that the burden of serious diseases such as cancer falls disproportionately on these groups. He said that such "unacceptable disparities" are demonstrated by the fact that African-Americans have a 35 percent higher cancer death rate than whites do. Black men are also twice as likely as white men to die from prostate cancer. African-Americans and Hispanics in general are more likely to be diagnosed with cancer at a more advanced stage than white Americans are. Where one lives, Kennedy added, is likely to affect the quality of care one gets. As an example, he noted that rural Appalachian populations are more likely to die of conditions such as heart disease and cancer because appropriate care is not available to them.
"Poverty contributes to this," Kennedy stressed, "and we must overcome this and other barriers to proper care. We must provide needed resources for data collection and research that can help us accomplish this."
Certainly one of the most important barriers is health insurance coverage, which has become a highly charged political issue during this election season. "Lack of health insurance is the seventh leading cause of death in the United States," Kennedy said, noting that roughly 43 million Americans are now without any form of health insurance. While there are no easy solutions, he argued that "an important intermediate step" is to expand coverage for lower-income families. He expressed support for Al Gore's plan to expand the Children's Health Insurance Program to include their low-income parents, should he be elected in early November.
Kennedy also spent time discussing two key pieces of legislation now pending in the Congress: the Patients' Bill of Rights and the Pain Relief Promotion Act. First, he expressed frustration at the fact that the Senate has not yet passed the former-mainly due to blockage by the Republican leadership, he noted-even though the House of Representatives passed it with a bipartisan vote. Kennedy said that one of the major arguments holding up the bill is the call for a closer look at clinical trials and how coverage for them should be addressed. He said that he sees this argument as a reflection of the growth of HMOs and the general movement away from coverage for clinical trials for patients who want to participate. Kennedy disagrees with the argument.
"This in unconscionable," he said. "We need to pass the Patients' Bill of Rights right now. Every day we delay, thousands of Americans are forced to go without the care they deserve and that they have paid for in their premiums." Kennedy also said he believes that this will be the first bill taken up on the Senate floor if Al Gore is elected president.
"This bill is endorsed by 300 medical organizations," he added, "and not a single one supports the Republican version."
Kennedy went on to stress that he does not support the Pain Relief Promotion Act sponsored by Republican Senator Don Nickles. Predicting that this bill will be on the national agenda in the next Congress, Kennedy urged his audience to make their views known to their local representatives. He explained that the bill would give the federal government the authority to investigate physicians who prescribe controlled substances for pain, particularly in cases where the patient dies soon afterward. In other words, the Drug Enforcement Administration would have the power to investigate whether the intent was to relieve pain or to help the patient die. It also could step in to determine whether a given amount of controlled substances was justified. Kennedy said that this portion of the bill was fueled in part by the controversy over the recently passed Oregon law permitting physician-assisted suicide.
Kennedy added that he would rather see more money allocated for the education of physicians and other health care providers on the effective use of pain medications for palliative care. The bill does provide for this, but the senator would like to see even more emphasis on education (in terms of dollars allocated) and less on the potential regulation of physicians by the federal government.
"I oppose any legislation that threatens to interfere with the physician-patient relationship," Kennedy said, "and I hope we can find a compromise on this issue."
"You deserve better from Congress in the years ahead," he added.