Health News Review

“When it comes to reining in health care spending, it still seems like each hospital administrator thinks the guy at the other hospital should do it.”  That was the lead, as Jenny Gold of Kaiser Health News reports that two Washington,DC hospitals – three miles apart – are building expensive proton beam radiation centers for cancer treatment. The two – Johns Hopkins’ Sibley Memorial Hospital and MedStar Health’s Georgetown University Hospital – will also compete with another new facility in downtown Baltimore – about 40 miles away. She explains:

“While the treatment has shown promise for treating brain and spinal tumors in children, the Hopkins facility is explicitly banned from treating pediatric cancers. That’s because Sibley Memorial Hospital doesn’t have a pediatric unit, nor does it have a permission from the city to build one.

(The 3 centers) will all have to turn to treating adult cancers — largely prostate cancer, for which proton therapy hasn’t been proved to improve results for patients or to reduce side effects — to stay profitable.

“Neither [Hopkins nor MedStar] should be building,” says Dr. Ezekiel Emanuel, a former health care adviser to the Obama administration who is now at the University of Pennsylvania. “We don’t have evidence that there’s a need for them in terms of medical care. They’re simply done to generate profits.”

The higher costs of proton services ultimately trickle down to taxpayers, employers and consumers in the form of higher health insurance premiums.

“It’s hard to bend the cost curve when you’re spending a lot of money,” says Emanuel. “These are tens if not hundreds of thousands of dollars in treatment for interventions that do not improve survival, improve quality of life, decrease side effects or save money.”

There are already 11 proton therapy centers in the U.S., and the Maryland Proton Treatment Center in Baltimore is one of 17 more on the way.

Former Boston medical center CEO Paul Levy wrote on Twitter, “Here they go again.”

In a New York Times editorial last year, Ezekiel Emanuel and Steven Pearson referred to the proliferation of proton beam therapy facilities as “crazy medicine and unsustainable public policy.”

If you missed it, Johns Hopkins Medicine also this week sent out a news release about its robotic surgery system.

We’ve written many past posts about questions of “the medical arms race” concerning both robotic surgery and proton beam therapy.

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Comments

Leonard Arzt posted on June 1, 2013 at 11:27 pm

Gary, guess what? The “medical arms race” is over. Proton therapy won. So did cancer patients in
the greater Washington, D.C. area (actually the folks in Baltimore prefer not being used in the same sentence as Washington), so did cutting edge radiation technology and medical innovation. I know it may be unsettling to you, including the idea that the nation needs a medical “arms race” to beat cancer, but physicians have always looked for ways to use radiation to treat cancer for more than 100 years. It’s a medical arms race we can not afford to lose.

    Gary Schwitzer posted on June 2, 2013 at 8:55 am

    Leonard,

    Guess what? Your response is predictable, given that you make your living promoting the proliferation of this technology.

    Will you/did you write to Kaiser Health News, NPR and to Paul Levy and to anyone who questions the evidence base for such proliferation?

      Leonard Arzt posted on June 2, 2013 at 9:42 am

      Gary, Of course. Like you say, that’s my mission. And I’m glad you acknowledge my response is predictable. Of course, so are you predictable. Lets be unpredictable next time.

      Gary Schwitzer posted on June 2, 2013 at 12:19 pm

      And my mission – pursued through a 40-year career in health care journalism – is to improve the public dialogue about health care. Our project tries to help people improve their critical thinking and analysis of claims about health care interventions. I am not paid by any drug or device manufacturer.

      I am going to end this thread because:

      A. I am traveling and not tending to the site frequently in the near future.
      B. The thread has become predictable.