The legislation that wasn’t

There’s been a significant amount of kerfuffle over legislation at the Wisconsin State Capitol that has passed over the last year, but yesterday we found some disheartened individuals because of some legislation that never received a public hearing.

Lawmakers for the second time cancelled a proposed hearing into the measure designed to treat chemotherapy administered orally or through pill form in the same fashion as chemotherapy that’s given through an IV at a medical center.

Supporters assert the issue is one of parity and that doctors and patients should decide the best form of cancer treatment not the insurance companies. Critics had labeled the measure another government mandate in the area of health care that would raise costs for other consumers.

Current Wisconsin law views IV chemotherapy as a medical treatment and oral chemotherapy as a prescription drug benefit. Usually, the former is covered more comprehensively than the latter, leading some cancer patients who have been undergoing chemotherapy in pill form to pay tens of thousands of dollars out-of-pocket for the medicine.

“We can understand that’s a difficult issue, but the issue underlying the problem is the high cost of prescription drugs and the legislation that’s been proposed doesn’t do anything to address that,” said Phil Dougherty, who works for the Wisconsin Association of Health Plans. “What happens if the cost that was borne by a few individuals gets moved into the costs for others, those costs are going to go up.”

Cancer patients who had lobbied for the measure said the idea of not undergoing a treatment that would be best for them because of how much it costs is unfair.

“It’s something that I don’t think most people would think about when they took out their policy,” said Lyle Drier, a cancer patient who had to pay $35,000 to treat her disease with an oral chemotherapy since her insurance didn’t cover it. “To me, if you have to have chemotherapy, it shouldn’t matter how it’s delivered, it should all be paid for the same way if your policy covers (chemotherapy) in the first place.”

We will explore this issue further on next Friday night’s Here and Now.

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