Fix critical health care program for the needy

I recently read a story about a program called Operation Cat Drop.This World Health Organization (WHO) program in the 1950s dropped cats, via parachute, onto the small island country of Borneo to control the rat population.While it is widely accepted that the program was a success, it was only necessary because the rat population grew due to native cats dying because of the chemical agent DDT, which was sprayed by WHO to control the mosquito infestation.There are many lessons one can take away from this, but the biggest might be the effect of unintended consequences. It’s what brings me to the 340b program.

The 340b program was created more than 30 years ago to allow covered entities such as rural clinics, children’s hospitals, and various community health centers to purchase outpatient drugs at a significant discount.The vote to create the program was overwhelmingly supported by both parties, including Arizona’s Republican Senator John McCain and Democrat Senator Dennis DeConcini, who both voted in favor of it.

The program was a success early, with the Ryan White HIV/AIDS Clinics a shining example of the program’s potential.But unfortunately, the 340b program over time started to become more opaque and often abused.A well-known example of this is when the University of Miami’s UHealth system, which participates in the 340B program, used revenue from their health system to help pay the salary of the University of Miami football coach.There are numerous other examples of underinsured or low-income patients being turned away from 340b hospitals, despite these hospitals receiving millions of dollars to treat patients just like these.

I recently read a story on the 340b program as it relates to prostate cancer care. It was disappointing to read that the program has not had the type of impact on treating prostate cancer patients as one would hope.That isn’t to say that the program hasn’t provided care.It is only to say that the original intent of the 340b program to serve the underserved and treat the undertreated, has come up short.

The House Energy & Commerce Oversight and Investigations subcommittee (which counts Arizona’s own Debbie Lesko as a member) held a hearing on June 4 to talk about the shortcomings of the 340b program and the subcommittee chairwoman, Cathy McMorris Rodgers, R-Wash., said something especially concerning to cancer patients.She said, “the New England Journal of Medicine found that the program further incentivizes hospital systems to acquire independent oncology practices, so that they can expand their 340B footprint. Some will argue that hospitals reinvest these savings in ways consistent with the intent of the program, but there’s little evidence to prove this.” It’s yet another example of ways this program has veered off the track.

Now that we’ve identified the problems, it is time for Congress to come up with an answer.Fortunately, there are several bills aimed at bringing greater regulatory oversight and federal guidance to the program. They’ve been introduced before but have unfortunately fallen victim to special interests which thrive in the current ambiguity of the system.My hope is that there is momentum, especially after the recent subcommittee hearing. We will see.

The fact is that we need an “Operation Cat Drop” for the 340b program. It's time for Congress to shine a light on the program and bring some much-needed transparency to it.Reforming it to get it back to its intended purpose should be the first priority. Recently introduced bills like the 340b ACCESS Act (H.R. 8574) give groups like mine hope that there are corrective measures on the horizon. I hope that Arizona’s leaders will work together to create the solutions needed to help the in-need patient populations of Arizona and the rest of the country.

Bruce Williams is president of the Arizona Prostate Cancer Coalition.

 

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