Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, December 30, 1993                   TAG: 9312300195
SECTION: VIRGINIA                    PAGE: B3   EDITION: METRO 
SOURCE: Associated Press
DATELINE: VIRGINIA BEACH                                LENGTH: Medium

LEGISLATOR WANTS CANCER TREATMENT TO GET COVERAGE

Most insurance companies classify such transplants as experimental and refuse to pay for them. In the procedure, bone marrow is extracted from the patient and replaced with bone marrow uncontaminated by cancerous cells.

"I've had the legislation drafted, and I'm confident this bill will be passed," said Del. David Brickley, D-Woodbridge, chairman of the House Health, Welfare and Institutions Committee.

"It's a real tragedy that the determination of a woman's life is more dependent on who her insurance company is than on who her doctor is," Brickley said.

Blue Cross/Blue Shield of Virginia, the state's largest insurer, will oppose the bill as it did a similar bill last year, said Rod Mathews, a company lobbyist. Blue Cross considers the treatment experimental.

Insurance companies point to incomplete findings by the National Cancer Institute, which remains uncertain about the benefits of bone-marrow transplants.

"It's not completely clear whether or not it does help patients over the long term," said Dr. Michael Friedman, associate director of the institute's cancer therapy evaluation program. "If we thought the question was answered, we would not be sponsoring clinical trials. We don't know the answer."

Blue Cross wants to delay any coverage of such transplants until the institute's study is completed, which will take at least another two years.

Cost is another concern for legislators.

"One of the big problems with health-care costs is all the mandates," said Del. George Heilig, D-Norfolk, who serves on a state commission reviewing mandated benefits. "When you mandate this, you put this in every insurance policy and force all these thousands of people to pay for it."

Heilig, who opposed Brickley's bill a year ago, said he is now undecided. "It's a very emotional issue for families. I don't know what the answer is."

Cost also is an issue for those with breast cancer.

Mary Ella Douglas discovered Blue Cross did not cover the bone-marrow transplant that doctors said she needed to survive.

"I've always had medical insurance, thinking that if you're sick you'll be taken care of," said Douglas, a former marketing director who lives in Virginia Beach.

A fund-raising campaign by family and friends raised about $88,000 to pay for Douglas' transplant.

Advocates say there is evidence that transplants are effective.

The Duke University Medical Center, which has conducted more than 700 transplants for breast cancer over the past decade, found that 72 percent of women with breast cancer lived at least five years cancer-free after the treatment, according to figures compiled by a North Carolina task force.