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

DATE: FRIDAY, April 15, 1994                   TAG: 9404150080
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A9   EDITION: METRO 
SOURCE: Associated Press
DATELINE: WASHINGTON                                 LENGTH: Medium

INSURANCE DICTATES LIFESAVING OPERATIONS

Economic barriers, such as a lack of health insurance, deny some leukemia patients lifesaving bone marrow transplants or delay such care until it is too late, Congress was told Thursday.

Dr. Mary M. Horowitz, scientific director of the International Bone Marrow Transplant Registry, said that even if there is health insurance coverage, leukemia patients often have to wait weeks or months to get approval for the procedure from insurance companies.

And for some types of leukemia, those delays are potentially lethal, she testified before a House Ways and Means subcommittee.

``If there were not economic barriers, these transplants would be done much more quickly,'' said Horowitz, a Milwaukee blood expert who performs about 50 marrow transplants a year.

The physician was called to testify about two General Accounting Office reports that compared the quality of health care in the United States with the care given in other countries with different health-care systems.

One study compared survival rates for four types of cancer in the U.S. with rates in Ontario, when the Canadian government pays all health bills.

The results show that survival rates for the more expensive U.S. system were roughly equal to that of Canada for three types of cancer. The U.S. system had slightly longer survival rates only for breast cancer, the study showed.

A second study examined the availability of bone marrow transplants in the treatment of leukemia in 10 industrialized countries, including the United States. By almost all standards, the United States was far down the list, the studies found.

For example, in the treatment of chronic myeloid leukemia, which can be cured only with bone marrow transplant, U.S. patients had only one chance in three of getting the therapy. The United States ranked seventh out of the 10 nations in this measure.

In Sweden, the United Kingdom, New Zealand and Denmark, all with medical care delivery systems different and cheaper than the U.S. system, a patient had about one chance in two of getting the marrow transplant.

by CNB