Making Cancer Care Great Again

Michael L. Millenson

Michael L. Millenson, President of Health Quality Advisors LLC and an Adjunct Associate Professor of Medicine at Northwestern’s Feinberg School of Medicine

Q: Donald Trump’s campaign for the presidency included a promise to repeal “Obamacare” in its entirety. If he succeeds in fulfilling that promise, what impact can we expect on American cancer prevention and cancer treatment?

A: Donald Trump, emboldened by eliminating ISIS, ending illegal immigration and energizing the economy, will eradicate cancer. Or at the very least, I predict, he will append it to his list of promised achievements as president.

Our current chief executive, dubbed “No Drama Obama” by his staff during the 2008 campaign, couldn’t resist the heady promise of a cancer “moonshot.” Trump, who’s declared, “I will take care of ISIS,” “close up those borders” and “jump-start America,” will likely rev up the rhetoric back to Nixonian “War on Cancer” levels.

A candidate whose campaign centered on his personal pledge to “make America great again” will surely be galvanized by the chance to make cancer care “great,” too.

The current Cancer Moonshot initiative, featured in President Barack Obama’s last State of the Union Address, is codified in a presidential memorandum of Jan. 28, 2016 and placed within the Office of the Vice President. While fighting cancer was of deep personal interest to Vice President Joe Biden, Vice President-elect Mike Pence was governor of Indiana, where pharmaceutical giant Eli Lilly has a major portfolio of oncology products. Coincidentally, Lilly in October introduced a new version of its PACE Continuous Innovation Indicator (CII), a customizable, online tool to review progress against cancer in order to inform public policy and accelerate innovation.

The current executive director of the Cancer Moonshot initiative, Greg Simon, was an aide to former Vice President Al Gore. But Simon is also a cancer survivor and entrepreneur who once worked for New York City-based Pfizer. He came to his current post from FasterCures, a foundation whose work has strong support among Congressional Republicans.

Whether enthusiasm for anti-cancer combat entails increased funding remains to be seen. However, a Trump administration may downplay cancer prevention. Recent research among a population of mostly white Americans aged 25 to 79 found that lifestyle changes related to smoking, drinking, diet and physical activity can reduce the risk of dying from cancer by 14 to 61 percent. Given the central role played in Trump’s electoral triumph by a working class population more prone to those behaviors, I wouldn’t expect a lot of new government nagging.

And while the Centers for Disease Control and Prevention has recommended that pre-teens be vaccinated against the HPV virus, linked to a series of cancers transmitted through sexual activity, I wouldn’t expect this to be an area where President Trump speaks out publicly, either.

Some current cancer patients are reportedly “frantic and scared” that Trump’s vow to ax Obamacare (a/k/a the Affordable Care Act) will sweep away its ban on lifetime dollar limits on coverage and its protection against denying coverage to those with pre-existing conditions. Trump has said he plans to keep both those prohibitions, but those who are sick remain worried. If the provisions are repealed, said a 32-year-old mom with breast cancer, “I can’t afford treatment and I die.”

Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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