Shouldn't the "free market" decide?

Something seems very fishy about a company that appears to have directly lobbied the legislature for a special favor. If it's as great as they say it is, why the need for legislative intervention?

The Journal of Clinical Oncology notes:

Because of the high capital cost of a proton therapy facility, when a hospital invests in a proton therapy center (or any other expensive new technology), it takes a very substantial financial risk. It has likely elected to reduce its investment in other important areas of health care, it needs to amortize its costs rapidly, and it needs ultimately to generate a profit. Thus, the use of protons becomes as much a business decision as a clinical one; creditors and investors may drive the utilization and potentially the patient mix.

The National Cancer Institute on PT:

The position of those at NCI is that, while this technology is Experts at NCI and around the country also point out that there is a lack of published randomized controlled trials (RCT) to show that proton therapy works better than standard radiation therapy at increasing survival or improving quality of life for patients.

They go on to note that even though the beams are more precise ("thinner" as it were), they are questions of precision (are you hitting the target, or has the patient and/or target organs moved?). The "wider" traditional radiation beams allow for some positioning error, while a proton beam could miss entirely if the patient or target tumor moves slightly.

The bill comes just three months after the opening of the $115 million Provision Center for Proton Therapy in Knoxville.

The center was developed by a long-time friend of Governor Bill Haslam, Dr. Terry Douglass. Haslam attended the dedication for the center in 2012 and talked about his friendship with Douglass.

"I was trying to think how long we've been friends," Haslam said. "I think Terry and Crissy and I became friends about 30 years ago, I'm afraid to say."

But Douglass told a House subcommittee last week the non-profit cancer center is not financially viable unless private insurance companies cover proton therapy.

While the facility is non-profit, our investigation discovered Dr. Douglass also has a substantial amount of his personal money involved in the center. A spokesman said he loaned the project $42 million.

"We spent $115 million assuming that would happen, assuming there would be private care reimbursement," Dr. Douglass told lawmakers.

What kind of business person invests at such risk without a business plan that shows a market? He goes crying to his friend Bill, "you have to pass this law for me buddy, or I'll go broke! ?????

The irony of every conservative in Nashville opposed to Obamacare because the "government is forcing them to buy a product" is just too... I dunno.. ironic?

In the interest of fairness, it should be noted that at the very end of the original article, there's this:

After our questions Gov. Haslam said, through a spokesman, that he is opposed to the bill.

Really, though, the thing that is truly offensive about this legislation is the fact that the sponsors of this bill see no irony in their actions. They cry that an insured patient should have affordable access to proton therapy treatment if they want it, but they couldn't give a rat's derriere about the hundreds of thousands of Tennesseans who can't get affordable access to any medical treatment if they need it. They think it's a fine idea to mandate that insurance companies cover this specific technology, regardless of proof of efficacy or future cost, but they won't expand Tenncare (100% paid for by the feds for three years, and 90% after that) because it will cost too much and freedom!

So what does the bill adress regarding dental insurance, dental standards, etc?

Probably nothing.

It's likely being used as a "caption" bill with language vague enough to be expanded into almost anything that involves x-rays and such.

(link...) emails

and omg... "medical tourism..."

(link...) new story

(link...) lobbyist

Just last year, the center pushed a bill that would put the University of Tennessee on the hook for $98 million if the project failed.

I'm going to try to research his statement that Blue Cross "in most other states" already covers PT.

Blue Shield of California, which sent a letter this week to 300 radiation oncology and urology practices in the state, advising them that the company will stop covering the procedure at the end of October;
Aetna, which stopped covering the procedure on Aug. 1; and
Regence—a Blue Cross Blue Shield insurer in the Northwest—which stopped covering the procedure three years ago.
The three insurers join Highmark and Blue Cross Blue Shield of Kansas City, which have long-standing positions against the procedure. Meanwhile, Cigna plans to review its coverage policy later this year.

(link...)