Delaware is a unique state—it’s small, our politicians are readily accessible, and we are pioneers in getting legislative priorities moved forward.
—Jon Strasser, MD
Although the state of Delaware comprises just 2,489 square miles, giving it an area ranking of 49 out of 50 states, its small size gives its population of nearly 1 million an advantage many larger states do not have: ready access to local politicians to address complex issues such as improving cancer care. At the forefront of that effort is the Delaware Society for Clinical Oncology.
Since its founding in 1994, the Society has worked with state legislators to advocate for better cancer care and develop strategies to reduce the state’s cancer mortality rate, which is much higher (193.5 per 100,000 persons) than the national average (183.8 per 100,000 persons).1 Nevertheless, recent improvements in access to cancer screenings and cancer treatments are resulting in declining cancer death rates.
Recent legislative accomplishments should also help increase patient accessibility to cancer care and improve outcomes. Last year, the Society was instrumental in getting Delaware’s Oral Chemotherapy Parity bill signed into law with bipartisan, unanimous support. The Society also worked with Representative John Carney (D-DE) to address the problem of chemotherapy drug shortages in the United States and had another success in 2012 with the reauthorization of the Prescription Drug User Fee Act.
The ASCO Post talked with Jon Strasser, MD, President of the Delaware Society for Clinical Oncology, about the Society’s legislative successes, the ongoing challenges it faces, and its future goals.
Affiliation with ASCO
Why is it important for your Society to be an ASCO state affiliate?
ASCO supports many of the issues that are important to us and gives us a backbone for collaboration with other states in terms of influencing public policy, both on a state and national level. Delaware is a unique state—it’s small, our politicians are readily accessible, and we are pioneers in getting legislative priorities moved forward. We see the accomplishments other states have made in providing better care for patients with cancer, and we try to adopt things we think might fit best for our patients.
Challenges and Strengths
What challenges do you face that are unique to your community and oncology practice?
We are still struggling with improving the health of our population. We have high rates of smoking and obesity and high incidences of cancer, as well as continued high cancer mortality rates. I think we have risen to those challenges, and we are starting to see the results of our efforts with significant reductions in cancer mortalities. Although Delaware’s cancer mortality rates still exceed the national average, we have dropped from having the highest national mortality to number 14, and our mortality rates are dropping at two times the national average.
As a Society, we do a lot of community outreach to support programs that affect our patients’ health. With support from the Society, our state created the Delaware Cancer Treatment Program, which provides uninsured cancer patients with 2 years of coverage through Delaware Medicaid policy and was funded by our state’s share of the tobacco settlement. It is open to those cancer patients who are uninsured with incomes up to 650% of the federal poverty limit.
We’re also involved in making sure our patients have access to high-quality care and support the practice of state-of-the-art, evidence-based medicine. The majority of our members are involved in the Helen F. Graham Cancer Center at Christiana Care Health System in Newark, which is the dominant cancer center in Delaware, and we all participate in multidisciplinary clinics and in managing patients in a multidisciplinary format.
We are strong leaders in advocating multidisciplinary care, and that has probably had the biggest impact in terms of reducing cancer mortality in our state. We also have extremely high enrollment into national clinical trials. And because of our reputation, we have been very successful in attracting top-notch oncology clinicians to Delaware, which is enormously helpful.
Your Society is very active legislatively. What are your current areas of concern?
We try to focus on promoting good policy that impacts our patients positively. When it comes to health-care reform, a lot of the issues we grapple with involve how to make care more efficient and more cost-effective. On a local level, we are interested in making sure our patients have access to care, and we supported the Delaware Cancer Treatment Program, so patients don’t have to worry about how they’re going to pay for their care. We’re trying to minimize the stress in our patients’ lives, so they can focus on getting well.
What are your immediate goals?
We are primarily working on improving health-care access for patients. Our next goals are to consider how the Affordable Care Act will impact cancer care and how we, as leaders in our state, can make health care more cost-effective. We want to be participants with a voice in these issues and, at the same time, make sure that any reforms don’t sacrifice the ability of our patients to get the high-quality care they need. ■
Disclosure: Dr. Strasser reported no potential conflicts of interest.
1. Department of Health and Social Services: Cancer Incidence and Mortality in Delaware: 2003-2007. Issued March 2012. Available at dhss.delaware.gov/dhss/dph/dpc/cancer.html. Accessed May 2, 2013.