They Cut Cancer Research to ZERO (w/ Annabelle Gurwitch) | How to Fix It
Quick Read
Summary
Takeaways
- ❖Lung cancer in non-smokers is increasingly linked to environmental particulate matter from fossil fuels and wildfires, highlighting the critical intersection of health and climate policy.
- ❖The Trump administration allegedly zeroed out DoD funding for lung cancer research for 2025, despite military veterans having 25% higher rates of lung cancer due to toxic exposures.
- ❖State-by-state variations in Medicaid expansion lead to vastly different survival rates for cancer patients, as biomarker testing for targeted therapies isn't covered in 26 states.
- ❖Pharmacy Benefit Managers (PBMs) are accused of 'double-dipping' by not applying patient assistance program funds to deductibles and out-of-pocket maximums, effectively collecting twice from patients.
- ❖The European S2 program, allowing patients to receive covered care across EU borders, offers a model for the U.S. to implement cross-state Medicaid/Medicare coverage.
Insights
1Non-Smoking Lung Cancer and Environmental Toxins
Annabelle Gurwitch, a non-smoker, was diagnosed with stage 4 lung cancer during COVID-19. Accepted science now identifies environmental toxins, specifically particulate matter from fossil fuel emissions and wildfires, as the second leading cause of lung cancer after smoking. This directly links healthcare policy with environmental protection, a connection often ignored by administrations gutting anti-pollution efforts.
Gurwitch's personal diagnosis and subsequent research, citing 'accepted science in the last few years' () and the connection to 'particulate matter in the air' () from 'fossil fuel emissions' and 'wildfires' ().
2Zeroing Out Cancer Research Funding
The Trump administration allegedly cut funding for lung cancer research through the Department of Defense (DoD) to zero for 2025. This is framed as a shocking policy decision, especially given that military personnel have a 25% higher rate of lung cancer due to exposure to toxic chemicals and burn pits, highlighting a hypocrisy in caring for veterans.
Host John Avlon states the Trump administration 'cut funding for cancer research, lung cancer research, cancer research to zero' (), which Gurwitch confirms, specifically noting 'lung cancer funding through the DoD... was zeroed out' ().
3State-Level Disparities in Cancer Treatment Access
Life-saving biomarker-targeted therapies, which have dramatically improved survival rates for cancers like Gurwitch's, are not uniformly available across the U.S. Due to decisions on Medicaid expansion, 26 states do not cover biomarker testing, meaning patients in those states may never know they are eligible for these treatments. This creates significant state-by-state variations in survival rates.
Gurwitch states, 'in the United States there are 26 states where this biomarker testing isn't covered' (), leading to 'lower survival rates' () in states like her birth state, Alabama, compared to California.
4Insurance Companies' 'Double-Dipping' Scheme
Pharmacy Benefit Managers (PBMs), acting as intermediaries for insurance companies, are exploiting a supposed loophole in the ACA. They classify life-saving medications as 'non-essential health benefits' and refuse to apply contributions from pharmaceutical patient assistance programs towards patients' deductibles and out-of-pocket maximums. This forces patients to pay these amounts themselves, allowing PBMs to 'collect twice.' Gurwitch is the named plaintiff in a class-action lawsuit against this practice.
Gurwitch describes how PBMs 'are not applying this' () patient assistance money to deductibles, leading to them 'collect twice' (). She mentions her class-action suit, 'Gurich versus Savon SB Express Scripts and Accredo Health' ().
Bottom Line
Military veterans face a 25% higher risk of lung cancer due to exposure to toxic chemicals and burn pits during service, yet DoD funding for lung cancer research was reportedly zeroed out.
This highlights a profound hypocrisy in political rhetoric about supporting veterans versus actual policy decisions, directly impacting the health outcomes of those who served.
Advocacy groups could leverage this specific data point to pressure lawmakers for increased, dedicated funding for veteran-specific cancer research and treatment, tying it directly to military service conditions.
The 'cancer warrior' trope, while well-intentioned, can be detrimental, pressuring patients to adopt an identity that doesn't align with their personal coping mechanisms or pre-diagnosis self.
This societal expectation can add emotional burden to patients already facing a life-threatening illness, making them feel inadequate if they don't conform to an idealized image of resilience.
Healthcare providers and patient support networks can foster environments that validate diverse coping strategies, encouraging patients to maintain their individual identities and preferences, rather than imposing a 'warrior' narrative.
Key Concepts
The Infraordinary
Coined by French philosopher Georges Perec, this concept emphasizes finding joy and meaning in the daily, mundane aspects of life, rather than solely focusing on grand, 'bucket list' experiences. Gurwitch applies this to long-term illness, advocating for 'durable gladnesses' over exhausting 'carpe diem' pursuits.
The Feynman Technique (Applied to Science Communication)
Inspired by Nobel laureate Richard Feynman, this technique suggests that true understanding of a concept comes when one can explain it simply enough for an intelligent child (or, in Gurwitch's adaptation, one's mother) to grasp. Gurwitch proposes this as a mandatory training for scientists and doctors to combat disinformation and secure public funding.
Lessons
- Advocate for national legislation to mandate coverage of biomarker testing for all cancer patients, ensuring equitable access to precision medicine regardless of state of residence.
- Support efforts to implement a U.S. version of Europe's S2 program, allowing Medicaid and Medicare to cover treatments across state lines, eliminating geographical disparities in care.
- Demand greater transparency and federal enforcement against 'double-dipping' practices by Pharmacy Benefit Managers (PBMs) to prevent them from exploiting patient assistance programs and increasing patient financial burden.
Implementing Cross-State Healthcare Coverage (Inspired by EU's S2 Program)
**Study the S2 Model:** Analyze the operational and financial mechanisms of the EU's S2 program, which allows citizens to receive covered medical care in any EU country, with costs reimbursed by their home country's insurance.
**Propose Federal Legislation:** Draft and advocate for federal legislation that enables Medicaid and Medicare patients to access covered care across state borders within the U.S., particularly for specialized treatments or when local coverage is insufficient.
**Address Interstate Reimbursement:** Establish clear federal guidelines and mechanisms for interstate reimbursement between state Medicaid programs and the federal Medicare system, ensuring seamless financial transfers and preventing administrative burdens on patients and providers.
Notable Moments
Gurwitch recounts being talked into an X-ray by a 'cute doctor' during a COVID test, which unexpectedly led to her stage 4 lung cancer diagnosis, humorously suggesting attractive doctors as a 'fix' for healthcare engagement.
This moment highlights the serendipitous nature of her diagnosis and introduces her unique, humorous approach to a serious topic, setting the tone for her 'cancer slacker' philosophy.
Gurwitch describes her initial 'carpe diem' reaction to her diagnosis, attempting to steal art from the hospital and joking about committing crimes due to losing her fingerprints from medication side effects.
This vividly illustrates the initial existential crisis and the extreme, often humorous, ways individuals might react to a terminal diagnosis before settling into a long-term coping strategy focused on 'durable gladnesses.'
Quotes
"You can't eat and exercise your way to health. Sure, those things help, but there are other factors involved."
"When you see me, it is not positive thinking. It is not ivormectin. It is not this... I am made of pharmaceuticals and caffeine."
"If you are serving in the military, your rates of developing lung cancer are 25% higher than the regular population. So why is that? That's exposure to toxic chemicals and burn pits."
"If scientists and doctors could explain to their parents what it is they're doing and studying and the innovations they're making, we could do this would make them better communicators."
"I'm not going to let cancer rob that from me. Like, you know, I I this is part of what makes me me. This is part of my identity."
"I didn't want to run a marathon before cancer. Do I have to do that now?"
Q&A
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