Legislature(2005 - 2006)BUTROVICH 205

04/28/2006 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 281 SCHOOL DIST. ENROLLMENT SHARING/CORRESPON TELECONFERENCED
Scheduled But Not Heard
+= HB 442 HEALTH CARE DECISIONS TELECONFERENCED
Moved CSHB 442(JUD) am Out of Committee
+= SB 287 POSTSECONDARY TUITION FOR FOSTER CHILDREN TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
= HB 393 INSURANCE FOR COLORECTAL CANCER SCREENING
Moved SCS CSHB 393(HES) Out of Committee
  SCS CSHB 393 (HES)-INSURANCE FOR COLORECTAL CANCER SCREENING                                                              
                                                                                                                                
2:31:37 PM                                                                                                                    
CHAIR  DYSON   announced  SCS   CSHB  393(HES)   to  be   up  for                                                               
consideration.                                                                                                                  
                                                                                                                                
EMILY  NENON,  Alaska  Government  Relations  Director,  American                                                               
Cancer Society, said  that she had spoken  with committee members                                                               
and staff in  advance to ensure that her  testimony would address                                                               
all of the questions that they  might have, but that she would be                                                               
happy to answer any additional questions that might arise.                                                                      
                                                                                                                                
She  said  that   when  Heath  Hilyard  presented   the  bill  on                                                               
Wednesday,  he talked  about the  fact that,  if colon  cancer is                                                               
identified before  symptoms appear,  there is  a greater  than 90                                                               
percent survival rate.                                                                                                          
                                                                                                                                
According to  Cancer Facts  and Figures  2006, which  publishes a                                                               
five-year average  of cancer incident  rates, Alaskan  women have                                                               
had the  highest colon cancer  rate in  the nation over  the past                                                               
five years. The rate of colon  cancer in Alaskan Native people is                                                               
nearly double that of the U.S. white population.                                                                                
                                                                                                                                
2:33:54 PM                                                                                                                    
MS.  NENON said  that  this bill  provides  guidelines for  colon                                                               
cancer screening. For the general  population, anyone over age 50                                                               
should be  screened, but  people are  generally not  eligible for                                                               
Medicare  until age  65, which  leaves a  15-year window  of time                                                               
when  screening  is  recommended  but   may  not  be  covered  by                                                               
insurance.                                                                                                                      
                                                                                                                                
The Institute of Medicine reports  that the death rate from colon                                                               
cancer could drop by up to  80 percent if a majority of Americans                                                               
were screened  regularly. The current  annual expenditure  in the                                                               
United  States on  colorectal cancer  health care  costs is  $6.5                                                               
billion and part of  the reason for that is that  it is not being                                                               
identified early enough.                                                                                                        
                                                                                                                                
The New England Journal of  Medicine published an article in July                                                               
of  2004  called "The  Price  tag  on  Progress," that  is  about                                                               
chemotherapy  for colorectal  cancer.  It states  that "the  near                                                               
doubling of  the median survival  achieved over the  past decade,                                                               
has been  accompanied by a  staggering 340 fold increase  in drug                                                               
costs" just for the initial  eight weeks of treatment. Assuming a                                                               
patient continues to  receive treatment until the  median time to                                                               
progression, eight  months of front-line therapy  followed by 4.1                                                               
months of Cetuximab and Irinotecan therapy would cost $161,000.                                                               
                                                                                                                                
2:37:22 PM                                                                                                                    
CHAIR DYSON  said that the issue  the committee has to  decide is                                                               
whether or  not to mandate  that insurance carriers  provide this                                                               
service to their clients between the ages of 50 and 65.                                                                         
                                                                                                                                
MS. NENON  said that is  correct, and  that 18 other  states have                                                               
already taken  this action. She recognizes  that state government                                                               
doesn't  regulate  every  insurance  plan,  but  sees  it  as  "a                                                               
critical  piece  of  the puzzle."  The  American  Cancer  Society                                                               
worked hard to get Medicare  coverage for screening added in 2001                                                               
and, working with federal employee  health benefit plans over the                                                               
past three years, has increased  the number of federal plans that                                                               
cover the  full range  of colon  cancer screening  from 25  to 70                                                               
percent.                                                                                                                        
                                                                                                                                
2:38:37 PM                                                                                                                    
SENATOR  OLSON asked  how this  would decrease  the incidence  of                                                               
colorectal  cancer  among  Alaskan Natives,  particularly  women,                                                               
when they are  dealing with issues such as a  lack of clean water                                                               
and inadequate sewage treatment.                                                                                                
                                                                                                                                
MS.  NENON  responded  that  DHSS   has  been  working  with  the                                                               
Comprehensive  Cancer   Control  (CCC)  partnership  to   form  a                                                               
colorectal  cancer joint  task force  between  the Alaska  Native                                                               
Tribal Health consortium and the  state's CCC program to consider                                                               
those  issues.  They are  looking  at,  among other  things,  the                                                               
possibility  of sending  gastrointestinal doctors  from Anchorage                                                               
to regional hospitals to do mass screenings.                                                                                    
                                                                                                                                
SENATOR OLSON asked whether these  would be private physicians or                                                               
doctors from  Alaska Native Medical  Center (ANMC) and  who would                                                               
be paying for it.                                                                                                               
                                                                                                                                
MS. NENON responded that it would  be a joint effort and they are                                                               
still working on the funding,  but that some doctors in Anchorage                                                               
have  offered to  donate their  time.  They anticipate  receiving                                                               
some regular reimbursement for those procedures.                                                                                
                                                                                                                                
SENATOR OLSON  commented that he  assumed these  physicians would                                                               
be gastrointestinal internists who  have already been trained and                                                               
are not going out for the experience.                                                                                           
                                                                                                                                
MS. NENON replied yes.                                                                                                          
                                                                                                                                
2:40:48 PM                                                                                                                    
SENATOR WILKEN  said that most of  the committee is of  an age to                                                               
consider  this issue  seriously and  commented on  an article  he                                                               
read  about  a month  ago  in  Scientific  American about  a  new                                                               
digital  screening  procedure  that   may  replace  the  existing                                                               
sigmoidoscopy and colonoscopy within the next 10 years.                                                                         
                                                                                                                                
MS. NENON said that she is looking forward to that.                                                                             
                                                                                                                                
2:42:23 PM                                                                                                                    
SENATOR WILKEN moved  to report SCS CSHB  393(HES) from committee                                                               
with individual recommendations.                                                                                                
                                                                                                                                
SENATOR GREEN  said that she  did not object, but  was indisposed                                                               
to introduce anything that is a mandate on anyone.                                                                              
                                                                                                                                
CHAIR DYSON agreed that it presents  a real concern for him also,                                                               
particularly when he considers  the insurance companies' previous                                                               
remarks about this matter.                                                                                                      
                                                                                                                                
SENATOR GREEN  commented that, unlike  the lower 48  states, when                                                               
the  legislature  makes a  law  in  Alaska that  impacts  private                                                               
programs and plans, a large part  of the state is not impacted by                                                               
it.                                                                                                                             
                                                                                                                                
CHAIR  DYSON  announced that  without  further  comment SCS  CSHB
393(HES) was reported from committee.                                                                                           

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