Jan. 14--U.S. Rep. Rosa DeLauro, D-3, has reintroduced legislation that would end the practice known as "drive-through mastectomies," where women are forced to leave the hospital sometimes only hours after breast surgery.
First introduced by DeLauro in 1996 and resubmitted last week at the start of the 112th Congress, the Breast Cancer Patient Protection Act would ensure that breast cancer patients who have had a mastectomy or lumpectomy are able to remain in the hospital for up to 48 hours after surgery.
The measure passed in the House of Representatives in 2009 by a vote of 421-2, but did not get to the floor of the U.S. Senate, according to a Congressional aide. The bill already has bipartisan support, she said.
With an estimated 207,090 new cases of invasive breast cancer found in American women last year, DeLauro said it is critical that they receive the care they need. The act would give patients and their doctors more control over treatment decisions, she said.
It would also ensure that women who have a mastectomy or lumpectomy for treatment of breast cancer have access to secondary medical opinions, and are ensured coverage of radiation therapy should they choose to have a lumpectomy. It also mandates a third party reviewing process before an insurance company would be able to rescind an insurance policy.
"To imagine women coming out of surgery, still in pain and groggy from anesthesia, and being told to leave the hospital is simply unconscionable," said DeLauro, a cancer survivor. "Breast cancer treatment surgery is surgery, and should be taken seriously. I have worked with insurance companies to end these callous policies, but piecemeal changes are not enough. The Breast Cancer Patient Protection Act will ensure that this basic consumer protection is guaranteed to women across the country, no matter what insurance they have, and is simply the right thing to do."
Local breast cancer advocates say they support the bill, which would benefit breast cancer patients nationwide.
Anne Morris, executive director of the Connecticut affiliate of Susan G. Komen for the Cure, said that legislation was passed in Connecticut in 1997 that mandates insurance coverage for at least a 48-hour hospital stay following a mastectomy or lymph node dissection. If DeLauro's bill passed, then breast cancer patients would be helped nationwide, she said.
"We're fortunate to have it here in Connecticut. We fully support it," Morris said. "Obviously we used to be subjected to the same problem many other women are still facing."
Dr. Denise Barajas, director of the Women's Center for Breast Health at the Hospital of Saint Raphael, said that serious complications can occur when a patient is sent home too soon. "Certainly the bill doesn't call for everybody to stay in the hospital for 48 hours, but to have the option" with a patient and her doctor making the decision, Barajas said.
In other parts of the country, women are having to choose mastectomy because they don't have access to radiation therapy coverage because of where they live, she said.
The bill would prohibit insurance plans from restricting benefits made by doctors and their patients to a stay that's less than 48 hours for mastectomy or breast conserving surgery and less than 24 hours for a lymph node dissection, the aide said.
In testimony on the floor of the House in 2009, DeLauro referred to women in other parts of the country who were released hours after surgery and then suffered from infections. She originally decided to introduce the legislation because Dr. Kristen Zarfos, a Connecticut breast surgeon, told her that HMOs were forcing her to discharge her patients before they were ready.
"This bill does not mandate a 48-hour hospital stay if a patient chooses to go home sooner, nor does it set 48 hours as a maximum amount of time a woman can stay in the hospital. It simply ensures that any decision in favor of a shorter or longer hospital stay will be made by the patient and her doctor, and not an insurance company," DeLauro testified.
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