Blair Horner: New York Undermining Cancer-Fighting Efforts

Feb 12, 2018

The governor has done a lot to promote the state’s program to boost breast cancer screening rates.  He spent considerable time advocating for the expanded program and made it a centerpiece of his 2016 State of the State address and earlier this month issued a news release about his Administration spending nearly $38 million on breast screening services.  But cancer is not only a women’s issue, it affects all of us.

Cancer is the second leading cause of death in America – a close second to heart disease.  According to the American Cancer Society’s estimates, in 2018 over 110,000 New Yorkers will receive a cancer diagnosis and over 35,000 New Yorkers will die from the disease.

Four cancers – female breast, prostate, colon and lung cancers – are responsible for roughly half of the cancers expected in New York State – both in terms of the number of cases and the estimated number of deaths.  Those “big four” drive the state’s cancer experience.

Of course, high rates of cancer occurrence do not necessarily translate to deaths occurring at the same rate.  While female breast cancer is the leading cancer for women, for example, it is not the leading cancer killer.

That “distinction” is reserved for lung cancer.  Lung cancer is far and away the biggest cancer killer in New York State, accounting for roughly one quarter of all cancer deaths.

And that key statistic should drive public policy.  We know that the overwhelming majority of lung cancers result from exposure to tobacco smoke. 

There is no news there.

Using the experiences of states like New York, the federal government has offered blueprints on how to design tobacco control programs to have the most beneficial impact.  And here is where New York’s program starts to slide off the rails.

The CDC recommends that New York State spend roughly $200 million on its tobacco control program.  But New York never has.  In terms of spending on tobacco control, the high water mark was in FY2007-08 when the state spent over $85 million.  But tobacco control spending has declined since 2008.

The program has suffered from devastating cuts during the Cuomo Administration and has lost more than half of its funding from 10 years ago.  New York State was once considered the fifth best in tobacco control efforts; due to these budget cuts, it has tumbled to 22nd. 

What is most inexplicable about this approach is that the state has the money for the program.  It collects over $1 billion in tobacco taxes and other revenues.

In this year’s budget, the Administration is expecting additional revenues from legal settlements with the tobacco companies to total $400 million.

Yet, the governor proposes no new money to fight tobacco use.

In another cancer-fighting area, the state is not improving its efforts.  New York State offers a Cancer Services Program (CSP), which provides breast, cervical and colorectal cancer screenings and diagnostic services at no cost to women and men, typically those that lack health insurance.  If the screening test finds something abnormal, diagnostic (testing) services are available for eligible women and men at no cost.  The CSP will also provide a case manager who will guide someone with cancer through their follow-up diagnostic appointments.

If breast, cervical or colorectal cancer is found, eligible women and men may be able to enroll in the special cancer treatment program to receive full Medicaid health insurance coverage for the entire time they are being treated for cancer.

But that program has never been adequately funded, with experts stating that it only historically offered help to 15 percent of the eligible population.  Even with the expansion of health insurance under the Affordable Care Act, the CSP is still not adequately funded to meet the needs of the uninsured. 

The governor’s budget ignores that best scientific evidence behind cancer screening and instead has consistently tried to cut spending for this important program.  Last year, CSP took a 20 percent reduction in funding.  This year, the governor is not proposing to increase the program’s spending to meet the state’s needs. 

As lawmakers move ahead on developing a final budget, they should make sure that new revenues are added to the state’s tobacco control and cancer screening programs.  Not only is it the right thing to do, those investments will save lives down the road. 

Blair Horner is executive director of the New York Public Interest Research Group.

The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.