STAT, June 2, 2017
Max Blau



Taxpayers in Louisiana are helping to subsidize construction of two health care centers offering a divisive cancer treatment — even as state lawmakers prepare to cut millions from basic health services.

The treatment is called proton therapy, and this spring, the state’s economic development department promised up to $10.6 million to two companies, one to build a center in Baton Rouge and the other in New Orleans.

Proton therapy is touted as a procedure with low side effects — a pencil-sized beam of protons is shot directly at tumors, with the goal of sparing the healthy tissue around it. It’s a therapy that only works well on a few cancers, and hasn’t had rigorous trials to test its more global efficacy. It’s a big gamble with tax dollars in a state where the Legislature is trying to pare more than $200 million from its health care budget.

“Changing technologies are a risk,” said Louisiana Economic Development Secretary Don Pierson. “For proton therapy, we don’t know five years from now if there will be a neutron beam, or something, that changes how they treat cancer.”

Health care companies often work with governments to build facilities, typically through bonds or subsidies, or through university partnerships that could potentially absorb more risk. But, with a medical community divided on whether this more expensive treatment is better than traditional radiation therapies, it brings to question why economic development agencies, whose bread and butter is job creation and tax base development, would roll the dice on these investments.

Pierson said he believes proton therapy could help turn Louisiana into a lucrative medical tourism hub. State officials, including the governor, are sold on the idea of a live-saving procedure, even if only a few people will benefit.

That reasoning doesn’t sit well with some experts, including Amitabh Chandra, director of health policy research at Harvard’s Kennedy School of Government. State funding, Chandra said, should value health outcomes instead of economic ones. [...]

bioethics health care finance health law policy insurance market medical tourism public health regulation