"The National Patient Advocacy Foundation keeps a log of patients who have contacted their organization regarding denial of access to cancer clinical studies; the number exceeds 3,000 in 1998 and is rising each year." "If an oncologist is faced with a choice, he may elect to treat a patient with the most cost-effective regimen rather than enroll the patient in a clinical trial that could be significantly more expensive." "53.7% of oncologists said they hesitate to use expensive chemotherapeutic drugs and 87.4% hesitated to refer a patient for consideration of a bone marrow transplant." 

The recent press release by the National Cancer Policy Board was a giant step in the right direction. They stated what poor treatment Americans are receiving for cancer. Many doctors are simply not knowledgeable about the most recent treatment developments, according to their report. Research shows, for example, that Tamoxifen is the best treatment for post-menopausal women with breast cancer that has spread to lymph nodes, but only 60% of such women receive the drug. The cost of treating one single woman with recurrent breast cancer because she failed to receive tamoxifen would approach the cost of all the tamoxifen used by all women, and that certainly would not count the pain and suffering saved. 

Dr. David Lawrence, a physician and CEO of Kaiser Permanente, said that extrapolating from a Harvard study of medical care accidents in hospitals, these accidents are responsible for over 400,000 deaths per year; more than tobacco, stroke, diet, alcohol, drugs, firearms or automobile accidents.  He defines these accidents as the misuse, overuse and underuse of medical interventions.

Quotes from a Page 1 article in The Wall Street Journal Tuesday, August 29, 2000 titled: "Vital Signs Improve At Texas Cancer Center After Radical Measures - M. D. Anderson Builds Ties To HMOs, Its Former Foes; More Doctors, More Beds", stated: Still, by its own estimate, the hospital remains 30% to 40% more expensive per night than area competitors. . . Medical director for managed care . . says some of the hospital’s specialists order too many tests....Dr. Raber defends the hospital’s pricing and test-ordering policies. “We don’t cut corners,” he says. “We ask ourselves when we have the patient in front of us, what’s the best thing for the patient? Not what’s the best thing to save money.” Cigna Corp.’s South Texas-area HMO, which put 166,000 of its members into the M. D. Anderson capitation program in 1998, says cancer costs for the group have dropped 15% because the hospital’s high quality care has resulted in fewer complications that cost money to treat later. “They have a realistic and cost-effective approach,” says Charles Smith, the HMO’s medical director.

Mandatory second opinions would save the lives of many cancer patients plus reducing recurrences, complications, etc. The cost effectiveness is absolute.