The Cancer Moonshot is a Ghostly Galleon

Deepti Pradhan
6 min readMar 27, 2022

Aiming high is indeed laudable, but what about making existing resources available to all who need them?

The Big C looks down upon the galleon

She’d been diagnosed with non-small cell lung carcinoma (NSCLC) completely out of the blue. A routine post-tick bite evaluation revealed a spot on the lungs, and from that moment it was full steam ahead in determining what that spot was and then, addressing treating it with all the resources currently available. Or at least that is what it should have been. He had knee-replacement surgery scheduled, but the preoperative blood work showed an extremely high white cell count which on further analysis revealed a case of leukemia. Again, treating with all available resources should be a no-brainer. Then, there’s the story of the person who after two previous cancers, was cancer-free for twenty years when she found her way to the emergency room because of excruciating abdominal pain. Testing revealed liver cancer. Armed with previous experience of the healthcare system she felt confident that she would get the same level of care she’d received in her youth; only to be disappointed.

All these stories share a common thread — the recently diagnosed cancer patients were all retired individuals who were previously gainfully employed in mid-to-high income jobs, and had paid up to 12% of their earnings into the health care system. Only one of these cases had needed to access cancer-related care previously.

Repairing requires commitment

It’s not news that health care in the US is woefully inadequate when it comes to outcomes — data collected before the pandemic tell us that health care in the US is the least affordable of major high income countries (HIC). According to this 2021 report from the Commonwealth Fund, “The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes, but second on measures of care process.” Despite spending more than most HICs, the US healthcare system performs worse than any comparable country as also shown in reports from the OECD.

Graph of health care system performance compared to spending — USA lags
Source: Eric C. Schneider et al., Mirror, Mirror 2021 — Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries (Commonwealth Fund, Aug. 2021). https://doi.org/10.26099/01DV-H208

Particularly around election time, the refrain that the health care system is broken…

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Deepti Pradhan

Employed at Yale University, Deepti is primarily a scientist & patient advocate. She runs Tilde Cafe, a forum to make science accessible (www.tildecafe.org)