ERWIN, Tenn. – There's one last hope for Tennesseans who might benefit from a state-of-the-art cancer treatment.

Republican Gov. Bill Haslam vetoed the Cancer Patient Choice Act late last week, but there's talk of a possible special session to override his veto.

The legislation would mandate that the state employee insurance program cover proton therapy at the same rate it currently pays for traditional radiation.

Retired school teacher Elizabeth Clarke contracted a rare case of tongue cancer last year, and had to pay $72,000 for proton therapy out of her own pocket.

She was able to preserve her ability to eat normally by choosing the therapy, which targets a very specific area and limits radiation's exposure to healthy parts of the body.

"The side effects from the cancer that I have are so terrible,” Clarke states. “I don't understand what his thinking is, because there's so much research on what it does."

In a statement, Haslam specifically opposed the mandate language in the bill and said in a statement that the "state plan currently covers many forms of radiation treatment."

Several private insurers cover at least part of the cost of proton therapy, as does Medicaid and Medicare.

Tom Welch, president of Provision CARES Proton Therapy Center in Knoxville, says the mandate would come at no additional cost to the state or taxpayers, since centers such as his say they would accept the agreed upon rate for traditional radiation.

"I have only concluded that he has bowed to the wills of the insurance lobby,” Welch says. “The Speaker of the House and Lt. Gov. (Randy) McNally could call a special veto override session, to have a vote to override the governor's veto."

State Rep. Bob Ramsey (R) of Blount County – one of the sponsors of the legislation – says the plan is to wait to see what other bills the governor may veto before calling a special session.

Regardless, it is too late for Clarke and her husband, who feel lucky they had the savings to spend on her health.

"Our thoughts are with our savings,” she says. “What are you saving it for if you have no quality of life?

“If you can't eat, you don't have any saliva, what good does the money do? And so we decided that my quality was more important than having money in the bank."

Clarke says her concern lies with people who don't have coverage for proton therapy, or the savings to pay for it, since it would be impossible to secure a bank loan to pay for such treatment.


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A bill in the Tennessee General Assembly is reigniting debate over how rural hospitals can staff anesthesia providers. House Bill 979 would address the shortage of anesthesiologists in rural Tennessee by allowing hospitals in counties with fewer than 105,000 residents to directly employ physician anesthesiologists.

Hospitals now have to use third-party anesthesiology services.

Dr. Louis Chemin III, anesthesiologist and physician with Tennessee Anesthesiology Consultants Exchange, supports physician supervision in what's known as the "Anesthesia Care Team" model. He said anyone hired as an anesthesiologist would be required to follow strict medical guidelines.

"Currently under state law, a hospital cannot employ an anesthesiologist, a radiologist, a pathologist or an emergency medicine physician. If this bill were to pass, it would allow hospitals in these rural communities the option to hire an anesthesiologist," he contended.

Chemin said the bill would allow a hospital anesthesiologist to perform anesthesia in one operating room, or to supervise the process in up to four operating rooms.

On Wednesday, the bill passed the House with a vote of 72 to 5, with 11 members "present but not voting." It now heads to the state Senate.

When a physician anesthesiologist provides medical direction to Certified Registered Nurse Anesthetists or Anesthesiologist Assistants, Chemin explained, they must comply with seven steps outlined by the Centers for Medicare and Medicaid Services to qualify for reimbursement under Medicare.

"This law means that if a hospital employs an anesthesiologist, that they must allow the anesthesiologist to practice in a way that is safe and is in agreement with these seven steps," he continued.

Chemin added that these requirements would ensure the anesthesiologist's active involvement in the patient's care and safety.


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A new report found Missouri's public health agencies are not sharing information effectively and fixing the problem could lead to better health care for people in the state.

The Missouri Department of Health and Senior Services released its first assessment of the state's digital health system, highlighting ways to improve how health data is shared and used. The evaluation uncovered significant gaps in sharing critical information such as disease rates, hospital visits, birth outcomes and access to care.

Joshua Wymer, chief health information and strategy officer for the department, shared key insights from the report.

"Data is still often siloed," Wymer pointed out. "There was an opportunity with data to advance inoperability, there's an opportunity to always be better at privacy and security because we know that the threat of that is always evolving."

The report recommended establishing clear rules and strong leadership for better data management. More than 200 organizations took part in the assessment, through 25 meetings across nine regions.

A separate study found health care providers said patient access to electronic health records improved communication and treatment discussions. Wymer also shared what citizens expect from the systems as health data grows in importance.

"They expect their data to not only be available and readily accessible, but they expect it to be private and secure," Wymer reported. "And they expect an experience that moves closer and closer to them and their routine and their priority."

The assessment revealed Missouri's public health agencies have different digital capabilities but are ready to adopt new data systems.


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Wednesday is National Healthcare Decisions Day and advocates are calling attention to Florida's pressing need for advance care planning, particularly among vulnerable groups.

About one in five Floridians is over 65 and the state also struggles with one of America's highest uninsured rates, at 10.7%, significantly above the 8% national average.

Brandi Alexander, chief engagement officer for the national end-of-life advocacy group Compassion & Choices said Latino residents have nearly double the uninsured rate of white Floridians. She noted there are good reasons for anyone to plan for their future health care needs.

"Nearly half of the population are people of color in Florida," Alexander pointed out. "A 2021 study found that the preventable mortality rate for Black individuals was 1.5 times higher than it was for their white peers."

The annual awareness day encourages families to discuss and document their medical preferences before a crisis strikes. Florida's 52 licensed hospice organizations serve patients through hundreds of care teams statewide, according to state health data. Alexander emphasized clarifying care wishes can alleviate burdens on families and reduce preventable suffering.

Alexander added normalizing the conversations can empower patients and reduce disparities.

"The more we have tools and the more we normalize the conversation, we can start changing some of the negative stigma that comes with talking about death," Alexander stressed. "Because once you're talking about it and you know what options are available to you, you can then really advocate for yourself within the health care system - and that's how we really create change."

Free resources, including advance directive forms and multilingual guides, are available through the state health department and advocacy groups like Compassion & Choices.