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On December 8, 2003 George W. Bush signed into law the Medicare Prescription Drug Act. This law will have a devastating effect on American cancer care. The law places the entire oncology community on the threshold of not being able to provide cancer care. Physicians, hospitals, Medicare, and patients will be negatively affected by public law 108-173.

Oncology is one of the few remaining areas of medicine that boasts a large percentage of independent practitioners. 80 percent of cancer care is provided in an outpatient, community-based setting. Besides providing convenient, personalized care, these clinics have also been an integral part of cancer research. Sixty percent of clinical trials occur in community cancer clinics.

For years oncologists and nurses have been underpaid for their efforts curing cancer. Though Medicare has overpaid almost $570 million annually for drugs, it has underpaid physicians and staff for the administration of these drugs. Every year Medicare underpays oncologists and their staffs nearly $718 million for the essential medical services they provide. The new law diminishes the reimbursement for the drug itself without compensating appropriately for administration. Private practices may well be put out of business under these new guidelines.

What does that mean for hospitals? Physicians will only be able to refer to hospitals. Some hospitals will refuse treatment because the out-of-pocket costs are too high. The ones that admit the patients will encumber an already-overburdened system. Nursing teams in hospitals a notoriously overworked. A procedure like the administration of chemotherapy requires constant supervision which hospital nursing teams are unequipped to handle.

Admittance into a hospital is more costly than outpatient administration of chemotherapy. Outpatient chemotherapy has actually reduced the cost of chemotherapy to Medicare. By shifting cancer treatment away from community clinics, the new Medicare law will end up costing the system millions more than it hoped to save by cutting drug reimbursement.

Most disconcerting is that this law will have negative repercussions for the patient. One of the largest problems with socialized medicine is the lack of choice on the part of the patient. Independent medical clinics provide patients with choices for their care. Public law 108-173 will eliminate choice for people who truly need it.

Patients turn to local clinics to provide quality care without driving hours to receive it. The unspoken reality here is that Medicare patients will not be feasible to treat if a provider must lose money to do so. Moreover, if private medical clinics are no longer able to treat cancer on an outpatient basis, patients will have to travel farther to get less personalized treatment that takes longer. All the while, their lowered immunity will be exposed to all the bacteria present in a hospital.

Cancer remains one of the most pressing medical issues of our society, yet our government has undercut the faculty we have to treat it. Please contact your representatives and tell them how you feel. Vote and use your power to help win the war against cancer.

Write your representative

Write your senator

Write the president

 Other Resources

Community Oncology Alliance

Southeastern Gynecologic Oncology, LLC.

American Society of Clinical Oncology

San Francisco Chronicle article about cuts in cancer funding 

Association of Community Cancer Centers

 
 

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