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
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.