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          Front Page  opinion  guest_columns

Monday, October 19, 2009

Cuts Will Hurt Cancer Care

By Dr. Victor V. Vigil
Hematology Oncology Associates
          President Obama has announced a plan to cut hundreds of billions from Medicare over the next decade to reduce federal spending on health care. While we agree that cost cutting is important, we want to provide information regarding the reality of what will occur if payment for life-saving chemotherapy is further reduced.
        Community cancer clinics treat more than 80 percent of Americans battling cancer and are already struggling to care for their Medicare patients. Given that the administration is now discussing an additional $313 billion in cuts to Medicare, in addition to significant cuts already proposed, cancer care in this county is heading for a potential disaster.
        We all agree that the Medicare system is broken, even though 45 percent of all cancer patients rely on it for their care. In fact, the cancer care delivery system is already in jeopardy due to cuts in Medicare over the past two-three years and the lowered payment for chemotherapy drugs and administration of those drugs by oncologists.
        The Medicare cuts have now reached the point where cancer care practices may not be able to stay in business and cancer patients often cannot afford to pay their portion for necessary treatments. Medicare does not pay enough for essential services required by cancer patients such as treatment planning and care coordination. Oncologists (cancer specialists) are often reimbursed less than the purchase costs for expensive cancer drugs. Clinics across the country report a freeze on hiring, staff cuts and some already have been forced to close facilities, especially in rural areas.
        If further Medicare cuts are made, our cancer care delivery system will be faced with not being able to give critical medicines to cancer patients, especially our seniors. The math is simple — if oncology practices are paid below our costs, we cannot stay in business to treat our patients.
        Health care reform should be guided by the principle that we "fix what is broken and build what already works." Although the United States already has the best overall cancer care in the world (as measured by five-year survival rates), on average cancer still kills one American each minute. We can certainly improve on our successes. Oncologists have been actively trying to present Congress with specific programs to enhance the quality of care while controlling costs.
        Most oncologists would rather focus on taking care of patients and not deal with the multiple layers of paperwork and bureaucracy involved in health care. It is walking into an exam room and seeing someone who needs our expertise and advice that keeps us going each day despite our 50- to 60-plus hour workweeks. The reality is that if we are paid below our costs, we will not be able to do that which we are trained to do and that which we do best.
        Please call your congressman and express your concerns about these cuts.
        This column was also co-authored Dr. Lovie D. Bey, Dr. Jody Jordan, Dr. Malcom H. Purdy and Dr. P. Lorraine Sanchez. All are part of Hematology Oncology Associates and practice in Albuquerque.