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The Sequester Is Forcing Cancer Clinics To Deny Chemotherapy To Thousands Of Elderly Americans

By Sy Mukherjee on April 4, 2013 at 9:10 am

"The Sequester Is Forcing Cancer Clinics To Deny Chemotherapy To Thousands Of Elderly Americans"

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In the aftermath of Congress’ failure to reach a deal averting the sequester, President Obama described the automatic spending cuts as foolhardy, warning, “The pain will be real. The longer these cuts are in place, the greater the damage.” Those words are now coming to fruition, as local cancer clinics all across America are being forced to turn away thousands of senior citizens on Medicare and deny them their chemotherapy treatments as a consequence of federal budget cuts.

The Washington Post’s Sarah Kliff reports that even the sequester’s relatively mild two percent cut to Medicare is forcing clinics to choose between providing care to patients, absorbing debilitating financial losses, or downsizing medical staff. Faced with those unsavory choices, clinics like North Shore Hematology Oncology Associates in New York are refusing to see as many as 5,000 of their Medicare patients:

Medications for seniors are usually covered under the optional Medicare Part D, which includes private insurance. But because cancer drugs must be administered by a physician, they are among a handful of pharmaceuticals paid for by Part B, which covers doctor visits and is subject to the sequester cut.

The federal government typically pays community oncologists for the average sales price of a chemotherapy drug, plus 6 percent to cover the cost of storing and administering the medication.

Since oncologists cannot change the drug prices, they argue that the entire 2 percent cut will have to come out of that 6 percent overhead. That would make it more akin to a double-digit pay cut.

“If you get cut on the service side, you can either absorb it or make do with fewer nurses,” said Ted Okon, director of the Community Oncology Alliance, which advocates for hundreds of cancer clinics nationwide. “This is a drug that we’re purchasing. The costs don’t change and you can’t do without it. There isn’t really wiggle room.” [...]

An analysis prepared by [the Center for Cancer and Blood Disorders director Ralph Boccia's] clinic estimates that, if the full 2 percent cut takes effect, between 50 and 70 percent of the drugs it administers would become money losers.

Doctors at the affected clinics have been warning their patients about the consequences of the sequester for weeks, starkly noting that the choice is between curtailing services or shutting down completely. A South Carolina oncologist with the Charleston Cancer Center told Kliff, “We don’t sugar-coat things, we’re cancer doctors. We tell [patients] that if we don’t go this course, it’s just a matter of time before we go out of business.” Patients seeking to continue their treatments will have to go to larger hospitals, where their out-of-pocket costs for the pricey chemotherapy drugs will be substantially higher.

As budget sequestration goes into effect, its ill effects are increasingly taking tangible form, with everything from health care services to aviation towers being forced to shut down due to insufficient funding.

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