Medicare patients should be pleased that Congress is working to
develop a bipartisan prescription drug benefit. However…
EDITOR:
Medicare patients should be pleased that Congress is working to develop a bipartisan prescription drug benefit. However, beneficiaries with cancer should be alarmed that one provision in the legislation threatens access to community-based cancer care.
Medicare currently makes two payments for chemotherapy and supportive drugs. One payment is for the drugs; the second is for administering drugs. This system of reimbursement is severely flawed. Medicare currently overpays for drugs, which results in inflated beneficiary co-payments. However, Medicare also underpays for the services of oncologists, nurses, pharmacists and other professionals involved in the delivery of quality cancer care. Congress should reform the system to more accurately reflect the actual cost of providing care.
Instead, the proposals being considered will significantly reduce Medicare payments for drugs without adequately increasing payments for professional services. The resulting net cuts will undoubtedly impact patient access to community-based cancer care. Some oncologists may close satellite offices, leaving patients in rural communities with long drives to and from chemotherapy treatment. Some oncologists may not accept new Medicare patients. If this happens, then patients will be forced to seek treatment in other locations. Hospitals have indicated they do not have the capacity or nursing staff to treat a large volume of new cancer patients on an outpatient basis. These cuts could result in a reduction in nursing staff, dedicated professionals who provide cancer patients with exceptional care.
Congress should be commended for trying to give seniors a prescription drug benefit. Preserving access to quality cancer care must also be a top priority.
Nancy Davenport-Ennis
president and chief executive officer,
National Patient Advocate Foundation
