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Cancer clinics are turning away thousands of Medicare patients. Blame the sequester.
Washington Post ^ | 4/4/13 | Sarah Kliff

Posted on 04/04/2013 10:54:15 AM PDT by illiac

Cancer clinics across the country have begun turning away thousands of Medicare patients, blaming the sequester budget cuts.

Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.

Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.

“If we treated the patients receiving the most expensive drugs, we’d be out of business in six months to a year,” said Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York. “The drugs we’re going to lose money on we’re not going to administer right now.”

(Excerpt) Read more at washingtonpost.com ...


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: government; healthcare; medicare; obamacare; sequester
And so it starts....
1 posted on 04/04/2013 10:54:15 AM PDT by illiac
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To: illiac

Liars. Medicare and Medicaid and Social Security were not included in the sequester.

Besides, if it were true, blame it on Obama. The sequester was his idea.


2 posted on 04/04/2013 10:57:33 AM PDT by txrefugee
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To: illiac

Republicans need to make a pre-emptive strike against the DemocRATS and make sure the ownership falls on the left, and with Obamacare. They CANNOT bend over and let BO assign the blame to them.


3 posted on 04/04/2013 11:01:53 AM PDT by ObozoMustGo2012
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To: illiac

Most of those Medicare patients are just racist white folks anyway.

Besides, we need to make room for the new anti-American Americans who broke Federal law coming in from the south.


4 posted on 04/04/2013 11:02:47 AM PDT by MichaelCorleone (A return to Jesus and prayer in the schools is the only way.)
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To: txrefugee
From the article:

Legislators meant to partially shield Medicare from the automatic budget cuts triggered by the sequester, limiting the program to a 2 percent reduction — a fraction of the cuts seen by other federal programs.

But oncologists say the cut is unexpectedly damaging for cancer patients because of the way those treatments are covered.

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.

5 posted on 04/04/2013 11:03:08 AM PDT by FoxInSocks ("Hope is not a course of action." -- M. O'Neal, USMC)
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To: illiac

Obamanation Counterculture File.


6 posted on 04/04/2013 11:03:08 AM PDT by Graewoulf (Traitor John Roberts' Commune-Style Obama'care' violates U.S. Constitution AND Anti-Trust Law.)
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To: ObozoMustGo2012
Republicans need to make a pre-emptive strike against the DemocRATS and make sure the ownership falls on the left, and with Obamacare. They CANNOT bend over and let BO assign the blame to them.

Right... like they stood up for Government Accountability for Fast & Furious?

7 posted on 04/04/2013 11:04:48 AM PDT by OneWingedShark (Q: Why am I here? A: To do Justly, to love mercy, and to walk humbly with my God.)
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To: illiac

Obomination begins...Americans die...


8 posted on 04/04/2013 11:05:43 AM PDT by AngelesCrestHighway
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To: illiac

My brother died of cancer. I wouldn’t wish it on anyone.

Still, I’d like to know what makes anyone think that someone else should have to pay for their treatment. Obviously, these treatments are not self-sustaining in cost. They need the unending flow of stolen dollars, perhaps because they have not had to learn how to run a business without it.

The ads for Cancer Treatment Centers of America seem fishy to me. They seem like one of these parasite companies that is only in business for the Medicare dollar. If they go out of business, that will probably be a good thing.


9 posted on 04/04/2013 11:07:30 AM PDT by Empire_of_Liberty
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To: illiac

I slipped in the shower this morning... you know why?

yep ...Sequester


10 posted on 04/04/2013 11:07:31 AM PDT by Mr. K (There are lies, damned lies, statistics, and democrat talking points.)
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To: illiac

Medicare or Medicaid? It was my understanding that, miserly as Medicare payments were, Medicaid was much worse.


11 posted on 04/04/2013 11:08:39 AM PDT by Pearls Before Swine
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To: Empire_of_Liberty
Still, I’d like to know what makes anyone think that someone else should have to pay for their treatment.

Well, today when you pay for your own treatment, you can't help but pay for the treatment of three or four others. So, you have to be in a payment club, or else they hit you with extortionate charges.

In a sane world, I'd agree with you, though.

12 posted on 04/04/2013 11:10:14 AM PDT by Pearls Before Swine
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To: ObozoMustGo2012

From the Washington Post

http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/14/romneys-right-obamacare-cuts-medicare-by-716-billion-heres-how/


13 posted on 04/04/2013 11:10:19 AM PDT by Perdogg (Sen Ted Cruz, Sen Mike Lee, and Sen Rand Paul are my adoptive Senators)
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To: Pearls Before Swine

I talked to a woman at a party who is a “health care consultant”.

(basically a MBA type who consults with hospitals)

She told me that only 3 to 7 percent of uninsured bills get paid, the rest is written off and “spread” across insured payments.


14 posted on 04/04/2013 11:14:05 AM PDT by nascarnation (Baraq's economic policy: trickle up poverty)
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To: txrefugee

this is true. Excellent point
SS and Medicare were NOT part of the sequestor
this from the AARP site Q&A

So here’s what you should know:

I’m on Medicare. What happens to my benefits?
Good news. No change in Medicare benefits, including Part D low-income premium and cost-sharing subsidies and catastrophic subsidy payments.


15 posted on 04/04/2013 11:14:38 AM PDT by RWGinger
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To: Mr. K

oh shoot...I took more than 6 Sequesters in a 24 hour period...should I induce vomiting?


16 posted on 04/04/2013 11:15:32 AM PDT by ItsOurTimeNow ("This ain't no party, this ain't no disco, this ain't no foolin' around.")
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To: nascarnation
She told me that only 3 to 7 percent of uninsured bills get paid, the rest is written off and “spread” across insured payments.

I believe that. The whole system is set up with the big payers getting discounts, even though they are now the true market. In order to have these pretended discounts, the hospitals lie in wait for that rare uninsured party who also has some net worth, and attempt to loot him mercilessly with quintuple charges and the proverbial $50 aspiring.

It's exactly this sort of predatory behavior that government is supposed to contain, but in the medical field, it not only doesn't do that, but it is the source and cause of much of it.

17 posted on 04/04/2013 11:22:45 AM PDT by Pearls Before Swine
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To: illiac

According to Rush this a.m., this is all BS! If it is happening, it’s because those running the “clinics” are trying to help Obamacare.


18 posted on 04/04/2013 11:26:39 AM PDT by vette6387
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To: RWGinger
this is true. Excellent point
SS and Medicare were NOT part of the sequestor

Read post 5 above, which includes the quote: "cancer drugs . . . are among a handful of pharmaceuticals paid for by Part B, which covers doctor visits and is subject to the sequester cut."

19 posted on 04/04/2013 11:28:03 AM PDT by FoxInSocks ("Hope is not a course of action." -- M. O'Neal, USMC)
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To: illiac

Wow, it all that happens when 2% of the budget it cut, what happens when the US Dollar collapses and/or the Gov’t is bankrupt?


20 posted on 04/04/2013 11:41:43 AM PDT by PGR88
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To: nascarnation

And that is why the big hospitals wanted Obamcare passed. They see it as a way to cover a large % of the currently uninsured so what they used to write-off will be paid for by Obamacare.

Also what many uninusred, who aren’t trying to bilk the system, may not know is there are organizations out there that will negotiate medical bills, fees et al on their behalI had a family member who was unemployed and uninsured and had to visit the ER. When he recieved his bill he called the hospital and they cut the ER bill from 1,300 to 600.

The ER physician used a third party billing organization, that was not cooperative at first. So he found an organization called Medical Cost Advocate. MCA negotiated the physician bill on his behalf and had it reduced by 60%. Their fee is 35% of the amount saved. Example the ER physician bill was 780.00 they negotiated it down to $312.00, plus their charge of 163.8 for a bill totaling 475.8 versus the original physician charge of 750.00.

Maybe pricey but now that he has an idea of the physician’s true cost/charge, the next time he visits the ER and if he is uninsured he has a starting point to where he can negotiate the bill.

Almost all uninusred can negotiate their medical bill if they are willing to take the time and make the effort. The first bill for their medical episode is not written in stone.


21 posted on 04/04/2013 11:43:14 AM PDT by CharlesMartelsGhost
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To: FoxInSocks
What people don't realize is that Medicare reimbursement for drugs for the community oncologist is based upon the average sales price for a given drug. The price that some oncologists have to pay is way above average, as it is based upon volume. It is like comparing Wal Mart acquisition costs to a mom and pop store. Which one gets the better price? The 6% above the average sales price barely covers (and in many cases, doesn't) the costs of nurses to administer the chemo, pharmacists to mix it, the IV tubing, equipment, rent, electricity, insurance, taxes, etc. A 2% cut in reimbursement for drugs may well either put some solo oncologists out of business, or force them to send patients to a hospital setting for chemo, which ultimately is more expensive to the Medicare system.
22 posted on 04/04/2013 11:49:08 AM PDT by SC DOC
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To: illiac

And myriad groups around the country and the world, donate to this organization. What a sham.


23 posted on 04/04/2013 11:58:37 AM PDT by SgtHooper (The last thing I want to do is hurt you. But it's still on the list.)
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To: illiac

You can’t manage on 2% less monies?

Gimme a break...


24 posted on 04/04/2013 12:11:50 PM PDT by Vendome (Don't take life so seriously, you won't live through it anyway)
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To: Mr. K

Holeee Cow!

I got a paper cut on my tongue this morning for the same reason!

Sequester, Schmester....


25 posted on 04/04/2013 12:13:26 PM PDT by Vendome (Don't take life so seriously, you won't live through it anyway)
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To: illiac

“blaming the sequester budget cuts.”

Those evil Repubs and their $44B cut to the entire federal budget is causing the deaths of millions, while the benolavent Dems and their $715B cut to medicare built a heaven for those that the evil republicans murder!


26 posted on 04/04/2013 12:15:58 PM PDT by CSM (Keeper of the Dave Ramsey Ping list. FReepmail me if you want your beeber stuned.)
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To: CharlesMartelsGhost

I pay for my medical care out of my pocket.

I had problems with my bladder a few years back.

I went to one of those Doctor in a Box places, as my regular doctor had recently passed away and I hadn’t gotten around to finding a new one. Total Bill for diagnosis and Cipro? $200 bucks. Paid it.

The way it was explained to me didn’t feel right, so on the advice of a friend I went to the emergency room. Got a diagnosis and then referred to an internist. I wasn’t there 10 minutes, didn’t take any tests like I did at the previoud doctor and was handed a bill for $2,000 bucks.

Didn’t like the diagnosis from them either.

Found one of the best internist in our area. Called em up and asked for an appointment. They wanted to know who referred me. Gave them friends name and mentioned they were a patient.

She laughed and said “No. I mean what doctor recommended you and what is your insurance”.

Startled for a moment I asked why I would need a referral and I don’t have insurance.

She replied that they need to bill the insurance company and they usually see patients referred to them by a doctor.

Told her I pay cash and I understand he is the best.

So, she tells me it’s very expensive.

I cut her off, telling her I don’t care. I’m in pain, I’ve already seen two doctors who I don’t trust their diagnosis and I’ve money. That’s cash.

So she tells me it’s $400 bucks!

I laugh and tell her I generally carry $1,000 for emergencies and for me, this is one of those emergencies. I also informed her I wouldn’t even beg a negotiated price, I just want to see the best guy for the job and get a proper and correct diagnosis.

She informs me they have never had a cash customer before and she didn’t know how to handle it. She would need to consult with the doctor and call me back.

So, she calls me and tells me the doctor said to come in the next day at 10am and it’ll be $400 bucks.

No problem.

So I show up and the doctor sees me immediately. Hell, on freakin time. I knew right there I was dealing with the right guy and a professional.

So he puts me under so he can put a camera in my urethra tube.

He finds out what is going on down there and after waking me up from the twilight drug, informs me I have to change my diet with no acidic foods, nuts, meat, cured meats, etc.

Blech!

He shows me pictures and describes how he arrived at his diagnosis and tells me it’s pretty common for men who love spicy foods, all the time.

He also prescribed some drug to help with the pain and healling.

I thank him and go to pay my bill. The office manager informs me it’s $200 bucks. I tell her I didn’t want a negotiated rate and I’m happy to pay what we agreed.

she tells me the insurance company pays less than that and the doctor felt like it was the right thing to and apparently I was pretty funny while I was under.

I shrug and whip out my cash. She doesn’t have change. I tell I’m going to lunch down the street and I’ll come back with the exact amount afterward or she can just take $300.

She laughs and says it’s quite all right.

So I go to lunch and have Hot and Spicy soup and General Tso’s pepper chicken.

I go back and pay the good doctor.

So I follow his instructions to a “T” and all ends up being well.

I call the Hospital that gave me a bill for $2,000 bucks and inform them I’m not paying for an incorrect diagnosis.

She gets testy with me and inform her I paid two other doctors no problemo but, your doctor wasn’t even in the ball park of being correct and the internist said I would have got sicker if I had followed his plan.

She asks if I can get her documentation. I ask why? and she tells me if true she’ll blank out my bill.

So I swing by with all my documentation and she zero’s out my bill on the spot.

Just gotta be strong on yer healthcare.


27 posted on 04/04/2013 12:33:15 PM PDT by Vendome (Don't take life so seriously, you won't live through it anyway)
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To: AngelesCrestHighway

Death Panels, anyone?


28 posted on 04/04/2013 1:04:08 PM PDT by Jimmy Valentine (DemocRATS - when they speak, they lie; when they are silent, they are stealing the American Dream)
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To: illiac

bump


29 posted on 04/04/2013 1:15:19 PM PDT by lowbridge (Joe Biden: "Look, the Taliban per se is not our enemy.")
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To: Jimmy Valentine
Death Panels, anyone?

It's coming. My wife is going through treatments for cancer. She gets a mix of chemo drugs, the mix of four or five drugs changes depending on the treatment at the time. Just one, Rituxin, is billed at $12,000 per treatment. Thankfully, our insurance picks up most of the cost, while we pay a still large co-payment. One of our daughters works at the company that develops these drugs. She informs us that it costs them millions of dollars in R&D besides getting approval to sell, and they take huge losses on drug development that can take decades that is never approved. That's why they're expensive.

Not everybody has good insurance, or insurance at all to supplement Medicare. It's going to get ugly for folks who just want to live.

30 posted on 04/04/2013 2:27:38 PM PDT by roadcat
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To: illiac

In the past 24 hours, cancer patients’ access to Medicare treatment has been the focus of an alarming headline. In this case, the budget sequestration—an idea originally proposed and now routinely derided by President Obama—is identified as the culprit.

But policymakers and taxpayers alike may want to take a closer look: Immediately ahead, for fiscal year 2013, the total effect of sequestration will be $3 billion. That is the same amount Obamacare is supposed to reduce Medicare spending this year.

But if Medicare patients can’t access vitally needed care because of $6 billion in total reduced Medicare payments, they’d better prepare for next year. That’s when Obamacare cuts an estimated $41 billion out of Medicare—in addition to the Medicare sequestration cuts of $9 billion that year.

The total effect of sequestration on Medicare benefit spending is $100 billion from 2013 to 2023. Those cuts pale in comparison to the $716 billion in Medicare payment reductions required by Obamacare over the same time period. Included in these cuts is a payment reduction of $156 billion for Medicare Advantage plans. That kind of a slice is a lot more than just a “tiny haircut.”

By 2020, Obamacare will reduce overall Medicare spending by more than $100 billion a year.

The $3 billion in 2013 sequestration cuts is practically a rounding error when put in the context of Obamacare’s total Medicare cuts.

Liberals believe that payment cuts and price controls are good public policy. That’s how Medicare is supposed to control costs, right?

Oh, and by the way: These cuts are targeted to Medicare providers. They don’t cut “guaranteed” benefits. After all, that’s what President Obama, Vice President Biden, and their allies in Congress and the media told us, day in and day out, during the entire 2012 presidential campaign. That’s what all the liberals said. So, really, there is nothing for 50 million seniors to worry about, right?

Link: http://blog.heritage.org/2013/04/04/sequester-medicare-compared-to-obamacare/?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=Feed%3A+FoundryConservativePolicyNews+%28The+Foundry%3A+Conservative+Policy+News.%29


31 posted on 04/04/2013 3:54:05 PM PDT by CharlesMartelsGhost
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