Ronald DePinho, M.D.
Posted on 12/11/2013 10:45:04 AM PST by ShadowAce
Just recently, the University of Texas MD Anderson Cancer Center was announced as one of an elite group of six cancer research and treatment centers throughout the world who will participate in an ongoing collaborative effort to fast-track the advancement of cancer treatment development as part of a new GlaxoSmithKline initiative. It is just one in a series of many examples of how MD Anderson is the preeminent cancer research and treatment center in the United States, if not the world.
According to a new report in the Financial Times, new healthcare plans are being nudged by the statutes of the Affordable Care Act, otherwise known as Obamacare, so that they will exclude in-network coverage for patients to visit top cancer hospitals for advanced therapy — including MD Anderson — when the plans go into full effect next year.
Under the new healthcare plans, a cancer center like MD Anderson will not be included as part of the choices within patients’ covered networks. Instead, visiting MD Anderson for cancer treatment would be “out-of-network,” meaning that very little of the cost would be covered by insurance; most would come out of pocket.
According to the FT report, the shift by insurers to exclude coverage to top treatment centers has everything to do with the new statutes handed down by Obamacare, which seeks to balance costs through what critics see as rationing of care and limiting choices for patients:
“One of the biggest goals of ‘Obamacare’ was to make subsidized healthcare plans that are being sold on the new exchanges as affordable as possible, while also mandating that certain benefits, like maternity care, were covered and that people with pre-existing medical conditions could not be denied access.
Amid these new regulatory restrictions, says Tim Jost, a health policy expert, insurance companies have had to come up with new ways to cut the cost of their products. In this new era, limiting the availability of certain facilities that are seen as too expensive – in part because they may attract the sickest patients or offer the most cutting edge medical care – is seen as the best way to control costs.”
The Obama administration has moved aggressively to characterize this lack of coverage as the fault of insurance companies, and that Obamacare in an of itself has not dictated that top research and treatment centers explicitly be excluded from plans that conform to the law’s new rules, with an HHS spokesperson noting that, “Decisions about which private health insurance plans cover which doctors is a decision currently made by insurers and providers and will continue that way.”
Yet, industry experts explain that, because new Obamacare statues have constrained healthcare insurers’ ability to maintain profitability, the only recourse is to narrow healthcare networks to include only the most cost-effective providers. Because of this, top cancer centers like MD Anderson, whose healthcare prices billed to insurers — and ultimately patients — are higher due to its faculty of world-renowned researchers and medical practitioners, are too expensive to include in networks.
Supporters of Obamacare have sought to portray these research institutions’ price points less as a result of their excellence, and more because of institutional inefficiencies. However, Thomas Priselac, president and chief executive officer of Cedars-Sinai Health System in California, explained to the FT, “There is confusion between price and efficiency,” adding, “The major teaching and research hospitals are more expensive not because they are inefficient but because of what they do.”
Ronald DePinho, M.D.
While Obamacare is already facing the prospect of the so-called “death spiral” in striking a balance in solvency with the risk of the healthy, young “invincible” generation rejecting the coverage, thus hyper-inflating healthcare costs for the rest of Americans, the risk of reducing revenues to research and treatment centers such as MD Anderson is that Americans could lose access to critically important specialized treatments, as well as experimental research that in necessary in continuing to advance new treatments and possibly cures for deadly diseases such as cancer.
Dr. Ronald DePinho, CEO of MD Anderson, offered what can now be seen as a prophetic set of comments on this issue back in May, when he said in a candid memo to the institution: “We can’t run the institution at an operating loss, especially at a time when the health care field faces external challenges from implementation of the Affordable Care Act, the budget sequester and continuing federal deficits. If we don’t make changes now, we potentially will find ourselves in a crisis that will force us to take drastic measures that could hurt our ability to meet our mission.”
If this was Dr. DePinho’s position in May, certainly it has sharpened in the months since the rollout of Obamacare.
[UPDATE 12/9/2013 1:15pm CST: An MD Anderson spokesperson issued the following statement to the press in response to the Financial Times article:
“All patients deserve access to top tier cancer care. MD Anderson and the nation's other top cancer centers play a key role in the fight against cancer, and particularly aggressive forms of the disease or rare cancers where expertise is limited to only a small number of facilities worldwide.
In addition, our country's leading cancer centers help bring down the cost of care for all patients by conducting research that leads to new and better treatments, better cancer fighting strategies and increased efficiencies that lead to cost savings. This knowledge is shared among all cancer care providers to benefit patients in the US and beyond our borders.
While every cancer patient may not need to come to MD Anderson, we believe both insurance providers and our health care system must work together to ensure patients have that option so that all of us have the best chance of beating cancer.” ]
Also, many of the large insurers have firmly negotiated rates with MDA because MDA is the 800 pound gorilla of cancer treatment, and all the major insurers almost have to deal them or they are missing a big piece of the market.
What this really means is that people that are dumb enough to sign up for an Obamacare plan will not have access to MDA.
They will be relegated to use less qualified facilities that the government deems suitable for their use. And, more of them will die if they ever get cancer.
I have seen thousands of people who are helped to stay alive longer and enjoy it far better than otherwise possible by this great institution and the Dr.s there and their chief practitioners, nurses, therapists, specialists, etc. I tell you, they are among the most capable, personable and professional in the world.
The very idea that these sick, fascist/Nazi bastard SOBs (and pardon my French) would somehow work it to deny coverage of this type to the tens of thousands who need it and are now getting it in the best medical system in the world...turns my stomach, causes me literally to puke, and makes me see red.
For people like me, who are being treated now on an ongoing basis for very rare cancers that in my State of Idaho they had never even seen one like, much less treated...the long term prognosis of this type of decision will ensure a much earlier death.
Here's a warning to these sick POSs. There are people who will not only see red, but will demand equal payment in kind. When you push good people to the point of death, they sometimes decide that they might as well take a few of the sorry bastards with them.
Other's may say..."But what good will that do, you are not going to get at the real culprits."
Perhaps not at first...but as more and more are forced into that logic, and more and more people rebel against this, the more whittling and nibbling will occur, and they will ultimately cut into the muscle, the meat, and then into the control mechanisms of this monstrosity. On top of that, these tyrants cannot keep all of the people necessary to defend themselves on their own plans...so there will be push back and fighting within their own ranks.
The monsters behind this need to feel directly the weight of their decisions. This is not something where people tighten their belts and don't spend $50 or a $100 dollars as much on fuel because of their leftist/Marxist/fascist decisions, they are pushing it to a life or death condition for a more and more people.
And that is their intent. It has been all along.
It is becoming more and more patently obvious that this isn't, and never was about "affordable," or "good health care," in the least.
It is about the abject and naked use of life and death conditions to compel and force the people of this nation, using health care as a weapon, to bow down at the alter of big government, do it their way, or risk death...they are abject tyrants trying to exercise complete control.
Well, they have completely miscalculated. I pray in 2014 and 2016 we turn this completely around as a result of their miscalculations. But make no mistake. It is also different this time. People's very life and that of their loved ones now hang in the balance and it is becoming clear to them.
These dastardly, evil, conspiring, lieing, powermonging despots may soon learn what King George, the Barbary tyrants, Hitler, Mojo, Stalin, Hussein, Bin Laden and so many others learned.
...and as Patrick Henry knew, 235 years ago; 'There is a just God who presides in the Heavens. We will not fight alone. He will raise friends...and conditions...to fight with us. And a free, God fearing people, who repent and humble themselves before the God of this land, will bring the tyrants down.' (II Chron 7:14)
Sic Semper Tyranus!
I've BEEN there (on the ready) for some time now.
I'm quite sure I have emphasema (no one will actually SAY the word ... just .. COPD), and I know enough about how badly I breathe ...
never mind.
Love to you and yours, brother ... Merry Christmas.
Your rant is probably prophetic.
5.56mm
The sad thing is Gabrial, is that many Americans will be forced to go to the exchanges.
What you are seeing in the individual coverages will spread like cancer to the group coverages next year.
I am on a plan, a group plan, that includes coverage that allowed me to go to MDA Anderson in 2010 and have my lifer saved there from a very rare cancer...and now be seen each year for checkup and treatment as required.
Next year you will see most plans like the one I am on canceled...just like the individual plans are being canceled now. Once they are, you will either be able to get a new plan from your provider that meets the ObamaCare requirements (meaning no MD Anderson) and will cost about 3x as much per months with a 3-4x larger deductable, or will have to go to the exhanges to get a plan (which will mean the same).
The people who can afford to pay for MD Anderson out of pocket (meaning they are very well off...which I have no problem with and say good for them) will do so. There are many people in the US who have that wherwithall and will make use of MD Anderson, many from overseas will too...and in fact, already are.
But the vast majority of Americans will be denied this service. A service they have now...and they will be put into a position where decision making regarding their very life will be handed over to the government and it bureaocrats and panels.
This will impact me and my family personally, along with so many others.
This situation is one we have expected...but prayed may not come...and now it is. It is intolerable and cannot be allowed to stand.
I say that not just for my sake...I made my peace already and am willing to happily live as long as the good Lord determines for it is in His hands, and submit to His will in all things. But I know there are many thousands, from children, through young adults, to newly weds, and parents with young families...all the way up to Sr. citizens who can enjoy life with their grandkids, who this type of decision will be, in effect, a death sentence.
These tyrnats are using the health care system as a weapon, a weapon to control the vast majority of the American people.
IMHO sooner or later, we as a people have to stand, whatever the cost, and show them we will not bow to such control.
In addition, the people of means all over the world will continue to come...as they already are doing. I saw so many people from all over the world while there.
When it comes to these conditions...life and edeath...it was so neat for me to see how people's cultures and ideoloogies melt away in the face of that condition. Grandpas and Grandmas, parents and children...they were all just that, and very willing to interact with others to share their conditions and experience there. Such stark conditions, times, and decisions regarding health and life and death, I saw tended to bring people together.
And to a person, no matter where they came for, I saw them thankful to God above, however they addressed Him, that the Unitied States of America had a system that could generate a place like MD Anderson where they could come.
I expect MD Anderson will continue to get the funding and the pateints they need to stay in operation. it's just that a large segment will now be denied. But as others find that with Obama Care their local providers are, in effect dumbed down and overburdened with care...those who can will use their resources to go to these places and they will continue to operate, helping whomever comes to their door.
God bless you and your family, Jeff. You know, there are a lot of us older types out there who understand what’s going on and share your outlook.
There is justice, and then there is retribution.
God will preserve you, Jeff. Thanks for your comments.
They truly have miscalculated. A grizzly is most dangerous when backed into a corner or worse when her cubs are in the corner with her.
Does anyone know about Moffitt in Tampa?
"Why Americans are letting this destruction of our medical system go through is beyond me, totally."
The answer is found next to the answer to; why do many people b*tch & moan about paying 50 to 100 dollars a month on meds that are keeping them alive or allowing them a better life but have no problem shelling out $200 per month for that iphone...
Or leasing a luxury car like a BMW/Mercedes/Lexus for $400-500/ month besides their yearly cruise or exotic vacation.
Right on, brother!
I continue to keep you in my prayers. You are an inspiration for all of us.
Amen.
Jeff -
You are just hitting the tip of the ice berg. I truly hope John Q. Citizen gets his cranium out of his rectum and realizes where Obama has taken us. What I fear is that Obama will keep everyone sucking right along after him and take this country with them.
I’m praying for our country.
This is exactly what is happening at MD Anderson. And a significantly high percentage of those cash paying foreigners are rude, arrogant racists (who hate pork). Those specific patients treat the staff terribly, resulting in a concerning exodus of medical personnel.
I agree with you completely Jeff
As JimRob said, Amen!
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