Posted on 12/01/2004 7:09:48 PM PST by NormsRevenge
WASHINGTON - Medicare payments for cancer drugs will decline next year but will still exceed what doctors pay for them, congressional investigators said Wednesday.
Cancer doctors and some patient advocates have said the Bush administration's planned cuts would imperil office-based chemotherapy treatments and force patients to travel to hospitals for their medicines.
But Medicare payments for the drugs will exceed doctors' costs by 6 percent on average, while reimbursements for other services will be more than double, on average, what they were two years ago, the congressional Government Accountability Office said.
The GAO study was based on 16 drugs that account for 75 percent of Medicare payments to cancer doctors.
The changed reimbursement, part of last year's Medicare prescription drug law, is an effort to address long-standing excess payments for the drugs and insufficient reimbursement for administering the medicines and other office expenses.
Medicare won't pay for most prescription medicines until 2006, but it covers the cost of intravenous chemotherapy and other treatments that must be dispensed by medical professionals.
GAO examined payments to cancer doctors in 2003, as well as projections for 2004 and 2005. It found a steep decline in payments for the medicines, but a significant increase in the reimbursement for administering them and other expenses.
Medicare chief Mark McClellan said the report confirmed administration assertions that payments would ensure "access to high-quality ambulatory cancer care."
Sen. Charles Grassley (news, bio, voting record), R-Iowa, who requested the GAO study, said, "This report is good news for cancer patients and highlights the adequacy of payments to oncologists, both in drug payments and drug administration services."
The American Society of Clinical Oncology (news - web sites), which has opposed the changes, responded that the study was flawed and underreported some physician costs, GAO said.
Cancer specialists and patient advocates have asked Congress to essentially freeze payments at current levels until various agencies complete studies of the new pricing system, expected in 2006.
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On the Net:
Government Accountability Office: http://www.gao.gov
Did you know that 85% of all Medicare expenditures are spent on people in their last futile month of life?
"Did you know that 85% of all Medicare expenditures are spent on people in their last futile month of life?"
It is true that a significant amount of money is spent on people before they die, and it is true that a portion of that money is spent for futile care in pointless efforts to prolong life. However, it is not true that 85% of Medicare expenses are for people just before they die (no way; the majority of Medicare expenditures, for example - are spent for outpatient and chronic care - not acute inpatient care at all). And, it is not true that all money spent in the final month of life is futile. If you have a stroke or cancer or an aneurism, for example, - it may kill you - and it may not kill you - but in many cases you will only know after treatment whether it was futile or not . . .
Having said that - American's do have unrealistic expectations about the health care system's capability to prolong life. In general, we don't accept death even though the eventual mortality rate for the living is always 100%. Futile efforts to extend life occur primarily because the family members (i.e., we Americans) demand it and we legally have the right to do so and our insurance companies and the government-as-insurer - have little effective recourse to deny such futile treatment.
Tubebender, as you probably know... It is next to impossible to get people to plan and then to reduce plans to writing in legally binding terms and commit to implementation before it's too late... Especially when left up to their own devices and without some serious professional coaching.
Analysis paralysis and procrastination is the rule, rather than the exception, because the only thing worse than fear, is dread!!!
"Did you know that 85% of all Medicare expenditures are spent on people in their last futile month of life?"
Futile? I don't know about futile but I certainly wouldn't go to a VA hospital hospital and tell the deserving patients there that their last hours on this earth are futile.
In view of the fact that most taxpayers spend 70-80% of their lives being taxed to support Medicare, I think they are entitled to use some funding for their last days.
"In view of the fact that most taxpayers spend 70-80% of their lives being taxed to support Medicare, I think they are entitled to use some funding for their last days."
Not all of us. Fat cats like Tereh-za and John Edwards manage to shelter income and avoid Medicare taxes. Edwards avoided over 500K in Medicare tax by setting up his one man shell corporation and classifying his tort booty as dividends.
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