This is an archived article that was published on sltrib.com in 2017, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
I'll never forget the day my doctor told me I had cancer. It was in my gallbladder, several lymph nodes and at that point inoperable. If I did not receive treatment soon I was going to die.
I was devastated. My mind was in a million places at once. But one thing I didn't worry about was how to pay for my medication. At that time I was covered by Obamacare with a low deductible and yearly cap. My doctor prescribed a powerful chemotherapy drug that worked to shrink the tumors and enabled the removal of the tumors. We had it beat- for a while, at least.
Now my cancer has come back, and I need another round of chemo. I've also turned 65 and am on Medicare. If some officials in Washington get their way, cancer patients like me might not be able to beat the disease. MedPAC, the Medicare Payment Advisory Committee, just recommended that Congress dramatically cut reimbursements to doctors who prescribe life-saving drugs. If Congress heeds their suggestions, it could drive cancer clinics into bankruptcy and prevent patients from accessing treatment.
Medicare Part B covers drugs that a doctor or nurse personally administers through infusion or injection. These are medicines, like chemotherapy, that are too powerful for patients to take at home.
Part B is unique in that doctors buy these medicines themselves. Once the patient receives the drug, the doctor can apply for reimbursement from Medicare. In the past, Medicare paid for the average cost of the drug, plus an additional six percent fee to help cover the cost of ordering, storing, and administering it. But, that fee has been whittled down through automatic budget cuts. Now, MedPAC wants to reduce the fee even further.
Medicare reimbursement cuts will particularly hurt small clinics. Reduced reimbursements mean small medical practices may actually administer some medicines at a loss.
Others will have no choice but to stop prescribing them or go out of business. Many cancer clinics are already relying upon payments from other sources to offset their losses from administering medicine to Medicare patients.
Specialists like oncologists and rheumatologists who rely on cutting-edge drugs to treat the most serious illnesses would be most impacted by the cuts.
Small clinics may end up going out of business entirely. Nearly 400 cancer clinics have closed since 2008, and 400 more are at risk of going out of business. In Utah, five clinics have shut down, while two more are struggling to stay open.
The medicines covered by Medicare Part B are among the most important, life-saving drugs we have. They are cancer therapies, autoimmune medicines, and treatments for macular degeneration and osteoporosis.
This is not only an issue for seniors. My daughter has Crohn's disease. Clinics closing would make it harder for her to receive care for her autoimmune condition as well. Thousands of Utahns could be left with fewer treatment options or would force them to drive farther to receive care.
Cancer is scary enough. Patients shouldn't also have to worry about government officials driving doctors out of business and making it nearly impossible for them to provide lifesaving treatments.
Mary Bishop lives in Salt Lake City and hopes to live long enough to see her granddaughters graduate from college.