Sequester and cancer

For most of us the "sequester" has just been a weird word that meant small airports were going to have to shut down because of less federal money to keep them open. But for those of us in the cancer community, the sequester is now emerging as something that will impact us in a number of ways -- some immediate and some long term. Last week I heard a story on NPR about less money being granted for research by NCI and other funding agencies in Washington because of the sequester. They interviewed a young cancer researcher who spent most of her time trying to find funds to set up her lab. She had been unsuccessful, and by the end of the interview said she was considering looking into other areas for a career. Folks this is the brain trust that will find the cure for us – and they can't get the money to do their work. Score one for Sequester – 0 for cancer.Now it's cancer treatment for our Medicare patients who are being cut off due to the sequester. To follow the impact of the sequester and Obamacare in general, read the Washington Post blog by Sarah Kliff. One of her latest blogs, which you can see her discuss here in a video blog, pointed out that the small clinics around the country that take Medicare patients are having to turn them away because of the Medicare cuts required by the sequester. Right now the oncologists who administer expensive chemotherapy drugs, and many are very expensive, are reimbursed by Medicare plus 6 percent for storage and all the costs associated with giving the drug. The cost of the drug isn't going down, so it's the associated costs that are being cut. These are costs associated with running the clinic and hiring staff called nurses. The critical part of cancer care we have been fighting in the cancer community for more of not fewer. The answer found by the clinics is to turn the patients away and tell them to go to hospitals for treatment, which ultimately will be more expensive, and, by my way of thinking, less personal than their clinic setting. Indeed, a study done by Millman found Medicare patients ended up with an average of $650 more in out-of-pocket costs when they were seen only in a hospital. And for rural cancer patients, traveling to a larger cancer center may mean significant travel they can neither afford nor endure. One report even had Rush Limbaugh eating his words. When he announced that the so called cuts to Medicare were, in fact, inaccurate and that Medicare was protected, one of his own followers, a conservative oncologist called in and explained that, actually, Medicare cuts were causing Medicare patients to be sent to other locations or to be turned away. What does all this mean. Medicare is supposedly one of our protected rights. We worked for it, but it's looking more and more like it will be gone by the time many of us get a chance to use it -- and if we can there won't be any doctors left who take it. And as for those who have the misfortune to be diagnosed with cancer while on Medicare, well, . . .