Cancer, Sequester, and Obamacare

 

As the sun shines outside, its glow softened by a layer of yellow pollen on the window of the doctor’s office, I sit in a sterile room with an afghan over my legs and medicine dripping into my arm from an IV. I’m not alone. The room at the oncologist/hematologist office is filled with people lying on recliners with IV lines leading from bags of medicine to their arms or necks. I feel like I’m in a creepy science fiction film, and we’ve all been abducted by aliens.

There aren’t many younger people like me in the room; most are older, accompanied by spouses or grown children. One woman is alone, but she is asleep. Some have been there many times, and the nurses know them by name. They have the typical look of those who have been undergoing chemotherapy for cancer—the ashen skin, the swollen faces, the weary eyes, the scarves wrapped loosely around their heads to hide their baldness. I feel guilty because I’m not there to get chemo. My treatment is for something less serious. But here I sit for two hours amid the cancer patients with shadows from dogwoods dancing across the windows to the steady clicks and beeps of IV pumps.

A nurse changes my bag of medicine, and I watch the golden liquid run through the tiny tube until it reaches my blood where it ebbs and flows with every pump. My stomach turns and I look for something to distract me. I pick up a flyer sitting on the table next to me, and it does little to ease my nausea. It’s a letter from the doctor asking cancer patients to contact their congressional representative to stop the sequester cuts.

We are writing to tell you about severe cuts to cancer care that the government is making. . . . A special committee of Congress tried but failed to reduce government spending by at least $1.2 trillion. That kicked in automatic spending cuts that will be made to defense, healthcare, education, and other government programs. These automatic spending cuts are referred to as “sequestration.” Among the sequester cuts will be an overall 2% cut in Medicare payments that will negatively affect providers of medical care, including community cancer clinics.

Unfortunately, with cancer drugs the real impact of sequester cuts will be far greater than 2%, because many of these drugs will end up costing more than what we are paid to give them to our patients.

We ask you to join us in fighting these destructive sequester cuts to cancer care. We are working with other cancer care providers across the nation in asking Congress to help stop these cuts. Please join us by contacting your members of Congress.

What they don’t say in the letter is that while the total effect of sequestration for the fiscal year 2013 will be $3 billion, this is the same amount Obamacare is supposed to reduce Medicare spending this year. But, as reported by Heritage, 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. . . . By 2020 Obamacare will reduce overall Medicare spending by more than $100 billion a year.”

I want to stop the nurse and ask her if the doctor’s office had given a similar letter to patients when Obamacare was coming down the pike. Did they put out a letter before the election warning patients of the cuts in Obamacare and asking them to vote for Romney so the healthcare law could be repealed? Did it even cross their minds? I want to ask her if they plan to distribute another letter next year urging cancer patients to contact the White House or the media or anyone about how they’re suffering under Obamacare.

Of course, I don’t say anything. I don’t want to offend the person controlling the IV pump to my bloodstream. Maybe another day when needles aren’t involved.

There are 38 comments.

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  1. Profile Photo Thatcher
    @DougKimball

    The question is, of course, rhetorical, because the answer is “no.”   Welcome to the politics of government controlled health care.  Faced with sickness and death, the demand for benefits becomes shrill.  So long as politicians think that they hold the ability, no not just ability but the moral authority to deliver benefits, then expect this kind of personal demand on our elected officials will become deafening, drowning out everything else. Government becomes the center of every personal health crisis.  These oncologists, faced with reduced profits or even losses, have played right into the liberal playbook, letting no crisis, invented or not, be wasted.  “Contact your legislator.  Demand more!  Those Bad Republicans want you to DIE!”  (And we are not in this to lose money helping you.) Current demands on the treasury are are a mere trickle when compared to this. 

    • #1
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    @DCMcAllister
    Doug Kimball: Those Bad Republicans want you to DIE!”  (And we are not in this to lose money helping you.) Current demands on the treasury are are a mere trickle when compared to this.  · 10 minutes ago

    Whenever I see the sequester being attacked in the healthcare setting and not Obamacare, I see blame the Republicans not Obama. Very frustrating.

    • #2
  3. Profile Photo Member
    @

    It has to be talked about ESPECIALLY when needles are involved. All that is necessary for the ultimate triumph of evil is for a few good men to do nothing.

    if we can’t talk about it when it so obviously matters, when can we talk about it? When it doesn’t matter?

    • #3
  4. Profile Photo Inactive
    @DCMcAllister

    Tom–you’re right of course. I already plan to ask my questions on my next office visit (though not when I have my infusion). I’ll also direct my inquiries to the office administrator who signed the letter. I don’t want to bug the nurses while they’re working. You’re right though. People do need to stand up. I especially expect that of the doctors themselves who should know better.

    • #4
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    @Pilli

    Where are the Republican leaders?   They should be screaming that Obama is responsible for cutting off the cancer treatments.  He would rather cut cancer treatments than cut INCREASES in ___________.

    Fill in the blank.

    • #5
  6. Profile Photo Inactive
    @DCMcAllister

    Pilli–it’s especially irritating when the president is throwing expensive parties for himself at the While House. There needs to be more outcry against King Louis Obama and Michelle Antoinette. Espeically when people like cancer patients are being affected!

    • #6
  7. Profile Photo Member
    @NathanielWright

    I will pray for you over the next few weeks.

    First, that your chemo goes well.

    Second, that your conversation with the administrator doesn’t cause backlash. I have known too many angry liberals, and fear any criticism might lead to conflict.

    • #7
  8. Profile Photo Member
    @
    Denise McAllister: Tom–you’re right of course. I already plan to ask my questions on my next office visit (though not when I have my infusion). I’ll also direct my inquiries to the office administrator who signed the letter. I don’t want to bug the nurses while they’re working. You’re right though. People do need to stand up. I especially expect that of the doctors themselves who should know better. · 0 minutes ago

    Doctors have a lot of clout and I was very disappointed that they didn’t make a bigger fuss. They are very busy, I know, and have greater concerns of life, death, quality. But just like their everyday patients (us) this is the kind of thing I believe we need more of and am trying to preach. Not ‘winning the culture’ or anything, just speaking up in our personal lives. Not being afraid of actual retaliation, or just being thought of as mean and nasty. You can choose your battles of course but be clear in your mind why. Ask yourself how seriously you take this mess and don’t keep blaming something outside like the gov’t or even the Leftists.
    • #8
  9. Profile Photo Contributor
    @RachelLu

    I hope whatever you needed wasn’t too serious, Denise!

    Fear is a powerful motivator. Doctors in particular are in an excellent position to use it. Shame to see them exploiting that for political purposes.

    • #9
  10. Profile Photo Member
    @
    Nathaniel Wright: I will pray for you over the next few weeks.

    First, that your chemo goes well.

    Second, that your conversation with the administrator doesn’t cause backlash. I have known too many angry liberals, and fear any criticism might lead to conflict. · 11 minutes ago

    Take a Scots-Irish friend with you to handle the conflict, or somebody else who will glory in it. Stir things up! Hey, a Scots-Irish, lawyer, friend would be the best wouldn’t it?I’m saying this generally because you should handle it your own way, of course. And I will pray for you too.
    • #10
  11. Profile Photo Thatcher
    @DougKimball

    Please, people!  Do not fall into this trap!  This is not a fight about who will preserve or boost Medicare benefits.  Medicare is nothing more than a price fixing, care rationing ponzi scheme hoisted on our retirees.  It faces a insolvency because of demographics – too many people (baby boomers) retiring, not enough contributors (working Americans.)  Participant, that is beneficiary growth far exceeds funding growth.  Add to that, reductions in future funding under ACA.  The result a big squeeze – yet lower reimbursement rates (read price controls) and rationing (when physicians refuse to treat patients or when coverages are limited.)  Democrats see the political blowback and are already directing it at Republicans, but the problem is that the entire construct is unsustainable.  Medicare needs to change, to be privatized with subsidies for the very poor, not just poor in terms of income, but assets as well.  State premium subsidies should not protect inheritance.  Like it or not, health deteriorates as we age.   Trusts and other mechanisms, if not protected by long term care insurance for those whose assets are being protected, should be tapped to reimburse the government for premium subsidies if the benefactors subsequently require them.

    • #11
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    @rayconandlindacon

    @PM; “Doctors have a lot of clout and I was very disappointed that they didn’t make a bigger fuss. They are very busy, I know, and have greater concerns of life, death, quality. ”

    How can we actually know when the doctors, associations, Republicans, or anyone cries out.  They are shouting into the pillow of the MSM.  Unless you listen to right wing talk radio or read Drudge, etc., none of the outcry exists.

    Watch CBS news for a few days and catalog what you do not hear.

    If outcry happens in the forest, and no one hears, did anyone cry out?

    • #12
  13. Profile Photo Inactive
    @user_264030

    That’s a pretty morbid picture, Denise. The Guardian had a piece last year that discussed how doctors choose to die, and how many refuse terminal cancer treatment after seeing the effects of chemotherapy on a person’s life. At some point, continuing to live seems less a health issue and more a lifestyle choice. I don’t know if that makes the “healthcare” propaganda better or worse. It seems a pretty cruel lifeline to tug at, regardless of whether we all should be paying for the lifeline in the first place.

    Also, I’m not following the logic of why patients having to pay a portion of their cancer drug costs is far more devastating than a decrease in services from care facilities. Are they implying that drugs are more valuable per dollar spent than the care the providers are providing? If that’s the case, then maybe the providers should be taking more of a cut, if what they really cared about was the highest quality care for their patients. (cue laugh track)

    Edit: Ack! I didn’t meant to imply you’re gonna die of cancer and treatment will degrade your life!

    • #13
  14. Profile Photo Inactive
    @MothershipGreg

    What’s interesting about the WaPo piece which is helping to gin up this hysteria is no real numbers are mentioned, as are discussed here:

    Conway: Sure. Take a typical course of chemotherapy, which might cost $10,000. 

    Under ASP + 6%, the markup was $600. Thanks to the sequester, the markup goes to $400 at 4%.

    That’s a $200 swing per patient. And a typical medical oncologist sees 300 to 350 new patients per year—doing some back-of-the-envelope math, that translates to $60,000 or $70,000 in lost revenue per physician.

    And that’s not counting patients receiving ongoing treatments.

    What are the odds that the vast majority of these cancer patients would be able to directly pay that additional $200 to keep the cancer centers open?  Doesn’t it seem more efficient to have the people directly benefiting from chemotherapy actually paying for it? Surely we have enough cancer charities in this country to step in for those who couldn’t pay?

    Of course, directly paying  for services, even a little bit (NO COPAYZ 4 CONTRACEPTIVEZ YAY!) must not be allowed, for reasons discussed here.

    • #14
  15. Profile Photo Inactive
    @NickStuart

    A couple of months ago Victor Davis Hanson wrote a piece to the effect that we are only now just beginning to see the effects of what Obama has wrought (from a running start from every president since Roosevelt).

    We’re beginning to see the leading edge of the very hard fact that the money isn’t there.

    • #15
  16. Profile Photo Member
    @

    First and foremost: Prayers!

    Next, are you familiar enough w/the nurses to know which one(s) might be approachable?  How about one or more of the docs?  They can’t be on board here.  Godspeed, my friend!

    • #16
  17. Profile Photo Inactive
    @DCMcAllister

    Nanda–thank you, and to all wishing me well. I wish I knew the nurses better. Unfortunately I’m the quintessential introvert and tend to have my nose in a book or my iPad when in public. I’m listening and watching but not usually engaging. I do plan to talk to the office manager. She doesn’t give me my meds or draw blood, so maybe I’ll be safe. :) As for the doctors, that is something I wonder about. Don’t they realize what is going on? I’d say they just don’t want to bother their patients with political issues, but this letter puts that theory to rest. If they’re going to blame the sequester, why not Obamacare–the real monster.

    • #17
  18. Profile Photo Member
    @drlorentz
    Denise McAllister: As for the doctors, that is something I wonder about. Don’t they realize what is going on? I’d say they just don’t want to bother their patients with political issues, but this letter puts that theory to rest. If they’re going to blame the sequester, why not Obamacare–the real monster.

    My heart goes out to you, Denise. Best wishes for a swift and complete recovery.

    As to the substance of your post, of course your observations are right on target. Do the doctors get it? Who knows? Maybe they are afraid to offend liberal patients. Medicine is a business, after all. Your vignette makes me think of H.L. Mencken:

    Democracy is the theory that the common people know what they want, and deserve to get it good and hard.

    It’s not what we signed up for, I know. But a majority did.

    • #18
  19. Profile Photo Inactive
    @DCMcAllister

    drlorentz–thank you for your kind words. “Democracy is the theory that the common people know what they want, and deserve to get it good and hard…. It’s not what we signed up for, I know. But a majority did.” This is one of the frustrations though, isn’t it? We don’t live in a democracy, and yet we are turning into a “mob rules” society.

    • #19
  20. Profile Photo Member
    @6foot2inhighheels

    There’s a very good reason the letter doesn’t address the real problem of Obamacare. The point of the “letter” is to inform patients of how punishing sequestration is.   Perhaps everyone is already aware of this, but most doctors and nurses are as clueless about Obamacare as they are trusting of the informational packets they get from governmental sources.  My intuition tells me that the flyer was provided to the doctor’s office/clinic by a source interested in hammering Republicans for “forcing” sequestration.  Most doctors don’t have enough time to dictate carefully worded letters of this nature.  Taxpayer funded propaganda.

    • #20
  21. Profile Photo Inactive
    @RobGen

    Denise, my prayers go out to you.

    This is not a fight about who will preserve or boost Medicare benefits

    I need to become better informed on all this, but what is option number 3? Not medicare, not obamacare, so…

    I vaguely remember some intelligent proposals being outlined, by a very few, before obamacare was mashed down everybody’s throats – ones that both honored the demand for care for those who could not afford it and the realities of our economy. But they were like little whispers of intelligence before the media cannons of obamacare and it’s detractors.

    I  have my perfect-world scenario in mind, but that’ll never happen, so what should we be fighting for? If there’s another post on this, please forward me the link.

    • #21
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    @user_646399

    Denise, I hope you are recovering.  At age 68, I continue to work because I enjoy working as an anesthesiologist and to postpone becoming “insured” by Medicare as long as possible. By working, my wife and I are covered by group commercial insurance, so we still have some choices. After having to contend with Medicare’s low payments, burdensome documentation demands and absurd regulations, I have no desire to be subject to its strictures as a patient. Denise’s post has given me that sick feeling I get every time the government intrudes into the most intimate portions of my life. As you can guess, I have these symptoms frequently.

    Mothership_Greg’s link at the end of his post has a link which explains it all extremely well. The bottom line:

    -Doctors will practice by algorithm, not personalized care.

    -Patients will have choices limited to inexpensive therapies; opting out will likely require going offshore and paying out of pocket.

    -Rationing will also occur by waiting and inconvenience.

    -Commercial insurance will cease to exist (establishing a single-payer government program by stealth is the main goal of Obamacare).

    More painful details will follow – in hospitals and offices, at the worst moments.

    • #22
  23. Profile Photo Coolidge
    @FakeJohnJaneGalt

    I have been aggravating my liberial ObamaCare fans lately. They keep telling me how ObamaCare will save millions of lives. I keep explaining that it will not save even one life and for them to think it does shows a unique form of stupidity. At that point they usually go off the deep end for a while with the usual hate rant against all that opose the enlightened liberial Democrat agenda. When they finally run out of breath, I point out that we only get one birth, one life and one death. All Obamacare can do is alter the manner of these slightly, at a great cost in both wealth and liberty. Since Obamacare can not in actuality save a life like they are promising, what else are they promising will they not be able to delivery on?

    • #23
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    @PsychLynne

    First, Denise, Prayers to you and your chronic (?) condition–

    Denise McAllister:  As for the doctors, that is something I wonder about. Don’t they realize what is going on? I’d say they just don’t want to bother their patients with political issues, but this letter puts that theory to rest. If they’re going to blame the sequester, why not Obamacare–the real monster. · 16 hours ago

    Second, Oncologists have seen their income decrease prior to Obamacare passage.  The average over the last three years or so has been around 20%.  MDs are paid for administering chemo and this is a point of contention between them and healthcare reformers.  Reformers say things like: the oncologist isn’t even there, nurses are doing the work, how can that doctor make money on the backs of cancer patients? Of course, Obamacare will worsen this. 

    I would definitely say something and would start with the office adminstrator.  He or she can also give you sense of what the docs and nurses think, should you decide to talk to them.

    • #24
  25. Profile Photo Member
    @JoALT
    Denise McAllister: Tom–you’re right of course. I already plan to ask my questions on my next office visit (though not when I have my infusion). I’ll also direct my inquiries to the office administrator who signed the letter. I don’t want to bug the nurses while they’re working. You’re right though. People do need to stand up. I especially expect that of the doctors themselves who should know better. · 6 hours ago

    I agree with you Denise, how we make our stand is important. Make it professionally. I would personally write first to the office administrator and cc a copy to a strong local conservative media. For example, the editor of a TV station or the editor of a strong local magazine. This will make the office administrator take you seriously and not waste your time when she meet up with you. Indicate in your letter that you want an appointment and why it is important that they address these issues. How your questions will help them streamline their business operation in the community. I have found often, that the pen is mightier than the sword. 

    • #25
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    @donaldtodd

    Denise, you are in my prayers now.  However it may occur, I hope you get well…. soon.  dt

    • #26
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    @DCMcAllister

    DT–thank you. I really didn’t meant this to be about me. I just wanted to give context to the oncologist’s letter. Once again, though, everyone at Ricochet reveals their kind hearts. I’m sure I’ll be fine–if Obamacare doesn’t do me in first. :)

    • #27
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    @SteveS
    Denise McAllister: DT–thank you. I really didn’t meant this to be about me. I just wanted to give context to the oncologist’s letter. Once again, though, everyone at Ricochet reveals their kind hearts. I’m sure I’ll be fine–if Obamacare doesn’t do me in first. :) · 20 minutes ago

    I’m sure you’ll be fine also Denise. God’s speed!

    I’ve had both a yearly physical and knee replacement surgery in the last few months so I have had the opportunity to have multiple Obamacare discussions with various individuals within the healthcare community, namely doctors, nurses and Physical therapists. I was nervous bringing it up not knowing beforehand their reaction or politics but all were in total agreement of the added burdens and harm they are currently seeing now and what is looming over the horizon. 

    I would like to say I was encouraged by the consensus but I’m less then optimistic as to our future but go ahead Denise be bold , be courageous  and remember to question and speak the truth in love.

    • #28
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    @DaveCarter

    Not everyone can describe such a scene and soften it with the warm haze of sunshine through a veil of pollen, but you pulled it off beautifully.  Denise, allow me to add my own prayers and best wishes for you and your treatment, as well as the myriad people in the room waging their own battles.  

    Even as you fight for your health, it seems proper to fight against the people and policies that work against all of our health, though I think you’re wise to wait until the needle is out of your arm so you can take it up with the people that actually ordered the dropping of those little propaganda leaflets on the table in the first place.

    • #29
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    @DCMcAllister

    Keystone–sounds like we’re all going to have to stick together to make it through the Obamacare nightmare. Thank you for the encouragement. You have mine as well.

    • #30

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