Archived Messages From the President
April 20th, 2016
We sent out a survey on April 9th and got a great response, almost 2,000 of our activists took the time to give us their opinions. Click here to see the results.
Our survey asked questions about Medicare’s proposed payment cuts to doctors. We explained that “Medicare has announced its intent to set up a new “pilot” program which actually will affect most of the doctors in the US who provide patients with infused medicines. As opposed to other true pilot programs doctors are being forced to be part of this mandated program. This pilot program will actually cut the reimbursement rate Medicare will pay your doctor. As a result of this cut, many doctors have said that they will no longer be able to provide infusions in their offices. Patients who need this care will have to go to hospitals, which will cost both you and Medicare more, and are likely to be farther away with longer visits.”
We first asked if they or any of their family were covered by Medicare and if so if any of the Medicare covered members of their family received infused medicines. We were interested about this special subset of patients, those that were being treated in a doctor or hospital setting with infused medicines, because they would be the ones that would be most affected by these payment changes. Of the 1,955 who took the survey and answered the more general questions, 233 said they were involved with infused medicines. We then asked these 233 patients a series of questions comparing hospitals with doctor’s offices . . . asking where they felt more comfortable, which was more convenient, where they thought they would get the best treatment, where they really preferred to get treated. Over 90% chose the doctor’s office over the hospital. Now it isn’t a big surprise that people would prefer being treated in their doctor’s office rather than in a hospital, although the unusually high percentage was unexpected. It is surprising that Medicare, no doubt knowing that patient’s preferred doctor’s offices and without collaborating at all with patient groups, would burden patients with this “pilot” program. The results of one question, however, was not expected. 13% of the infused patients said they would quit getting their infusions if they couldn’t go to the doctor’s office. These are real patients who would stop getting critical care if they couldn’t go to the doctor’s office. This is extremely troubling, given that the fact that this “pilot” involves a very high percentage of the infusion sites, is not voluntary and is expected to become law within a few years.
It seems that Medicare proposed a new payment program without considering the patient’s preference and finances and this would be bad in and of itself but, unfortunately, it gets worse. It turns out that Medicare pays more when patients are infused at the hospital rather than at the doctor’s office. The bottom line is that under these proposed payment changes everyone loses; the community doctors who are driven out of business, Medicare – which pays more for a less convenient treatment and finally the patient who must travel further to get treated in a less desirable place and ends up paying more.
We want on to ask some more general questions about the powers of government and whether our activists thought that those powers were being used correctly. We asked if they thought Medicare should listen to doctors and patients before they made major changes to Medicare. It wasn’t surprising that after finding out about the proposed payment cuts, 98% of our activists said the government should listen. We then asked a question that I think goes to the root of the problem. We asked our activists if they thought that in the last few years the use of mandates, regulations and Presidential orders had increased, decreased or stayed the same . . . 96% of them said they had increased. From my observations I also think they have increased, I think we have seen a shift in the power of the Presidency that is unprecedented, goes against the balance that our forefathers envisioned when they created the Constitution and is dangerous. I think it is a form of regulatory activism or autocracy and it is of great concern to me and, from the 1,266 comments we received when we asked out activists what Congress should do, they are concerned also (click here to see some of those comments.
I believe that these proposed payment changes are an example of this shift in power. I believe these changes were directed by the President and his administration and they directed CMS (Centers for Medicare and Medicaid Services, the agency that controls Medicare) to make these payment changes as a knee jerk reaction to the cost of oncology medicines. It shouldn’t be within the power of the President or CMS to fundamentally change a program that was signed into law. The balance of power embodied in the Constitution dictates that only Congress has the power to change this law. This is the reason that RetireSafe is up on the Hill trying to get Congress to stop these proposed cuts before they get implemented and become permanent. This survey and accompanying comments are a powerful weapon to go back to Congress and show them how the people feel about these proposed payment changes. We will continue to defend your benefits.