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Health reform


Jack Willis August 20th, 2009

I always enjoy checking the mail. I'm a retired kind of guy. Strolling to the mailbox often highlights my day. I even like junk mail. I always think someone's going to send me something important. (Th...

I always enjoy checking the mail. I'm a retired kind of guy. Strolling to the mailbox often highlights my day. I even like junk mail. I always think someone's going to send me something important. (They rarely do.)

On a recent trip out front, a letter from Cancer Care Associates in Oklahoma City caught my eye. (I thought it was a medical bill.) I'm a four-year cancer survivor, and CCA is my care provider. I ripped open the envelope, speed-read to see how much I owed, and then stopped abruptly. It wasn't a bill: "We need to make you aware of some changes being discussed that would hurt or even stop our ability to provide cancer care."

I hyperventilated, fearing an end to my follow-up visits to the oncologist " my security blanket " and imagining how active cancer patients must feel.

The letter asked me to lobby lawmakers for H.R. 2872, the Medicare Quality Cancer Care Demonstration Project Act of 2009. I couldn't decide. To lobby or not to lobby? Was this just a letter campaign to protect someone's bottom line or would the bill really help patients?

Providers don't much like the Obama administration's health care proposal to give patients a "public" insurance option. If a public plan is created, they say, it would be based on Medicare's lower rates and consequently drive down private insurers' payments. Providers say many practices would have to dramatically cut staff, even eventually closing offices. (Or raise fees. Or simply stop taking Medicare patients. Whoa, dude, I'm a Medicare guy.)

I Googled Community Oncology Alliance, a national nonprofit group of oncologists. Because it said 45 percent of all cancer patients are on Medicare, my calculations showed the cuts would affect nearly 8,000 Oklahomans diagnosed with cancer this year alone. During the past six years, Medicare cut payments more than 25 percent, causing services and drugs to be underpaid or unpaid. The 2010 Medicare Physicians Fee Schedule proposes another 21 percent cut in payments to physicians and an additional 6 percent cut to community oncology practices. (Hold on there, Barack. Let's have a beer at the White House and talk.)

I needed a patient advocate's view. I called Lorna Palmer, executive director of the Central Oklahoma Susan G. Komen for the Cure affiliate. That organization says "a key aspect of health reform is chronic disease management, and a key to chronic disease management is the coordination of care." Cancer patients need a coordinated treatment plan and follow-up from diagnosis through survival. A written plan allows patients to review it with their doctors and better understand the process ahead, monitor their health and participate in care decisions.

"A written plan will help coordinate care among a patient's many doctors and providers, reduce medical errors, and ultimately improve patient care."

Now, Medicare pays nothing for critical planning, coordination and end-of-life care. H.R. 2872 would set up a demonstration project in which community cancer clinics would collaborate with Medicare. COA calls the project a landmark initiative to transform the payment system for cancer. It's designed to enhance quality care while controlling costs.

This was a rare time my mail was important. Congress needs to know this is a good bill for cancer patients. This is one phone call I need to make. (Just call me "lobby guy.")

Willis, a former Muskogee Phoenix managing editor, is the author of "Saving Jack: A Man's Struggle with Breast Cancer."

 
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