Thursday, July 26, 2007

Why do they put nails in coffins?

To stop oncologists from giving chemotherapy!

This is a guest article from an anonymous pharmaceutical drug rep:

If you have cancer, a big factor in your chemo decision is profit. Medical Oncologists are the cancer doctors that give chemotherapy.

Most of them are in group practices that buy intravenous drugs from specialty wholesalers.

When it's time for your treatment, a nurse will 'hang a bag' on the IV pole near your treatment chair and start dripping chemo into your veins.

The office then bills insurance (80%) and collects your co-pay (20%). Medical oncologists make money by 'keeping the chairs filled'.

Recent changes to Medicare limit drug profits to about 6%. If physicians buy $1,000 worth of drug they are reimbursed $1,060.

This is enough to cover costs and make a modest profit. Every quarter, Medicare reimbursement rates for chemotherapy change. Office managers compare these rates with acquisition costs and recommend agents to avoid or take advantage of.

There are a two other problems with this system:

- If a physician's yield is constant they are inclined to use more expensive drugs, even if they have the same therapeutic effect. For example, the $6,000 profit of a $100,000 drug is much higher than the $60 profit from a $1,000 drug. Insurance companies and patients pay the difference.

- In order to make money, physicians must collect co-payments. Conversely, they lose money if they don't collect co-payments. Let's say a patient doesn't cough up his $212 co-pay for a $1,000 drug. Even if a physician gets $848 from Medicare, he just lost $152 in the transaction.

Do you think he's going to use an even more expensive drug? Even one that could be more effective? Not unless they collect that co-payment up front.

- Bottom line? If your medical oncologist is confident that you can make your co-payments, you'll get the most expensive drugs on the market whether you need them or not.

There's an old joke: Why do they put nails in coffins? They do it to stop medical oncologists from giving chemotherapy. I guess now it depends on whether or not the dead can afford their co-payments.


Anonymous said...


Anonymous said...

This is terrible! Another reason, though, why we have to have Universal Healthcare NOW and some good controls on pricing. Everyone makes profits on the patient. Did you know that insurers with supplemental Medicare plans also get SUBSIDIES out of ..MEDICARE..for each patient they write up? So, the patient pays for Medicare - it is not free, about $ 100.-- a month out of the Social Security Check, 20% copayments, supplemental insurance premiums and as I found out hospital deductibles are much higher than if you do NOT have that supplemental insurance. In 2002, a.o., the Medicare deductible was $ 780.-- for a hospital stay, but with an extra supplemental insurance it was much *cheaper*, nly $ 5000.--, as quoted to me. Stupid me, I said, *now why would I do THAT* - and I did not. The insurance premium for healthcoverage, including meds, is in The Netherlands, I believe Eur 90.-- (check this out for accuracy). Medicare is NOT FREE.

Anonymous said...

Here is another thought. For 2008 another 10% reduction of reimbursements to physicians are scheduled for Medicare patients. Unless all doctors find a way to get some extra profits, and even then, they are NOT inclined to take on new Medicare patients, and will even drop existing ones. That is a fact. Those who want universal healthcare must see to it that this reduction in reimbursements is dropped, as the reduction for 2007 was.

Anonymous said...

Some people are too lazy to do what it takes to heal naturally. All they know how to do is sit there and receive chemo. So, it's their loss. If you want to work and do things naturally, by all means, go ahead!

Anonymous said...

It is simply unbelievable that USA managed to keep thier for profit only health care system (if you can call it system) going all these years while all civilized countries in The West went the other way, universal health care. This is only possible in the socio-econmic system that you have and cherish, which is the brutal American style capitalism. This is the same system that your half-brain prez and his neo-con team is trying to spread around the world in the name of democracy and freedom. Can you $#^%$#@ing believe this? We in Europe and other cultured countries are simply appaled and &^%$##@*& to use some of more printable words.
Now you know why very few immigrants to US come from Europe and similar places. Those who do come don't know any better or are simply desparate to leave their troubled countries. No other reason to join you. As someone said "AmeriKa gut kontry, guverment no gut". Obviously east Europe accent.
Land of brave and free....and you don't do anything about this? Only well fed Mike is trying.