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Vacirca: Sequestration not hurting? Ask cancer patients

Clamps, scissors and other surgical instruments are seen

Clamps, scissors and other surgical instruments are seen in the operating room during a kidney transplant at Johns Hopkins Hospital in Baltimore, Md. Photo Credit: Getty Images

Some news reports suggest that sequestration is not having an impact on our country. Those reports are blind to what is happening to cancer care and the devastating impact of the sequester cut to cancer patients.

Sequestration resulted when Congress could not agree to federal budget cuts. Many made dire predictions about the automatic budget cuts required by sequestration, including an across-the-board cut to Medicare, but once they were imposed, much of the doomsaying ended.

Few understand the harmful impact that the cuts are having on cancer care, and their potential to seriously imperil its future.

Less than eight years ago, close to 90 percent of cancer treatment was delivered in community cancer clinics. We pride ourselves on providing our patients with the highest quality cancer treatment in a convenient location, a caring environment, and at a lower cost. It's now estimated that less than 70 percent of cancer care is delivered in clinics like ours, with treatment increasingly shifting to the more expensive, and typically less convenient, hospital setting. With roughly 50 percent of cancer care covered by Medicare, hospital cancer care costs taxpayers $6,500 more per patient per year and seniors $650 more in co-pays compared with care from community-based cancer centers, according to a study by Milliman, a leading health care market research firm. The expense is even greater for patients covered by private insurance.

The Center for Medicare and Medicaid Services, the government agency administering Medicare, decided to apply its mandatory cut from sequestration to the cost of cancer drugs. Because the sequester cut is being applied to these fixed, underlying costs, clinics like ours are faced with two painful options: send our patients with Medicare to the hospital for treatment with those drugs paid for by Medicare and reimbursed at less than cost, or absorb the loss and face the prospect, if this continues, of not being able to treat any patients because we have to close our doors. Our government may print money when it runs a deficit, but small businesses like ours operate in the world of economic realities.

The U.S. Senate is deliberating how best to address the sequester cuts' impact on cancer care but has yet to introduce legislation. In the House, thankfully, Rep. Renee Ellmers (R-N.C.) has drafted a bill to stop the government from applying the sequester cut to cancer drugs. The Cancer Patient Protection Act now has more than 100 co-sponsors, including Reps. Peter King (R-Seaford), Carolyn McCarthy (D-Mineola) and Tim Bishop (D-Southampton). I have met with the Rep. Ellmers on Capitol Hill to personally thank her on behalf of our patients and staff. Rep. Bishop visited our clinic to meet with patients and talk with the press. Unfortunately, Rep. Steve Israel (D-Huntington), a longtime co-chairman of the Congressional Cancer Caucus, has not supported it, despite pleas from patients in his district.

This country has the world's best cancer care but it is imperiled by the kind of harmful government policy that would mindlessly cut payment for cancer drugs. The sequester threatens to push cancer care over the cliff, resulting in more expensive and less convenient care for every American battling cancer, on Long Island and elsewhere. We need immediate help from Congress before it is too late.

Dr. Jeffrey Vacirca is chief executive and managing partner of North Shore Hematology/Oncology Associates.


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