Dismantling of Medicare benefits started already. Cutting medication.

[madfloridian]

This was before the Medicare Drug plan passed, which makes matters worse.

This was in the New York Times in April of last year. It shows the beginning of the end for the Medicare program. It is slow destruction. It is sickening. I do not have the link to article, but it would be archived and pay for access now.

SNIP……”WASHINGTON, April 20 - In a fundamental change, the Bush
administration has begun to weigh cost as a factor in
deciding whether Medicare should pay for new drugs and
medical procedures.
Most notably, in recent weeks, federal officials have
adopted policies to limit what Medicare pays for
prescription drugs. These actions, they said, set a
significant precedent, illustrating how Medicare will try
to control spending if President Bush and Congress agree on
a plan to provide more extensive drug benefits to the
elderly and the disabled…..”

¶The federal official in charge of Medicare and Medicaid told
doctors last month that they should not prescribe Nexium, a
new heartburn drug, saying it was identical to an older
drug, Prilosec, which became available in a cheaper generic
form in December. The admonition infuriated executives of
AstraZeneca, the maker of Nexium and Prilosec, who contend
the new drug is superior. (My doctor disagrees, prefers Nexium for some)

¶Medicare refused to pay the full price for a new drug to
treat anemia in cancer patients, saying it was
"functionally equivalent" to an older drug with a lower
price. Amgen, the maker of the new drug, Aranesp, contends
that it is more effective than the older drug, Procrit,
sold by Johnson & Johnson.

¶In deciding whether Medicare should cover a new test for
colon cancer, the government said last month that it would
analyze the cost-effectiveness of the procedure in
detecting cancer among people with no symptoms. The
government has rarely been so explicit about considering
cost. (Cost differential is $30 and could save lives)

{{More on that test: “But the new test, which uses more sophisticated
laboratory
procedures, is also more expensive. The company wants to
charge Medicare $34 for each test, compared with Medicare's
payment of $4.54 for the current test. On the other hand,
Enterix says, its test is much cheaper than a colonoscopy,
which can cost $500 or more.”}} Makes no sense at all.

The Bush administration's aversion to regulating prices
sometimes collides with its desire to save money for
Medicare.

"We fix prices for every physician procedure and hospital
visit," said Thomas A. Scully, administrator of the federal
Centers for Medicare and Medicaid Services, who sets
overall payment policy for the programs. "It would be much
better to have private health plans make those decisions,
but I try to be the best price-fixer I can be."

A federal advisory committee said last month that Medicare
should systematically weigh costs against benefits in
deciding whether to pay for new drugs, medical devices and
other technology. Medicare coverage decisions have an
impact far beyond the federal program because private
health insurers often follow the government's lead.

From April to December of last year, Medicare paid
hospitals $3.89 for each microgram of Aranesp given to a
Medicare patient for treatment of anemia in a hospital
outpatient department. But this year the Bush
administration cut the payment by 39 percent, to $2.37,
after concluding that Aranesp was "almost identical" to
Procrit and should be paid at the same rate. (This is not believed to be
true.....they are making decisions for doctors. )

"Both products use the same biological mechanism to produce
the same clinical result, stimulation of the bone marrow to
produce red blood cells," the government said. Medicare
spends more than $1 billion a year on the two drugs in
hospital outpatient departments and in doctors' offices.
Doctors decide which drugs to prescribe, based on
information from many sources.

Under the Medicare law, federal officials say, they have
broad discretion to set drug payments for outpatients at
whatever levels they consider equitable. Moreover, they
say, drug companies have no standing to challenge such
decisions in court because they are not among the intended
beneficiaries of the Medicare law.

Amgen disagrees with those conclusions. It says that
Aranesp is less expensive and more potent than Procrit, so
patients do not have to visit the hospital as often for
treatments. That is a significant advantage for patients
who are elderly, disabled or terminally ill, Amgen says.

Moreover, drug companies say, the concept of "functional
equivalence" cannot be found anywhere in the Medicare
statute. They say coverage decisions should be made by the
market - doctors, patients and private health plans - even
when the government is paying the bills.

Alan F. Holmer, president of the Pharmaceutical Research
and Manufacturers of America, said he was deeply troubled
by the new standard of "functional equivalence" because it
meant that Medicare might not pay for incremental
improvements needed to achieve major advances in drug
therapy. "Such a policy will chill innovation," Mr. Holmer said.

Who to believe? A gastroenterologist? Or the administrator who wants to
save money?

SNIP…”Mr. Scully is wrong in saying that Nexium and Prilosec are
identical," said Dr. Joel E. Richter of the Cleveland
Clinic, a former president of the American College of
Gastroenterology. "Nexium is superior for some patients,
particularly those with more severe forms of disease."

[DeepModem Mom]

1. I don't understand these people --

how do they sleep at night? Were they born with no conscience, or human empathy? Was it their upbringing? How do you participate in the denial of the most effective drugs to sick people, some with life threatening diseases?

[madfloridian]

2. They have no soul.

Just that simple. Look into Bush's eyes. There is no soul there.

[MichiganVote]

3. What's the matter? You don't want to pay for the new prez limo?

[grilled onions]

4. We Are Screwed

Being on disability Medicare is the only insurance I have. Already there are places that won't take on any more Medicare patients or have gotten out of taking them alltogether. If you "have" medicare you are considered "medically covered" so you can't seek out coverage for those who have none. On the other hand Medicare barely pays a thing and every doctors office drills the Meciare patient hoping to find if they have ANY OTHER insurance before they put you down with having Meciare only. As long as * and his kind are running the show it will only get worse.

[Coastie for Truth]

5. I have Barrett's Disease

My Dad died of esophageal cancer. Prilosec is decidedly inferior to Nexium.

That's my clinical opinion, and I am a doctor (PhD engineer, not MD)

And Senator Frist (who holds himself out as a Harvard Medical School graduate and a Board Certified Heart Surgeon - who trained at Stanford; and who owns HCA) - closed the San Jose Regional Medical Center -- with the only emergency room in a large metro area. Way to go Mr. Frist.

[madfloridian]

6. They don't pay for tests if the tests come out ok.

I know that is true of blood work, some of which can be very expensive. I don't know if it is true of things like MRIs, etc.

I don't think the doctors have much power anymore.

Our doctor just retired, just got fed up with all the regulations. Our new doctor is nice, but has fallen for the line that the drug companies are pushing.

They changed the blood sugar acceptable level to 100. It has always been 120. But when 8 of 9 on a panel profit from drug companies, it is profitable to lower it and prescribe drugs.

I told our new doctor about the reason for the new rules, and I said I hope you don't mind that I hold control over what medications I take....she laughed and said No problem.

[doodadem]

7. If you think this is scary,

you should see what they're doing at the Veterans Admin. My dad is 84 years old, and a WWII veteran. He had previously never taken a dime from the government, even in hard times. Last year, my brother and I convinced him to check out what he was eligible for in veterans benefits, to possibly supplement Medicare. He had been on the same high blood pressure meds for two+ years, and done really well with them. The doctor at the VA said, we want to switch you to this other drug which is "almost as good" as the one you've been on, and it's a whole lot cheaper. Two weeks later, my father has a debilitating stroke.
My sister is totally disabled, and on both Medicare and Medicaid. She's terrified of what this administration is going to do to both. On the VA side, think about how 10,000 disabled Iraq War veterans are taxing an already over-taxed system. Don't see much media coverage of that.