By Jeffrey Evans
Special to the Reporter
More than 38,000 Washington residents receive new cancer diagnoses each year, and the incidence of cancer in Washington is higher than most states. It’s a condition that impacts seniors the most, and nearly all cases depend upon Medicare Part B for treatment.
In my area of medical specialty — urology — I see the impacts of this every day. In 2014, it’s estimated that nearly 5,400 Washington state men were diagnosed with prostate cancer, and in that year alone, 730 are thought to have died from it. That’s why getting patients the care they need is so important.
This September, as we observe National Prostate Cancer Awareness month, some in the nation’s capital are considering cuts to Medicare Part B. Fortunately, some of our representatives — led by Sens. Patty Murray and Maria Cantwell, along with Rep. Dave Reichert — are working hard to defend patients from these cuts. More Washington representatives should follow their lead.
Under Medicare Part B, doctors pay for medications like chemotherapy on their own and administer the drugs in their offices and clinics. We rely on the government to reimburse us for the treatments. The reimbursement rate is based on a formula that considers the average sales price — or ASP – of the medication plus a small markup to cover shipping, storage, and administrative costs.
However, persistent budget cuts have put pressure on Part B reimbursement rates for physician-administered medicines. The Medicare Modernization Act of 2003 limited the reimbursement rate for drugs covered by Medicare Part B to ASP plus 6 percent of its cost. Today, as a result of the across-the-board budget cuts known as sequestration, the rate stands closer to ASP plus 4 percent.
In his latest budget proposal, President Obama has called to reduce the Part B reimbursement rate closer to 3 percent. But many doctors and clinics are already under severe financial strain when they treat Part B patients. Nationally, more than 300 oncology clinics have shut their doors since 2008, and nearly 400 are on the financial edge.
Seniors in poor and rural areas will be especially hard hit by further cuts to the Part B reimbursement rate, since these areas already have a severe doctor shortage. In fact, 19 out of Washington’s 39 counties are “severely underserved.” Washington’s doctor shortage is only expected to get worse. Almost 20 percent of local physicians plan to retire in the next five years, according to a report by the University of Washington.
Thankfully, Washington’s congressional representatives are giving patients hope. They are working to ensure that seniors have access to vital treatments.
Sen. Murray has been called the “Iron Lady” of congressional budget battles for her efforts to protect programs like Medicare. Sen. Cantwell has long fought to boost access to care for rural patients. Rep. Reichert has teamed up with the Grange — the agricultural advocacy group — to fight against cuts that would reduce the quality of seniors’ care. The list goes on.
Washington’s seniors deserve quality care. Medicare Part B provides that care, which is why it’s so essential for the program to remain strong. All of our representatives should follow the lead of Sen. Murray, Sen. Cantwell and Rep. Reichert to protect Washington’s seniors.
Jeffrey Evans is president of the Washington State Urology Society. He lives on Mercer Island.
