Obama's Medicare czar faces life-and-death decisions

Washington Examiner ^ | 8/16/10 | Editor

[Nachum]

Two organizations not known as members of the Vast Right Wing Conspiracy are worried that President Obama's recess-appointed Medicare czar won't allow the government health care program to cover two FDA-approved anti-cancer drugs with proven records of extending patients' lives.

The FDA approved Provenge, which is used to fight prostate cancer, and Avastin, which is used to delay the spread of breast cancer after it appears elsewhere in the body. The problem is that Dr. Donald Berwick, the man Obama recess-appointed as administrator of the Centers for Medicare and Medicaid, appears to be considering denying Medicare reimbursement for patients using Provenge and Avastin.

The Ovarian Cancer National Alliance explains the problem: "Medicare must cover therapies that are 'reasonable and necessary,' while the FDA is instructed to approve drugs that are 'safe and effective.' Because of the conflicting federal coverage and approval requirements, there are some non-FDA approved drugs (called off-label drugs) that are paid for by CMS. However, with respect to Provenge, it appears that CMS is arguing that while the treatment is safe and effective, it may not be reasonable and necessary. For the first time, an FDA approved anti-cancer therapy may not be covered by Medicare."

[Eric Pode of Croydon]

those of a palliative nature and those of a life and death nature

A reasonable point, but how do we decide which is which?

For example, I am personally aware of cases where $40,000 defibrillators have been implanted in patients with end-stage cancer and who died less than four months after the implant.

Bearing in mind that it's your and my tax money, are you willing to call that a "life and death issue" and give Medicare carte blanche to pay for it?

[Eric Pode of Croydon]

voters want to pay the taxes to proved very expensive end-of-life treatments

Some of the signs I saw in the tea party coverage ("Hands Off OUR Medicare") indicate that the answer must be yes.

Which means we drive the Medicare bus at its current speed until the wheels fly off and we're left with a smoking wreck at the roadside.

[muawiyah]

After reading a couple of dozen articles about these devices, I gathered the following:

The $40,000 price buys medical providers with a device that has mostly reusable parts ~ so when one patient dies in harness you pull it out, refurbish it, or cannibalize it for the parts, then it goes into another patient.

Still, I suppose there are some folks who demand all new parts, and others who want to be buried with the device.

Be sure to check your contract to see if they want it back!

There are probably other models out there that just trash out simultaneously when the patient dies.

Not being an expert in the devices all I can give you are ideas derived from following the evidence.

[muawiyah]

Probably. Why do you ask? Is it that you, perhaps, don't care?

Think for a moment of the vast politico-industrial complex backing up the modern antiseptic sterilized bandaid.

It costs a lot, and yet, if we'd just let the kiddies bleed their bodies would quickly form scabs and healing would proceed in a natural and healthful fashion just like it did for hundreds of millions of years.

If we could shut down the intrusive bandaid business think of the billions of dollars we'd save.