Medical Forum / Diseases and Disorders / Prostate Cancer / August 2004
Bush plan to cut medicare payments for cancer treatments
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John Brockhouse - 28 Jul 2004 16:22 GMT Group, Associated Press reports some treatments for prostate cancer will be cut in half. The same will apply to cancer drugs, which are to come under Medicare in 2006. One poster pointed out, the warriors who started the war in Iraq have never fought in a war. They have so far spent 200 billion taxpayer dollars in Iraq and counting. As an example, a portion of this money has gone to build new schools in Iraq and to provide 5 cent per gallon gasoline. And yet, American boys are being killed and injured by the hundreds by some Iraquis who yearn for the old regime of Saddam. If I had my druthers, I wish a portion of the billions would have spent on a cure for PCa. Instead, it is being cut to protect tax cuts for millionaires. For those who say it's better to fight in Iraq than in our streets, the target should have been Osama's terrorists. John in OR
Leonard Evens - 28 Jul 2004 18:39 GMT > Group, > Associated Press reports some treatments for prostate cancer will be cut [quoted text clipped - 12 lines] > the target should have been Osama's terrorists. > John in OR Far be it for me to defend the Bush administration. I agree with you that they are amatuerishly trying to cut spending to justify their tax cuts weighted to the ultra rich. But it is a bit more complicated than it might seem.
Oncologists administer drugs in their offices. Until now, Medicare has been paying prices based on some formula for wholesale prices, but in fact the drug companies have been charging the oncologists less than what Medicare pays, sometimes significantly less. Patients also pay about 20 percent of the cost, and according to news reports, in some cases, the drug company charges the oncologist less than the patient's copayment. So in those cases, the doctor makes a profit on the copayment alone, and in all the case the doctor makes a profit from the Medicare payment.
The oncologists maintain that they need the extra profits because they are not reimbursed adequately for their services in administering the drugs. Under the new rules, doctors will be reimbursed somewhat for such services, but the oncologists still think they will come out behind. Some oncologists have been threatening to stop administering these drugs or switching patients to other drugs, which may have more side effects. The news article I read pointed out that oncologists' incomes have risen faster than those of other doctors in recent years. Given that many of us have not had any increases in income, and in many cases, reduced real incomes, it is not clear why any doctors, who are supposedly dedicated to serving humanity, should be seeing their real incomes rise. Some doctors in the current market are losing real income.
It is very hard in these matters to see where the truth lies and who is pursuing an agenda which is in the interests of the patients. It seems a mixture of good intentions, greed, and stupidity. The Bush administration which is supposedly totally opposed to price controls in the drug market is in effect introducing price controls. (The Reagan administration did something similar for doctors' Medicare fees when costs were getting out of control.)
It would be good if some smart people could approach this whole subject honestly without ideological blinkers and come up with an equitable solution. But as things now stand there are too many special interests with turf to defend, so I suppose we will just have to muddle through. I am not at all confident that even under a Kerry administration anything sensible can be done, and I'm sure under the current administration it won't happen. That is a shame because other major industrialized countries have managed to do a better job at such things.
This, by the way, is on topic, because Lupron is one of those drugs. Indeed there has been a scandal about the way Lupron was handled by its manufacturer and some urologists and criminal prosecutions are now underway as a result.
John Brockhouse - 28 Jul 2004 22:18 GMT Leonard, As always you have responded with a lot of wellfounded facts and intelligence, which I respect. However, my rebuttal is not O/T, either, because it concerns the welfare of the group. I will agree that oncologists are probably overpaid by medicare. With my secondary insurance my brachytherapy didn't cost a dime. By the same token I have a young GP who used to charge $80 for an office visit, but has gradually increased it to $107, since he accepts Medicare, which approves 80% of $50, leaving him $40, my secondary pays the other $10. So he comes out $50 which I consider reasonable. I don't recall, but I think my brachy was 25k of which my secondary paid 9K. As for Bush admininstration, they refused to allow medicare to negotiate lower prices or to allow purchase of much cheaper Canadian drugs, on the phony charge they might not be safe. These refusals were to protect the drug companies monopoly. The price of the most popular drugs were increased as much as 10% in March to beat the entry of the Medicare discount drug card. The only fair solution is a universal health care plan in which everyone is provided affordable insurance. Ask the Canadian members of the group. From their comments I believe they are very enthusiastic about their health care. Any mention of rescending the tax cuts for the rich to help pay for health insurance or the war is regarded by the administration as a tax increase. A brilliant deduction, my dear Watson. As their hero, John Wayne, who never saw combat, either, would say "A man's gotta do what a man's gotta do" . If you don't agree with them, you are a traitor and therefore can go f__k yourself. And for good measure, that goes for the rest of the world. A breath of fresh air? You have to have clean air first. John in OR
Jim Baker - 29 Jul 2004 03:04 GMT Group- I had to check the date of these posts after reading them....thought they must be dated 9/10/01! Here we are fighting for the survival of our nation and way of life and the old saw about 'tax cuts for the rich' gets resurrected!!! Please read the following..............
A Parable: The Tenth Man By William F. Buckley Jr. The following parable just came in from a friend, via the Internet. It's possible everyone else in America has seen it. On the other hand, it's also possible that only my friend and I have seen it. Every night, 10 men met at a restaurant for dinner. At the end of the meal, the bill would arrive. They owed $100 for the food that they shared. Every night they lined up in the same order at the cash register. The first four men paid nothing at all. The fifth, though he grumbled about the unfairness of the situation, paid $1. The sixth man, feeling generous, paid $3. The next three men paid $7, $12 and $18, respectively. The last man was required to pay the remaining balance of $59. The 10 men were quite settled into their routine when the restaurant threw them into chaos. It announced that it was cutting down its prices: Now it would charge only $80 for dinner for the 10 men. This reduction wouldn't affect the first four men -- they would continue to eat for free. The fifth person decided to forgo his $1 contribution to the pool, and the sixth contributed $2. The seventh man deducted $2 from his usual payment and now paid $5. The eighth man paid $9, the ninth, $12, leaving the last man with a bill of $52. Outside of the restaurant, the men compared their savings, and angry outbursts began to erupt. The sixth man yelled, "I only got $1 out of the total reduction of $20, and he" - pointing to the last man - "got $7." The fifth man joined in the protest. "Yeah! I only got $1 too. It is unfair that he got seven times more than me." The seventh man cried, "Why should he get a $7 reduction when I only got $2?" The first four men followed the lead of the others: "We didn't get any of the $20 reduction. Where is our share?" The nine men formed an outraged mob, surrounding the 10th man. The nine angry men carried the 10th man up to the top of a hill and lynched him. The next night, the nine remaining men met at the restaurant for dinner. But when the bill came, there was no one to pay it. Well, parables do have their weaknesses. But they can be useful. Mrs. Clare Boothe Luce had the habit, in search of analytical clarity, of chopping off seven zeroes to illustrate her points. Thus the population of the world was 800 (read 8 billion) and that of the United States, 30 (not 300 million). By these devices, it is true, clarifications are more nimbly arrived at. As the parable above informs us, 10 percent of the American people (the 10th dinner guest) pay 59 percent of all the taxes. The lowest 40 percent pay none. The fifth quintile, 1 percent; the sixth, seventh, eighth and ninth, respectively, 3, 7,12 and 18 percent of the taxes. The parable, of course, then brings in the drama: The proposed tax reduction of President Bush (news - web sites) would reduce income taxes by a total of 20 percent, and the benefits of that reduction are distributed along the lines suggested for the 10 diners. And yes, the protests arise, reaching maximum volume in the matter of relieving the 10th man from his customary contribution of $59 toward the common meal to a contribution of $52. OK, but the drama is then taken to what one might call a fourth act, which is one too many. The 10th diner isn't going to be lynched, because his survival is too necessary to the other nine diners. What they will do is attempt to diminish the reduction in his allocation of his benefits from the reduced dinner price and spread it among themselves. They'd like to see the 10th man continue to pay 59 percent of all taxes. That way it doesn't hurt. Ah, but the parable writer obviously believes that it would hurt, in the long run. Because if that 10th diner tires, or is crushed into diminished productivity, he won't have the $59 to contribute to the pool, and that would be very, very inconvenient. Perhaps even life-threatening. If the restaurant has to go without that critical subsidy from the 10th diner, it might just have to reduce the rations paid out. Granted, if the parable were refined even further, it would have to ask, what was it that caused the 10th man to be so obliging in the first place? Were they threatening to lynch him if he didn't put out? Did the 10th man plot to protect himself? Was he the critical voter in Florida in November 2000?
> Leonard, > As always you have responded with a lot of wellfounded facts and [quoted text clipped - 27 lines] > You have to have clean air first. > John in OR Alan Meyer - 29 Jul 2004 03:31 GMT Be warned, this posting is way, way, off-topic. Please do not read it if that bothers you.
> Group- > I had to check the date of these posts after reading them....thought they > must be dated 9/10/01! Here we are fighting for the survival of our nation > and way of life and the old saw about 'tax cuts for the rich' gets > resurrected!!! Please read the following.............. Forgive me if I can't figure out how the soldiers in Iraq are fighting for the survival of our nation or our way of life. There were no weapons of mass destruction there. There were apparently no terrorists harbored there. However we have succeeded in stirring up a hornets nest of opposition to, and hatred of, the United States. Somehow I feel a lot less secure rather than more because of all the fighting.
> A Parable: The Tenth Man > By William F. Buckley Jr. ...
In Buckley's parable, 10 men go to a restaurant and all eat the same meal, but one man gets socked for 59% of the bill.
But the fact is that we don't all eat the same meal. Bill Gates or any of the Walmart heirs live in huge mansions, own fancy cars, vacation homes, and airplanes. They're served by servants. They jet around the world whenever they want. They eat at any restaurant they like - physical and metaphorical.
Is it so wrong to ask the people who benefit most from our American economy and society to pay a larger bill for it's administration? The Walmart heirs are worth $20 billion each (Really! There are five of them with 20 billion dollars each!) They make bunches of bucks every year from each of hundreds of thousands of Walmart employees who each get 6, 7, or 8 dollars an hour for their work. Is it so wrong to ask the heirs to give back more than we ask of the guy who shows up every night to stack merchandise that Walmart sells?
I'm not saying we need to plunder the rich. But I just don't have any sympathy for their tears when they cry about having to pay more taxes than I do.
Alan
Jim Baker - 29 Jul 2004 03:56 GMT So are you one of the four diners who eats for free?
> Be warned, this posting is way, way, off-topic. Please do not > read it if that bothers you. [quoted text clipped - 47 lines] > > Alan Alan Meyer - 05 Aug 2004 01:26 GMT We're still off topic here so please stop reading if that offends you. ----------
Jim,
Actually, I have a good income as a computer consultant and pay lots of taxes. I certainly pay more than I get back in services from the Federal Government, and I'm sure I pay more than the average guy.
But I don't mind. I'm perfectly willing to pay more than I do. The American economy and way of life have worked well for me and I'm willing to contribute to live here. I believe that I should pay more than the guy making $6 an hour at a grinding job at Walmart, and I'm happy to do so.
Alan
> So are you one of the four diners who eats for free?
> > Be warned, this posting is way, way, off-topic. Please do not > > read it if that bothers you. [quoted text clipped - 47 lines] > > > > Alan jhlms - 05 Aug 2004 01:51 GMT > We're still off topic here so please stop reading if > that offends you. [quoted text clipped - 71 lines] > > > > > > Alan All this being said, whould you not feel it fairer that everybody paid the same PER CENT tax. What seems to be the problem with passing a *flat tax*???? And why does this seem to be something that never makes it to the floor????
jh
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Steve Kramer - 05 Aug 2004 12:16 GMT > All this being said, whould you not feel it fairer that everybody paid the > same PER CENT tax. What seems to be the problem with passing a *flat > tax*???? > And why does this seem to be something that never makes it to the floor???? Amen! Seems like the most simplest, fairest idea of all. If you buy a Hugo, you pay tax. If you buy a Rolls, you pay lotsa tax. If you get hamburger, you pay less tax than the guy who buys steak. If you give your money away to charity, you pay not tax on it. If you put it in a bank and make it availble to others int he community, you pay no tax on it until you take it out and spend it.
So, easy. But the rich like making lotsa money and having lotsa loopholes. The lawyers like the business. IRS likes the business. The poor are ignorant and convinced that a flat tax makes them pay the same as the rich. That's why it doesn't get anywhere.
Alan Meyer - 08 Aug 2004 05:35 GMT > > We're still off topic here so please stop reading if > > that offends you. > > ... Still in effect. ...
> All this being said, whould you not feel it fairer that everybody paid the > same PER CENT tax. What seems to be the problem with passing a *flat > tax*???? > And why does this seem to be something that never makes it to the floor???? Of course there are theoretical taxes and practical taxes. Theoretically, the tax system is progressive, the rich pay a higher percentage than the poor.
In practice it is sometimes that way and sometimes not. For example the rich pay a much -lower- percentage of their incomes for social security and medicare taxes. The ceiling on those taxes ensures that.
This is particularly significant for people working for low wages since the social security and medicare taxes are a much higher percentage of their total tax paid than they are for the rich.
Also, the rich get to invest in various kinds of tax protected investments - from tax free bonds, to oil investments, to real estate investment trusts, to retirement accounts, to whatever else their lawyers and accountants find for them. The poor don't have money to invest and certainly don't have money for lawyers and accountants.
So in practice, there are quite a few rich people who pay less in taxes than you or I do, in spite of the "alternative minimum tax."
I understand that social security and medicare are not sold to the public as taxes but as insurance, but in practice, they are taxes.
Without a progressive tax, I have no doubt that the average rich person, taking advantage of the social security and medicare provisions, and the tax breaks and loopholes, would pay significantly less than the average Joe.
But beyond all that, the progressive tax seems fair to me. The people at the top certainly derive more benefit from our way of life than the people at the bottom. The law protects the poor and the rich equally. If either a poor man or a rich man steals a loaf of bread, the law goes after him. If either a poor man or a rich man has his Rolls Royce stolen, the law tries to get it back.
Do you see where that's going?
Alan
Danny McCarty - 09 Aug 2004 23:54 GMT >Subject: Re: Bush plan to cut medicare payments for cancer treatments - OT >From: "Alan Meyer" ameyer2@yahoo.com [quoted text clipped - 19 lines] >taxes. Theoretically, the tax system is progressive, >the rich pay a higher percentage than the poor. A head tax is unfair. A progressive income tax is unfair. A flat rate tax is a fair compromise.
>In practice it is sometimes that way and sometimes >not. For example the rich pay a much -lower- percentage [quoted text clipped - 40 lines] > > Alan Outlivecancer - 13 Aug 2004 02:25 GMT This is a great and healing place and has helped me in my panic-pain-PTSD the last year.You folks are great,go with healing, stay away from flat taxes until we have an effective .GAO.I was not born into Bush Kennedy old New England money, so let's focus on getting cures and healing from our GUV.We need research and priorities which come from political pessure and that's how a bill is passed:].
Neil Simpson - 05 Aug 2004 04:01 GMT > Actually, I have a good income as a computer consultant > and pay lots of taxes. I certainly pay more than I get > back in services from the Federal Government, and > I'm sure I pay more than the average guy. Good for you.
> But I don't mind. I'm perfectly willing to pay more > than I do. <snip>
Please feel free to take the standard deduction when filing income taxes, and pass up Schedule A entirely.
If that doesn't fill your need of contributing to the greater good, you can simply write a check to the US Treasury to pay down the federal deficit.
But don't commit me to more government social services which are simply a proxy for buying votes from special interest groups.
Larry - 05 Aug 2004 04:24 GMT > <snip> > [quoted text clipped - 6 lines] > But don't commit me to more government social services which are simply > a proxy for buying votes from special interest groups. Actually, the argument often used that people who think those who are willing to pay their fair share should just feel free to cut a check and "contribute" more is utter nonsense. Taxes aren't a contribution and this isn't church. We don't pass the plate for each to voluntarily contribute what he wishes. The tax system, in theory, should be fair and each should belly up their fair share. It's too easy to take the simplistic position that "Gummnt" just waists our taxes anyway so we shouldn't pay any. I too have a very good six figure income and am proud to be and American and to support the government. Sure I hate to see the waste - I especially hate to see how this current administration squandered the Clinton surplus - but this country will survive Bush and I will continue to proudly support this country each April 15th.
My 2 cents
Larry
John Loomis - 29 Jul 2004 01:51 GMT Here Here Leonard. The old saying.......It is better to have one "bad captain" on a ship than 2 good ones" In otherwords between Kerry and Bush we have what seems to be good pilots, determined, to direct the ship, and we have nothing............ I do not trust Bush, and or Kerry! Blue Cross of Calif, and Blue Shield are under the gun so to speak in our little town. Seems to say, we as a customer pay high premiums.....9,000.00 plus per year for partial payments and co payments. About 8,000.00 deductible, then they start to pay. Blue Cross would not pay for Viagra. I get embarrassed when at the Pharmacy, and ask for Viagra. Hum, looking over the glasses......some young chick or elderly man! You can get 3 pills for such and such, but Blue Cross does not cover viagra. I said, they cover birth control pills? Yes. That is to help a woman have sex without conception? right? Why do they not cover Viagra, to help a man have sex... Anyway, this is something I do not understand and build a better house, and know quality construction when I see it and do it. I am a professional. I feel like with the race for President, and such, and the War in Iraq........ What about the American People? What happened to "Health Care" Cost of fuel Alternative energy ideas. Schooling for kids. I am tired, frustrated, and the choice I have for President......is even worse...... We need a strong president that gets our a.ses out of World Politics, and addresses the problems at home. We need health care, low cost education, alternative energy, pollution standards for water and enviornment, We need to pull ourselves off the "Oil Tit" and grow up! Sorry if I only made partial sense....IT has been a long hard day. Love You all, and give me your ideas. Thanks Leonard. You are very smart. I am a worker bee, tired at the end of a day.......Still buzzzzz though! John Loomis
> > Group, > > Associated Press reports some treatments for prostate cancer will be cut [quoted text clipped - 62 lines] > manufacturer and some urologists and criminal prosecutions are now > underway as a result. Steve Kramer - 29 Jul 2004 02:02 GMT I've always considered your political opinions myopic, but I never thought you'd spam this NG.
 Signature Prostate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 non illegitimi carborundum
> Group, > Associated Press reports some treatments for prostate cancer will be cut [quoted text clipped - 12 lines] > the target should have been Osama's terrorists. > John in OR Neil Simpson - 29 Jul 2004 02:12 GMT > Group, > Associated Press reports some treatments for prostate cancer will be cut [quoted text clipped - 12 lines] > the target should have been Osama's terrorists. > John in OR Nice rant. The Debate Club experience paid off well. You omitted the OT Subject Line prefix though.
Outlivecancer - 02 Aug 2004 03:10 GMT You guys forget Colin Pwell and Bob Dole? Why would the guys in the white house spend money on moderates like them?
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