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Cancer, Chemo, and Crony Capitalism

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iStock_000007028394XSmallWhen Medicare reduced reimbursements for oncologists in 2003, some physicians started giving their patients more expensive chemotherapy and other cancer treatments—in return for kickbacks from the pharmaceutical companies, a new study has found.

The study, published in the journal Health Affairs, found that oncologists can buy drugs at deep discount and then dispense them at the higher Medicare rate in their offices. It lets oncologists run a kind of pharmacy as a side business (although it is rarely identified as such to the patients). This represents a considerable part of some oncologists’ income.
Talk about a huge conflict of interest! Oncologists prescribe specific drugs to their patients—and are then permitted to sell them those same drugs at a huge profit. Other doctors do not do this. But oncologists had an exception carved out for themselves.
Cancer patients often feel powerless, and they’ll do whatever their doctor tells them to do. Moreover, they can’t go to another source (other than another oncologist) for the chemotherapy drugs. And they often don’t have the luxury of time to explore other options and second opinions. It becomes, in effect, a closed market—crony capitalism at the expense of human health, made possible by a government favor posing as a government rule.
The authors of the study analyzed the records of over 200,000 lung cancer patients treated between 2003 and 2005. Before the Medicare cuts went into effect, 16.5% of such patients received chemotherapy; afterward, nearly 20%. That 2.5% difference could be considerable, especially if applied to a substantial portion of the 1,529,460 Americans that are expected to develop cancer in 2010, according to the American Cancer Society.
The study also found that doctors frequently switched to more expensive cancer drugs like docetaxel, for which oncologist get reimbursed about $2,500 per patient per month.
The bottom line, according to noted medical writer Ralph W. Moss, PhD, who created the important Internet journal Cancer Decisions, is that some oncologists in private practice may make crucial treatment decisions based not on medical necessity but on what is most profitable for themselves.
In his forthcoming book Customized Cancer Treatment, Dr. Moss notes that the public did not know about the existence of the chemotherapy concession until 1999. That year, at a Medicare Advisory Panel meeting in Baltimore, a gastroenterologist complained that the government had reduced his reimbursement rate for colonoscopies from $400 to $108. All the doctors in his internal medicine group were hurting, he continued, except for the two medical oncologists, whom he said were making a fortune running their in-office retail pharmacies. This offhand remark alerted the world to the fact that oncologists were selling drugs at a profit in their offices.
If this isn’t bad enough, it is much debated in the medical community whether many chemotherapy treatments do more harm than good. Dr. Mercola reported on a recent study which found that over four in ten patients who received chemotherapy towards the end of life suffered potentially fatal effects from the drugs, and treatment was “inappropriate” in nearly a fifth of cases. In a study of more than 600 cancer patients who died within 30 days of receiving treatment, chemotherapy probably caused or hastened death in 27 percent of cases.
In fact, as Mike Adams points out, even dispensing the chemotherapy drugs is dangerous, and the doctors, nurses, and pharmacists who handle the toxic medications are giving themselves cancer!
One last point: if you are ever treated with chemotherapy, be sure to review the scientific studies recommending the use of antioxidant supplements with it. Most oncologists refuse to accept any of this persuasive evidence and won’t tell you about it.

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