[Congressional Record Volume 149, Number 94 (Tuesday, June 24, 2003)]
[House]
[Pages H5802-H5803]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                MEDICARE BILL WILL HARM CANCER PATIENTS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from California (Mrs. Capps) is recognized for 5 minutes.
  Mrs. CAPPS. Mr. Speaker, the Medicare bill that we will vote on this 
week is a bad bill. It undercuts this critical program that has been 
provided health care to millions of seniors. It provides spotty 
coverage that will not help these seniors with their expensive 
medications. And it reneges on a promise that we have made to America's 
seniors by ending Medicare as we have known it. But I want to talk 
about a particularly objectionable provision in this bill that has not 
gotten much attention. The part that cuts funding for cancer care.
  The Medicare bill is supposed to make it easier for patients to get 
health care, but it will actually make it harder for cancer patients to 
get the care they need. Cancer is a scourge that has touched nearly 
every person and family in this country. Cancer patients and their 
loved ones have a very strong loyalty to the medical professionals, 
this whole team of oncology care givers who deliver what is so often 
brutal treatment. This is especially true of the often unsung heros of 
quality cancer care, oncology nurses.

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  As a nurse and someone who lost a daughter to cancer, I have seen 
firsthand essential contributions made by these amazing men and women 
who monitor and support, deftly guide the delicate treatment regimen. 
But the House Medicare bill has a provision that will cut half a 
billion dollars from cancer care in America.
  Anyone who thinks you can take this much money away from cancer care 
and not endanger the quality is fooling themselves. The bill does 
correct an overpayment for oncology drugs that goes on today. 
Medicare's system of paying for cancer drugs charges cancer payment and 
the government too much and doctors too much. There is no disagreement 
on that or on that it needs to be fixed. But while we have paid too 
much for cancer drugs, Medicare drastically underpays the oncology 
practice costs. The oncology community has been using this overpayment 
for medications as a way to make up for the underpayment in oncology 
services. And we should fix this overpayment for medications because 
the patients should not be overcharged for their medications. Of 
course, Medicare and taxpayers should not be overcharged either. But we 
also have to make sure oncologists are paid properly for their 
services.
  Cancer care has changed a great deal since the creation of Medicare. 
In fact, most of cancer care has been developed since Medicare was 
created, moving out of the hospital and into doctors offices and 
clinics where having oncology nurses and support staff are even more 
important. They are the frontline providers of cancer care, managing 
therapies and side effects, helping to keep seniors out of the 
hospital, saving the Medicare program money, providing counseling to 
patients and their families and conducting clinical trials and research 
to improve and advance cancer treatment.
  Yet, while patients value this high-quality hands-on loving care, 
Medicare dramatically undervalues and underpays the cancer care given 
by these nurses, pharmacists, social workers, and lab technicians who 
are part of the multidisciplinary cancer team.
  Without adequate resources, the reality is that physicians will be 
unable to sustain the provisions of quality care and will reduce their 
practices or close them entirely. The first services to be let go will 
be oncology nurses. In addition to cutting funds from cancer care, the 
new payment system in this bill will make many cancer patients, 60 
percent of the seniors on Medicare, go to the oncologists twice as 
often, frail, sick seniors doing this. It will actually cause cancer 
patients to pay more out of pocket costs and wait longer for treatment, 
increasing their health risks. It is so wrong.
  The gentleman from Georgia (Mr. Norwood) and I joined with the cancer 
community to craft legislation to resolve inequities in the cancer care 
system and address concerns about the overpayment for oncology drugs. 
And we work hard during the recent markup to try to correct the 
Medicare bills flawed cancer provision.
  Our proposal offers a more accurate payment for oncology drugs and 
would direct Medicare to establish new payments amounts for physician 
services related to the treatment of cancer patients, including the 
added work performed before and after patient visits and consultations. 
It is so essential. It recognizes the true cost of providing cancer 
care.
  We will all go home after we pass this Medicare bill, and we will 
have to face our constituents. I, for one, do not want to tell the 
cancer patients in my district that Congress has decided to curtail 
their treatment and endanger their care. I hope no one here will.
  Just listen to what the cancer community is saying about the House 
and Senate bills. Ellen Stovall of the National Coalition of Cancer 
Survivorship says, ``Instead of expanding access to life saving drugs, 
these bills limit access to cancer treatments for some of the most 
seriously ill Medicare beneficiaries.''
  Susan Braun of the Susan G. Komen Breast Cancer Foundation says, 
``The millions of cancer patients in this country who rely upon 
Medicare need to know that their access to care will be severely 
disrupted if these bills go through.''

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  They are going to hold us accountable, and they should.
  Mr. Speaker, I hope that all my colleagues will join me in fixing 
these unfair and shortsighted provisions of this Medicare bill.

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