Proposed Medicare Rule Would End Support of Anti-Rejection Drugs While We Pay More For Boondoggles


By Bob Aronson

UPDATE MARCH 10, 2014

Attention readers — Your outrage worked. Congratulations!!!!

The Obama administration said Monday that it would scrap much of a proposed plan to limit the types of antidepressants and other drugs that seniors can get through Medicare after a backlash from lawmakers and the health industry.

Original blog published February 28, 2014

This is one of the most important blogs I have published.  It is a direct appeal to you to take action.  You will find the steps you need to take at the end of this post.

here to help cartoonA government bureaucracy is seeking to change the rules that allow organ transplant recipients a broad choice of anti-rejection drugs.  If adopted it is the opinion of many medical experts that without the flexibility to select optional drugs many transplant recipients could die. 

Ask yourself, “How does it make sense to pay the cost of a transplant and then refuse to pay for the drugs that make it work? Would we train thousands of men and women to be soldiers and then send them into battle without weapons?”  It is quite likely that your answer would be, “Of course not! That would be insane.”

Unfortunately some bureaucrats are incapable of making decisions based on logic.  They waste billions of dollars and in the process hope we are fooled into thinking that wasted money represents good “investments.”  When these good “investments” go bad they don’t stop pouring money into them they cut expenditures elsewhere — and those cuts cause great harm to the citizens whose tax dollars pay their salaries.

This report is factual and intentionally biased. It is biased because I am a 75 year old heart transplant recipient who counts on Medicare to provide me with my anti-rejection drugs — drugs the government would like to take away so they can fund boondoggles.

Here is some perspective.  When you get a transplant, you must take anti-rejection or immunosuppressant drugs for the rest of your life.  Often, though, it is medically necessary to change to something different and more effective.  If the option for a life-saving change is taken away, many of us will die. 

How the rule makers can ignore that simple, medical fact is beyond me, but they also ignore reality when they say making these cuts will save $1.9 billion over several years.  Here’s reality.  If the changes are adopted they will not only endanger lives, they will in the end, result in taxpayers paying more, not less as the rule’s advocates suggest.   

Here’s how it works in real life.  If organ transplant patients don’t take their immunosuppressant drugs they will go into rejection and will be hospitalized at Medicare’s expense.

Physicians who are sworn to save lives will make every effort to do just that regardless of cost.  In the case of Kidney failure, rejection dialysiscould mean years of dialysis, a treatment that costs about $50,000 per patient per year (there are currently about 400,000 Americans on dialysis). In all cases it is entirely possible that patients who are rejecting their organs could be re-listed for second transplants. Depending on the organ, a transplant can cost in excess of $1 Million for the surgery and the first year of care.

It seems that the cost cutters think that by limiting options there is an almost immediate savings.  There isn’t.  There is, instead, an almost immediate rise in cost.  They seem to use the same twisted logic when trying to save money that they use when spending it.  You can read the detailed proposal here http://www.gpo.gov/fdsys/pkg/FR-2014-01-10/pdf/2013-31497.pdf

Some lawmakers insist that budget cuts be made and they are right, we spend too much as a nation but does it make sense to cut spending that will kill people?

There are two current military projects that are a very big part of the motivation behind the budget cuts.  They are the Gerald R. Ford aircraft carrier and the F-35 Joint Strike Fighter.  Together they have created cost overruns of nearly $200 Billion.  That’s right $200 Billion and the defense department wants more money even though the two projects are plagued with problems. 

These ghouls would actually take medicine from people who will die without it rather than cut dollars from bloated out-of-control projects that were never necessary anyway.

In 2005 the cost of the Gerald R. Ford was estimated to be about $8 billion, excluding the $4.7 billion spent on research Gerald r ford 3and development. Each year the estimate has gone up.  In 2013 a Government Accounting Office (GAO) report said that construction costs are now estimated at $12.8 billion.  That’s 22% over the 2008 budget, plus $4.7 billion in research and development costs.  Not only have the costs continued to rise above the original estimates the Navy is now asking for another $500 million and the aircraft carrier is nowhere near being ready for sea and is plagued with problems. If you would like to know more about the Ford and its problems this link will get you started.  http://www.freerepublic.com/focus/f-news/3110602/posts

F-35 3Then there is the F-35 Joint Strike Fighter.  According to Senator John McCain it is the most expensive weapons system in history and there’s no assurance it will ever do what it was designed to do.  Despite repeated disappointments and failures, we keep throwing good money after bad at it and now that project is $163 billion over budget, seven years behind schedule, and will cost taxpayers about twice as much as sending a man to the moon.  The cost of manufacturing the jets has increased a whopping 75 percent from its original estimate, and is now closing in on $400 billion. Over its lifetime, the F-35 program is expected to cost U.S. Taxpayers $1.5 trillion, between construction and maintenance of the jets.  http://www.pogo.org/blog/2013/03/20130306-air-forces-f-35a-not-ready-for-combat.html

If you would like more details on the F-35 this report provides them along with other links.
http://swampland.time.com/2013/12/18/how-not-to-buy-the-most-costly-weapon-system-in-the-history-of-the-world/

Instead of cutting out the fat in the national budget, though, the bureaucrats have decided to cut spending that very likely will result in death.  They would limit coverage of anti-rejection medicine that keeps organ transplant recipients alive.  Here’s a simple declarative sentence, “When you take away medicine that keeps people alive, they will die.” What part of that sentence don’t they understand? 

The American Kidney Fund is one ofakf logo two many organizations that takes exception to the proposed new rule.  Recently they sent out this letter to their members and other interested parties.

akf logo two

Dear____,

I’m writing to request your help with an issue that is of great importance to our nation’s transplant recipients.

Individuals who are fortunate enough to receive a kidney transplant—or a transplant of any other organ—must take immunosuppressive medications for the life of the transplanted organ to reduce the risk of losing the organ. Some patients rely on Medicare Part D to cover the cost of these medications.

Immunosuppressive drugs are one of six “protected classes” of drugs under Medicare Part D. This means that Medicare Part D must cover all approved immunosuppressive drugs, giving transplant recipients access to the full range of available medications.

On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) proposed a change to Medicare Part D that would revise the criteria for these protected classes of drugs. Part D plans would no longer be required to cover all approved immunosuppressive medications—instead, Part D plans would only be required to cover each subclass of immunosuppressive medications.

The American Kidney Fund believes that by not covering all of the specific drugs within each subclass, this rule would put patients’ health at risk. Transplant recipients often need adjustments to their immunosuppressive drug regimen. They require access to the full range of approved medications.

We are working hard to ensure that policymakers hear from the kidney community on this issue. You may click here to send a personalized letter to your Congressional representatives urging CMS to reverse this proposal. https://secure2.convio.net/akf/site/Advocacy?cmd=display&page=UserAction&id=119

Thank you for your participation in the American Kidney Fund’s Advocacy Network. Your voice makes a difference!

Sincerely,

Nikia Okoye

CMS (Centers for Medicare and Medicaid Services) will take public comment through March 7th. Please urge them to reject the draft rule change.  You can contact CMS with your comments in this manner. 

If you would like to comment directly to CMS you must do so before 5 PM on March 7, 2014.  Here’s how.

ADDRESSES

In commenting, please refer to file code CMS–4159–P. Because of  staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission.  You may submit comments in one of

four ways (please choose only one of the ways listed):

1. Electronically.  You may submit electronic comments on this regulation to http://www.regulations.gov  or go directly to http://www.regulations.gov/#!documentDetail;D=CMS-2014-0007-0002 . Follow the ‘‘Submit a comment’’ instructions.

2. By regular mail.  You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–4159–P, P.O. Box 8013, Baltimore, MD 21244–8013. Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail.  You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–4159–P, Mail Stop C4–26–05, 7500 Security Boulevard, Baltimore, MD 21244–1850.

4. By hand or courier. Alternatively, you may deliver (by hand or courier) your written comments NLY to the following addresses prior to the close of the comment period: a. For delivery in Washington, DC—Centers for Medicare & Medicaid Services, Department of  Health and Human Services, Room 445– G, Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201.

(Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an

extra copy of the comments being filed.) b. For delivery in Baltimore, MD— Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244–1850.If you intend to deliver your comments to the Baltimore address, call telephone number (410) 786–9994 in advance to schedule your arrival with one of our staff members.

Comments erroneously mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.

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magic kindom in backgroundBob Aronson is a 2007 heart transplant recipient, the founder and primary author of the blogs on this site and the founder of Facebook’s over 3,000 member Organ Transplant Initiative group.

Now retired and living in Jacksonville, Florida with his wife Robin he spends his time advocating for patients with end stage diseases and for organ recipients.  He is also active in helping his wife with her art business at art festivals and on her Rockin Robin Prints site on Etsy. 

Bob is a former journalist, Governor’s Communication Director and international communications consultant.

Posted on February 25, 2014, in Newsmakers and tagged , , , , , , , , , , . Bookmark the permalink. 1 Comment.

  1. This is an extremely important thing for all concerned to do. These letters really do count.

    Like

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