“The GOP Trickle Down Effect”: Sequestration Takes A Toll On Cancer And Medicare Patients
A funny thing happened on Rush Limbaugh’s radio show yesterday. The Republican host was complaining about a Washington Post report on sequestration cuts hurting cancer patients in the Medicare program, and told his listeners to ignore the news. “All of this is manufactured and made up,” Limbaugh said. How does he know? Because the sequester didn’t include “any cuts in Medicare,” he added.
And then Limbaugh got a call from a conservative oncologist — in this case, a physician who apparently shares the host’s worldview and has no use for the Washington Post — who conceded that the report is, in fact, accurate, forcing Limbaugh to change the subject.
Sequestration cuts are affecting Medicare — though not as much as some other programs — and as Sarah Kliff explained, cancer clinics really are turning away thousands of patients as a result of the Republican spending cuts.
Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.
Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.
Kliff talked to one Long Island oncologist who said he and his staff held an emergency meeting earlier this week and decided they would no longer see one-third of their 16,000 Medicare patients. “It’s a choice between seeing these patients and staying in business,” Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates said.
But if Medicare was supposed to be shielded from the sequestration policy, how is this happening? It has to do with how medical offices are reimbursed for medications that need to be administered by a physician — such as those given to cancer patients.
The New York Daily News reported today:
The so-called sequester cuts will force three-quarters of the thousands of cancer clinics nationwide to start referring Medicare patients to hospitals, according to the American Society of Clinical Oncology and other cancer treatment groups, which have appealed to the White House and Congress for help.
Elderly cancer patients are being hit hard because their drugs are among the handful of pharmaceuticals that were affected by the sequester cuts.
Medicare reimbursed oncologists for the cost of chemo drugs, plus 6%. But under the sequester, the federal government is now providing only 4% on top of the drugs’ cost, which can run $900 to $15,000 for a full course, depending on the cancer.
That 2% difference may not sound like much, but given the costs involved, it’s an enormous pay cut for the cancer clinics, which some are now saying is a prohibitive new expense they can’t afford.
Ted Okon, director of the Community Oncology Alliance, told Kliff, “If you get cut on the service side, you can either absorb it or make do with fewer nurses. This is a drug that we’re purchasing. The costs don’t change and you can’t do without it. There isn’t really wiggle room.”
Note, this doesn’t mean the sequester is necessarily cutting off cancer patients, but rather, it means these patients are being told by their local oncology clinics that they’ll have to seek care at hospitals — where the care will be less efficient and more expensive.
In case anyone’s forgotten, it’s within Congress’ power to simply turn the sequester off. The whole thing could take five minutes. But for now, congressional Republicans have ruled out the possibility of turning it off, and have also ruled out the possibility of a compromise to replace these brutal spending cuts.
With each passing day, we learn of increasingly drastic consequences associated with the policy.
By: Steve Benen, The Maddow Blog, April 5, 2013
“The World Today”: Martin Luther King And Today’s Gun Advocates
Martin Luther King, Jr. was assassinated 45 years ago yesterday, and one of the interesting little sidelights to the debate over guns that you might not be aware of is that gun advocates claim King as one of their own. You see, King had armed guards protect his family, and at one point applied for a permit in Alabama to carry a concealed weapon himself. He was turned down, since in the Jim Crow days the state of Alabama wasn’t about to let black men carry guns.
You can find references to these facts on all kinds of pro-gun web sites, as nonsensical as it may seem. Gun advocates want to claim King as part of their cause, but also want to completely repudiate everything he believed about the power of nonviolence, which is kind of like Exxon saying John Muir would have favored drilling for oil in Yosemite because he sometimes rode in cars. The reason Martin Luther King sought armed protection was there were significant numbers of people who wanted to kill him, and eventually one of them succeeded. If you’re a target for assassination, you should go ahead and buy a gun. But most of us aren’t.
This gets back to the threatening world so many gun advocates believe they live in. As they tell it, every one of us needs an arsenal of handguns and shotguns and AR-15s, despite the risk they might pose to ourselves and our families, because the risk from outside is so much greater. The imagine themselves as vulnerable as a civil rights activist in the Deep South in 1968. And they also believe that the authorities that are charged with our protection are indifferent or even hostile to our safety. That was certainly the case with King and other civil rights activists in the South in the 1960s; they knew that the government and the police wouldn’t be there to protect them, and some might even participate in trying to harm them.
But guess what: that’s not the world we live in today. The idea that the government is going to come knocking down your door, and you need to be ready to engage in a firefight with the police when that happens, is as ludicrous as the idea that MLK would be an advocate for further proliferation of guns if he were alive today.
By: Paul Waldman, Contributing Editor, The American Prospect, April 5, 2013
“This Has Got To Be A Trick”: Is This The Best The GOP Can Come Up With?
I think I’ve figured it out. Republicans must be staging some kind of fiendishly clever plot to lure Democrats into a false sense of security.
That’s the only possible explanation for some of the weirdness we’re seeing and hearing from the GOP. The party must be waiting to come out with its real candidates and policy positions at a moment when unsuspecting Democrats are in the vulnerable position of being doubled over with laughter.
Why else, except for the entertainment value, would the party nominate former South Carolina governor Mark Sanford — he of Appalachian Trail fame, or infamy — in next month’s special election to fill a vacant seat in Congress?
Sanford, you will recall, made news in 2009 when he went missing for a week, which is rarely a good idea for a sitting governor. Upon reappearing, he acknowledged he hadn’t been hiking in the mountains but rather was visiting his mistress in Argentina, which is never a good idea for a sitting governor, especially one who is married and preaches sanctimoniously about family values.
Sanford’s wife, Jenny, refused to play the role of dutiful spouse, basically telling interviewers that her husband was, in fact, a heel; they divorced the following year. After his term ended in 2011, he went slinking into the wilderness. But a toppling of political dominoes — former senator Jim DeMint resigned; then-Rep. Tim Scott was appointed to replace him; Scott’s seat in the House thus had to be filled in a special election — gave Sanford the opening for a comeback.
Last month, Sanford finished first in the GOP primary against a weak field. This week, he won a runoff. Since South Carolina’s 1st Congressional District is solidly Republican, Sanford’s victory on May 7 should be a foregone conclusion. Even the fact that Democrats are running an unusually viable candidate — Elizabeth Colbert Busch, the sister of late-night satirist Stephen Colbert — ought to make little difference. But the GOP establishment is worried.
So far, it appears that Sanford is less interested in victory than personal redemption. He had the nerve to ask Jenny Sanford to manage his campaign; she, of course, declined. As he gave his victory speech after Tuesday’s runoff, his fiancee — Maria Belen Chapur, the former mistress who lives in Buenos Aires — stood behind him. If Sanford ends up making this contest a referendum on his personal life, some loyal Republicans may hold their noses as they vote for him. Others will just stay home.
Republicans are also trying their best to lose a governorship, in Virginia, that could be theirs for the taking.
The Democratic candidate, longtime party fundraiser and operative Terry McAuliffe, has always shown more talent as a kingmaker than as a candidate. But he’s fortunate to have as his opponent Ken Cuccinelli, the commonwealth’s loony-bin attorney general. Describing Cuccinelli’s views as “far right” is like calling Usain Bolt “reasonably fast.”
At the moment, Cuccinelli is challenging an appeals-court decision that struck down Virginia’s sodomy law, which sought to restrict sex acts between any two people, including married couples. The Supreme Court ruled such laws unconstitutional 10 years ago, so the appeals court really had no choice. But Cuccinelli is appealing anyway.
When he was campaigning for attorney general, Cuccinelli refused to endorse his Republican predecessor’s policy of nondiscrimination against gays and lesbians. “My view is that homosexual acts, not homosexuality, but homosexual acts are wrong,” he said at the time. “They’re intrinsically wrong. . . . They don’t comport with natural law.”
Cuccinelli has also tried his best to halt all abortions, launched what looked like a witch hunt against climate-change scientists and generally pursued an ultra-conservative agenda with chilling gusto. Virginia has voted twice for President Obama; I’ll admit I was surprised when Cuccinelli won statewide office in 2009, even though the attorney general’s authority is limited. I’ll be really surprised if Virginians put him in the governor’s mansion, giving him the whole state as a sandbox.
You’d think the national GOP would try to avoid potential giveaways like these. But leading Republicans are too busy tying themselves in knots over issues that much of the country considers settled and done with — gay marriage, immigration reform, background checks for gun purchases, a balanced approach to debt reduction.
A party can be out of step on any of these issues and still win elections. But on all of them? I’m telling you, this has got to be some kind of trick.
By: Eugene Robinson, Opinion Writer, The Washington Post, April 4, 2013
“The Deadly Policies Of Red States”: Lots Of Students Are Being Left Behind
Last week, 35 former Atlanta educators were forced to take a perp walk, reporting to law enforcement authorities for arrest in connection with the nation’s biggest (so far) academic scandal. It was a disturbing spectacle. Once among the pillars of metro Atlanta’s middle class, they’ve been reduced to pleading that they don’t belong in jail.
And that may be true. The charges of a widespread conspiracy to cheat may represent the ambitions of a local prosecutor rather than any top-down plot carried out by a confederacy of criminals. But I don’t waste sympathy on the defendants: They deserve the ignominy of association with thugs.
I’m reserving my pity for the students in Atlanta’s public schools. They’re the victims of this massive fraud, the helpless pawns of adults who callously overlooked the needs of their charges and focused on preserving their careers.
Unfortunately, that’s been a recurrent theme in 40 years of school-reform efforts across the country. Whether represented by unions or organized as a powerful voting bloc or both, public school educators have put their paychecks front and center, discounting the needs of their students. Even good teachers — dedicated, hard-working and inspiring ones — have rallied to protect their peers, some of whom don’t deserve their support.
Atlanta’s scandal has reinforced long-standing criticisms of widespread testing in schools, a strategy that was exalted by George W. Bush’s No Child Left Behind Act. The critics are right: The overdependence on standardized tests has calcified instruction, failed students and encouraged fraud. Educators in poor neighborhoods, where students are more likely to score poorly, are singled out for official reproach.
Conversely, teachers, principals and superintendents who show miraculous results — turning failing students into suddenly brilliant ones — are showered with praise, promotions and, frequently, money. It’s no wonder, then, that some Atlanta teachers had after-school “parties” where they erased students’ answers and replaced them with the correct ones.
While Atlanta may have the best-documented case of test-related fraud, it’s by no means the only one. In an exhaustive investigation published last year, USA Today found evidence of fraudulent test scores in six states and Washington, DC. Even the vaunted Michelle Rhee, who led a reform effort in Washington, has been implicated, accused of turning a blind eye to suspicious test results.
But for all the problems associated with No Child Left Behind, Bush deserves credit for this much: He recognized the failures of public schools that are not doing very much to educate children from less-affluent homes. He described a culture freighted with “the soft bigotry of low expectations,” a phrase that still rings true.
For years, too many teachers in low-achieving schools have blamed their failures on children and parents, describing homes in which discipline is poor, mediocrity is lauded and failure is acceptable. If those teachers believe there is nothing to be done to improve the academic standing of those children, why teach? If the children are too “dumb” or too deprived to profit from their instruction, why do they stay?
Reams of research bear out the complaints of educators who say teaching poor kids is challenging: Children from less-affluent homes are more likely to read below grade-level, to need special help, to score poorly on standardized tests. But that hardly means they can’t learn.
They need teachers who believe in them. Those who believe they’re being unfairly tarnished by unworthy students don’t fit the bill. As psychologists point out, kids pick up those signals easily enough and behave as the teachers expect them to. In other words, they learn little or nothing.
In addition to dedicated teachers, those children need a community that’s also committed to them. That includes the politicians, activists and church groups who spend an inordinate amount of time defending educators rather than demanding good schools for the kids.
As Atlanta’s disgraced educators surrendered last week, a group of activist preachers — Concerned Black Clergy — assembled to suggest that racism was involved. “Look at the pictures of those 35,” said the Rev. Timothy McDonald. “Show me a white face.”
Would that McDonald and his allies were as concerned about Atlanta’s public school students, 80 percent of whom are also black.
By: Cynthia Tucker, The National Memo, April 6, 2013
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