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Medicare Changes Didn't Alter Cancer Care
Date:10/8/2007

't as rosy. While 46 percent of those 65 and older said they had money left over after paying out-of-pocket expenses before the Medicare changes of 2003, less than 26 percent said the same was true after 2003.

Rural patients now appear to be waiting nearly a week longer for treatment to begin -- almost four weeks, compared with three -- since the changes were put into place.

But, patients without any private insurance to supplement their Medicare said there was virtually no change in waiting times -- an average of 4.3 weeks before 2003, compared with four weeks after 2003.

While the authors called for additional research to continue monitoring the impact of the Medicare changes, they concluded that physician reimbursement reductions have not yet had a major impact on patient care.

"Given the amount of controversy at the time the changes took place, I think our findings were surprising to us," Schulman said. "But, at some level, I think the good news is that the policy process seems to have been responsive to the expressed concerns and helped to mitigate them."

Others took issue with Schulman's evaluation, suggesting that the Medicare glass is actually half empty, not half full.

"I'm surprised that the finding is neutral. I would've expected that the findings would be better," said Robert M. Hayes, president of the Medicare Rights Center, an independent, nonprofit national consumer service organization. "And they should be so much better given the amount of public money invested. But there's no sign of improvement."

"So, I'd say that this is another call for structural reform of Medicare," Hayes added. "Putting tens of billions of dollars into a program that seems not to be having any improved impact on very sick people raises obvious concerns about how well designed the program is. And this is another piece of evidence suggesting that we could be getting so much more positive outcome than we are."
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