Tuesday, December 23, 2008

Oncology -- and we shall re visit this AFTER Christmas....

Old Soldier Tom's Journal.

Sorry to Rain on your parade... but I thought I needed to post this news worthy message. Don't worry-- I get back into the snowy, cold, windy fun and glee in a few minutes... lol. I personally know what real, intense, acute pain is [from terrible accidents-- and I watched my fellow soldiers in Vietnam struggle to stay alive for a few hours more...at Bien Hoa, from 122 mm rocket attacks, etc], and I continue to get shots [injections] in both my knees every 90 days for bone on bone arthritis. But and I firmly believe that it's all about GREED, and many procedures won't do the job that "doctors" promise I am not afraid to die and meet my Maker.


Dear Reader,

Oncology has a dirty little secret.

Imagine you're an oncologist. Your patient is succumbing to cancer and will probably lose his battle within a few weeks. Chemotherapy will not prolong his life. Option A: Regretfully inform him that there's nothing more you can do. Option B: Prescribe a round of chemotherapy and turn an excellent profit.

Option B is chosen far more often than you might think.

Significant poisoning

Last month, a UK review of cancer cases produced shocking results.

In about 600 cases in which cancer patients died within 30 days of receiving chemotherapy…
  • 40 percent experienced "significant poisoning" from their treatment
  • About 25 percent of the deaths were accelerated or actually caused by the chemotherapy
  • One of the co-authors of the study told ABC News (Australia) that in 20 percent of the cases, the decision to administer chemotherapy was simply inappropriate
Professor Ian Olver – CEO of Cancer Council Australia – told ABC that some patients might not fully understand the limits of chemotherapy.

MIGHT not? Any thoughtful (and ethical) oncologist should start from Square One assuming that his patient doesn't understand ANYTHING about chemotherapy. And it's HIS job to thoroughly school each patient.

For instance each patient should fully understand that only 10 types of cancer are considered "highly responsive" to chemotherapy. And every patient should fully understand that in many cases, chemotherapy can only be expected, at best, to prolong life by a few months.

And to be completely aboveboard, every patient should also fully understand that oncologists stand to make a nice little profit nearly every time they administer chemotherapy.

Medicare pulled off the gravy train

It's called the chemotherapy concession (we'll call it "chemo con" for short), and here's how it works: Cancer patients often receive chemotherapy drugs in the offices of their oncologists. The doctors purchase the drugs themselves, then bill their patients. Here's the catch: Oncologists typically charge patients far higher amounts than they originally pay for the drugs.

This is completely legal. It's a "concession" for oncologists, to offset overhead, and it assumes that insurance companies will pay the lion's share. But it also tempts oncologists to administer chemo when the drug may not be effective.

When I first told you about chemo con in 2003, it was a real moneymaker. That changed somewhat in 2005 when Congress took Medicare out of the equation. But the con continues for all those other cancer patients whose insurance companies often pay exorbitant sums for cancer treatments. (Yep – this is one of the reasons our insurance premiums are always rising.)

So how pervasive a problem is chemo con? That question was answered by Ezekiel J. Emanuel, M.D., an oncologist and bioethicist. When Dr. Emanuel examined the medical records of almost 8,000 cancer patients, he found that in cases where chemotherapy was administered in the final six months of life, ONE-THIRD of the patients suffered from cancers that are known to be unresponsive to chemotherapy.

Without question, there are many ethical and honest oncologists who don't line their pockets by exploiting the system. But as long as this system allows a legal free-flow of cash, you can be sure that "significant poisoning" will continue.

Don't we just love the greedy 'doctors', CEO's and politicians ??

The embers glowed softly, and in their dim light,
I gazed round the room and I cherished the sight.
My wife was asleep, her head on my chest,
My daughter beside me, angelic in rest.

Outside the snow fell, a blanket of white,
Transforming the yard to a winter delight.

The sparkling lights in the tree I believe,
Completed the magic that was Christmas Eve.
My eyelids were heavy, my breathing was deep,
Secure and surrounded by love I would sleep.
In perfect contentment, or so it would seem,
So I slumbered, perhaps I started to dream.

The sound wasn't loud, and it wasn't too near,
But I opened my eyes when it tickled my ear.
Perhaps just a cough, I didn't quite know, Then the
sure sound of footsteps outside in the snow.
My soul gave a tremble, I struggled to hear,
And I crept to the door just to see who was near.

Standing out in the cold and the dark of the night,
A lone figure stood, his face weary and tight.
A soldier, I puzzled, some twenty years old,
Perhaps a Marine, huddled here in the cold.
Alone in the dark, he looked up and smiled,
Standing watch over me, and my wife and my child.

"What are you doing?" I asked without fear,
"Come in this moment, it's freezing out here!
Put down your pack, brush the snow from your sleeve,
You should be at home on a cold Christmas Eve!"
For barely a moment I saw his eyes shift,
Away from the cold and the snow blown in drifts..

To the window that danced with a warm fire's light
Then he sighed and he said "Its really all right,
I'm out here by choice. I'm here every night."
"It's my duty to stand at the front of the line,
That separates you from the darkest of times.

No one had to ask or beg or implore me,
I'm proud to stand here like my fathers before me.
My Gramps died at ' Pearl on a day in December,"
Then he sighed, "That's a Christmas 'Gram always remembers."
My dad stood his watch in the jungles of ' Nam ',
And now it is my turn and so, here I am.

I've not seen my own son in more than a while,
But my wife sends me pictures, he's sure got her smile.
Then he bent and he carefully pulled from his bag,
The red, white, and blue... an American flag.
I can live through the cold and the being alone,
Away from my family, my house and my home.

I can stand at my post through the rain and the sleet,
I can sleep in a foxhole with little to eat.
I can carry the weight of killing another,
Or lay down my life with my sister and brother..
Who stand at the front against any and all,
To ensure for all time that this flag will not fall."

" So go back inside," he said, "harbor no fright,
Your family is waiting and I'll be all right."
"But isn't there something I can do, at the least,
"Give you money," I asked, "or prepare you a feast?
It seems all too little for all that you've done,
For being away from your wife and your son."

Then his eye welled a tear that held no regret,
"Just tell us you love us, and never forget.
To fight for our rights back at home while we're gone,
To stand your own watch, no matter how long.
For when we come home, either standing or dead,
To know you remember we fought and we bled.
Is payment enough, and with that we will trust,
That we mattered to you as you mattered to us."

PLEASE, would you do me the kind favor of sending this to as many
people as you can? Christmas will be coming soon and some credit is due to our
U.S service men and women for our being able to celebrate these
festivities. Let's try in this small way to pay a tiny bit of what we owe. Make people
stop and think of our heroes, living and dead, who sacrificed themselves for us.

LCDR Jeff Giles, SC, USN
30th Naval Construction Regiment

OIC, Logistics Cell one.


garnett109 said...

It's amazing how bad greed is in hospitals

sober white women said...

This is why I fighting back and trying herbs and other stuff. I know so many people that have chemo, only to have the cancer return again. It is very sad.

Dirk said...

And this certainly isn't the only example - insurance has caused many more problems than it has solved. The medical profession worked so much better when it was done on a sliding scale & people paid for services themselves. Insurance is one of the chief reasons medical costs are so high now.

That was a really moving poem. I've seen it before, but thanks for sharing it again. It sure puts things in perspective.

Merry Christmas to you and your family!


natalie said...

dear Tom
there are many doctors who no longer ascribe to Chemo but instead prefer "experimental treatments"
good stuff
I like the Marine doing his duty
Merry Christmas