医改方案出来了，有谁在里面看出什么？

仓廪实而知礼节。国家富裕了，医改会成功。
现阶段还是搞好经济基础，有了钱，说话落地有声。不然，雁已过，空欢歌，说来说去犹未说。
再过20年，所有中国人治病不用付费。------期待有这么一天。

winnerwzs

尽管深化医改是一个长期渐进的过程，但是从这些改革政策和措施中，人们可以从中期待看病就医有一个更好的未来，有望得到更多的实惠

jackwen

中国患者的过高要求和国内较低医疗软硬件水平相差过大。一方面看国外电视的医疗如何好，但不能相提并论，不过中国的医学教育应该向国外学习，本科后真正想做医生的才进入医学院，才能从根本上提高素质。

guxingren

个人认为医改的最终目的是要让广大老百姓能看得起病。作为占人口很大一部分的农民兄弟确实太可怜了。希望新的医改能落实好，最终惠民于百姓！！！

guxingren

“健康是人全面发展的基础，关系千家万户幸福。”建立一个人人享有基本医疗卫生服务的制度，不但是民生之需，也是对医疗卫生事业的准确定位。目标已经给出了，接下来的就看医改新方案如何具体落实了。

我家在农村，祖祖辈辈都还没有享受过什么医疗保险！现在我爸这一辈参加农村医疗保险，只有到了一定金额才能按照规定报销部分！但是他们已经感受到了党和政府的温暖！

改革是前提，执行和落实市关键！期待改变“大病拖、小病扛、重病等死”的农村社会现象，让每个人都能享受到基本的医疗服务。医疗卫生作为社会公共服务，提供的是公共产品，应该是每个人都应该有权利去享受的。

祝福和期待美好！！！

houliang555

Drug treatment can run $1,000s per month

Oncologists increasingly must consider financial as well as medical questions

By DIANE COCHRAN
Of The Gazette Staff
It took one month for Roger Megerth to max out his credit card paying for a cancer drug.

His share of the tab for the oral medication, to treat kidney cancer, jumped from $20 to $988 a month when his insurance plan changed at the beginning of the year.

"I had to Visa charge it," said Megerth, a retired high school English teacher. "That was the only way I could pay for it."

Before Megerth had to find a way to pay for a second month, his physician decided it wasn't the right treatment for him and took him off it.
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"I'm not the worst-case scenario by any means," Megerth said. "I was fortunate the way it worked out. I think daily about people who are not so fortunate and have several drugs like this and just completely throw their budget out the window."

The high price of the drugs used to treat cancer is a growing problem for U.S. cancer patients and their doctors.

Some patients are basing decisions about treatment on money, and some oncologists are closing or restructuring their practices to compensate for financial losses tied to drug prices.

"I've never seen a provider turn away a patient, but what I've seen is patients making health care decisions based on economics," said Kristin Page Nei, government relations director for the American Cancer Society Action Network in Montana.

The American Cancer Society fields thousands of calls every year from cancer patients looking for financial help, Nei said. Because of eligibility restrictions, the organization can help only about 20 percent of Montanans seeking assistance.

"It's a symptom of a much larger problem," she said. "We need health care reform."

While reform is debated at the national level, local oncologists are looking for ways to adequately treat their patients and stay afloat.

"You can't just talk to patients about their cancer and the toxicity of treatment anymore," said Dr. Patrick Cobb, an oncologist at Hematology Oncology Centers of the Northern Rockies. "You can't focus exclusively on the medical aspect. You have to go into financials."

"None of us are trained to do that," said Cobb, also president of the Community Oncology Alliance, a national nonprofit group. "It's something most oncologists are uncomfortable doing, but, if you don't pay attention, you'll go out of business."

Cobb's practice closed an office in Sheridan, Wyo., last year because it had sunk too far into the red.

Reimbursements from Medicare and Medicaid lagged too far behind the amount the practice was paying to buy drugs from distributors. About 65 percent of Cobb's Sheridan patients were on Medicare or Medicaid.

The Community Oncology Alliance is lobbying Congress to pass legislation that would restructure the way the government pays oncologists for cancer drugs. The group says improvements to the reimbursement system that were promised in the 2003 Medicare Modernization Act never materialized.

Low government reimbursement rates are one reason Cobb's practice is building a multimillion-dollar cancer center on the city's West End. It will offer services, such as radiology, that are profitable and will counter losses on medication, he said.

"eople doing just chemotherapy in the office have had to sell themselves to another entity or do what we're doing now - bring in radiology," Cobb said.

At Billings Clinic, which is also building a multimillion-dollar cancer center, a financial counselor works full-time helping patients find ways to afford drugs.

"The drug itself is the most expensive part of treatment," said Felicia Pinnick, who estimated that two-thirds of Billings Clinic's cancer patients end up in her office.

Susan Jensen needed Pinnick's help when her health insurance wouldn't pay for a breast cancer drug. It cost $20,000 a month.

"Nobody can do that," Jensen said. "I don't know anybody who has an extra $360,000 lying around."

Dr. Tom Purcell, head of Billings Clinic's cancer department, agrees that something needs to change.

But Purcell isn't convinced that increasing payments to oncologists is the answer, because it would probably mean more cost to taxpayers.

"Where would the money come from?" he asked. "There is no more money."

Contact Diane Cochran at dcochran@billingsgazette.com or 657-1287.