Have you heard that Medicare is thinking about cutting back on the amount it is willing to pay for certain drugs used by cancer patients and people on dialysis? It should be a big concern in the black community because blacks rely more on Medicare to pay for drugs than the rest of the population, and because blacks make up nearly 40 percent of the people on dialysis, even though we are only 13 percent of the general population.
The drugs in question are called anemia drugs, and they stimulate the production of red-blood cells. The loss of red-blood cells often results from cancer chemotherapy and kidney disease, which is why cancer victims and people on dialysis are the heaviest users of the drugs. The most prescribed drugs of this type are Epogen and Aranesp, sold by Amgen, and Procrit, sold by Johnson & Johnson.
After reading several articles in The Wall Street Journal and discussing this issue with a medical doctor, my first response was that it’s difficult to talk about the issue of racial disparity honestly, even in a situation with life-and-death consequences. The drug companies are accused of playing the race card by talking about how restrictions on reimbursement for their product will disproportionately affect blacks. But the facts (and the Congressional Black Caucus) are on their side. Nobody is denying that blacks rely more on Medicare or undergo dialysis at higher rates than whites.
Some blacks are a little embarrassed by the controversy because it points out that too many tend to live less-healthy lifestyles than their parents or grandparents. To a certain extent, it reflects a lack of personal responsibility. Obesity goes beyond race and gender. Eating habits can be changed. The latest survey from the Centers for Disease Control and Prevention says life expectancy in America hit a record high of almost 78 years. White males average 75 years, while black men average only 69 years. White females average 80 years while black females average 76 years. Improving black health should be a high priority.
There’s also another side of the debate that isn’t getting as much attention as it should. The pressure to reduce prescriptions for anemia drugs isn’t coming from patients or even their doctors. It’s coming from Medicare in response to politicians and bureaucrats looking to save money. The American Society for Clinical Oncology and other medical societies oppose Medicare’s plan to restrict access to these drugs.
With government now paying nearly half of all medical expenses in the U.S.-and more than half of the black community’s medical expenses-calls for price controls and rationing of drugs are becoming more common. The poor and the unhealthy, the people with the least political clout, are the first to be hurt by these budget-cutting efforts.
When our access to life-saving drugs and quality health care depends on government funding, who decides what gets funded and what gets cut becomes a matter of life and death. We would be much better off if those decisions were made by patients and their doctors, not bureaucrats in Washington DC.
This problem, of government substituting its judgment for that of patients and doctors, is getting worse. In the past couple of weeks, new research was released showing that substitution of generic drugs for Lipitor, the popular cholesterol-lowering medication, could cause higher risk for heart attacks. Where did the pressure to replace Lipitor with generics come from? You guessed it. Government agencies looking to save money.
Yes, how we pay for our health care does make a difference, and it makes a difference regardless of a person’s race. But blacks of all political affiliations and incomes have special reasons to pay attention to this debate. Opposing restrictions on anemia drugs is a good place to start.
Lee H. Walker (firstname.lastname@example.org) is president of The New Coalition for Economic and Social Change. He is also chairman of the Illinois U.S. Civil Rights Advisory Committee.