Seeking to stop rising health care costs, the Centers for Medicare & Medicaid Services (CMS) wants to experiment with the way the Medicare program pays for drugs given to patients in doctors’ offices. These “Part B” drugs are complex, injectable medications, like chemotherapy, that must be given to patients by skilled medical professionals because they are potentially toxic and can cause severe reactions. Close supervision in a medical facility is a must!

The experiment came about because CMS believes that oncologists and other doctors are motivated to use higher-priced drugs since Medicare pays for them on a “cost plus” formula. The medical practice has to purchase the drug and is paid an additional percentage to cover the storage, preparation, and related costs. For the record, it should be noted that CMS and Congress came up with this formula—not doctors.

To hear it from the government, doctors are not heroes fighting cancer and other diseases daily in the trenches, but rather profiteers pushing costly and unnecessary treatments on ailing patients. That is not only insulting but an unsupported indictment of our nation’s medical care.

To “solve” this nonexistent problem of doctors purposefully prescribing more expensive drugs, CMS wants to drastically reduce payments to do the complete reverse—penalize the prescribing of high-priced drugs and incentivize doctors to give their patients cheaper ones, even if not appropriate.

The problem with the premise of this government medical experiment is that history holds some inconvenient truths showing that it will do the exact opposite of what CMS intends.

Believing the same thing as the government, the nation’s largest insurer, UnitedHealthcare, ran a pilot study to remove any financial incentive tied to drugs. The result—published in a peer-reviewed medical journal—was a 179% increase in spending on cancer drugs, not a decrease.

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