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Politics : PRESIDENT GEORGE W. BUSH -- Ignore unavailable to you. Want to Upgrade?

To: SeachRE who wrote (499627)	11/28/2003 8:24:18 AM
From: Kenneth E. Phillipps	Read Replies (1) \| Respond to of 769667

Doctors fear lower Medicare drug payments will hurt cancer clinics Scandal prompted bill's writers to cut reimbursements Dan Freedman, Hearst Newspapers Thursday, November 27, 2003 Washington -- Doctors who treat cancer patients say the new Medicare program approved by Congress last week will hurt their ability to operate small oncology clinics and administer chemotherapy. "This bill is so devastating," said Dr. William Schmidt, an oncologist in Charleston, S.C. "I feel like my legs are being cut off -- that I can't practice medicine the way a doctor should." At issue are the complicated formulas that the Medicare program uses to reimburse doctors for chemotherapy drug purchases and the expense of operating small cancer clinics. The new Medicare program's headline feature is prescription drug coverage for the 38-year-old system's 40 million elderly and disabled beneficiaries. But it also cuts at least $4.2 billion over 10 years from drug treatments primarily for Medicare patients with cancer, according to a Congressional Budget Office analysis. Cancer specialists such as Schmidt say the cuts will lower Medicare reimbursements and lead physicians to re-evaluate whether they can afford to continue treating Medicare patients. The cuts also may force layoffs of clinic nurses and other personnel, and the closing of smaller satellite clinics that serve patients away from urban areas, the specialists say. "This is the largest cut to cancer care since Medicare started" in 1965, said Deborah Kamin, policy director for the American Society of Clinical Oncology. "We don't want to panic people and scare patients, but this is a cut to cancer care of historic proportions." Rep. Michael Rogers, R-Mich., himself a survivor of bladder cancer, said he shared the same concerns, but he added that it was too early to predict the exact impact. "I'm a little nervous that when all is said and done, we may have taken a bigger bite (out of cancer care) than intended," Rogers said. Congressional targeting of cancer clinics goes back about two years to investigations on Capitol Hill that revealed doctors obtained cancer-fighting drugs at bargain-basement prices but then received Medicare reimbursements for five times the amount they paid. For instance, the House Energy and Commerce Committee in 2001 found that doctors paid $1.25 for 50 milligrams of Leucovorin, used in combination with chemotherapy to treat various forms of cancer. But Medicare reimburses the physicians $35.47 for that amount of Leucovorin. Cancer doctors say the excess money goes to offset the cost of staffing and maintaining their clinics. Medicare reimbursements for clinic expenses are insufficient, so doctors have come to rely on generous payments for drugs to keep their practices afloat, they say. The Medicare reimbursement system for cancer care was developed in the 1960s and 1970s, when most cancer treatment took place in hospitals. Medicare reimbursed doctors at a high rate for cancer-fighting drugs because the federal system factored in the time that high-salaried doctors took to administer the drugs in hospitals. Fast forward to the 1990s: Chemotherapy and other forms of cancer treatment increasingly are administered not in hospitals, but in small oncology clinics operated by the doctors themselves. But Medicare, under the old formula, reimbursed clinic and office expenses at a much lower rate. At the same time, doctors have incurred new practice expenses because they now must pay the cost of operating and staffing clinics. The Medicare legislation attempts to address the imbalance by taking away from the cancer doctors' drug reimbursement and adding to their office-expense reimbursement. According to the CBO, the legislation's $4.2 billion cut primarily affects Medicare reimbursements for drugs. Doctors can expect an increase in office expenses amounting to about $3 billion over 10 years, the CBO concluded. Whether it all balances out properly over the next decade or leads to clinic closures is the subject of intense debate. Rogers said he and others in Congress were forming a task force to monitor cancer clinics and call lawmakers to action if low reimbursement rates led clinics to close. "I want to make sure that if we've made a mistake in our calculations, cancer patients don't pay the price," Rogers said.

To: SeachRE who wrote (499627)	11/28/2003 8:26:54 AM
From: Kenneth E. Phillipps	Read Replies (1) \| Respond to of 769667

Soros 'speculating against dollar' Pound surges to five-year high against US currency. Buffett also said to be betting against greenback By Philip Thornton and Michael Jivkov 28 November 2003 The pound surged against the dollar yesterday amid speculation that Warren Buffett and George Soros, the world's most famous speculators, are betting the US currency will plummet. Sterling powered to a five-year high against the dollar for a second day as concerns over the US current account deficit continued to outweigh evidence of a rebounding economy. Traders believe selling the dollar is a one-way bet, and some latched on to rumours that speculators were building "short" positions on the dollar - betting it will tumble in the coming months. One hedge fund manager, who asked not to be named, said: "I have heard that both Soros and Buffett are shorting the dollar. There's a growing belief on Wall Street that the dollar is looking like a one-way bet downwards." A spokesman for Mr Soros, who famously "broke" the Bank of England when the pound crashed out of the exchange rate mechanism a decade ago, said he never commented on speculation. Mr Buffett was unavailable for comment. The surge in the pound to $1.7155, its strongest level since October 1998, was boosted after Merrill Lynch forecast the dollar would plunge a further 8 per cent by the end of next year. Demand for the dollar has waned on concern the country will not attract enough capital to fund its record current account deficit, which is expected to break through 5 per cent of GDP this year. In a massive revision to its forecast issued on the eve of yesterday's Thanksgiving holiday, Merrill Lynch said the pound would hit $1.85 - which would be its highest level since 1992. The blue chip Wall Street bank said sterling would rise on signs of returning economic strength, rising interest rates and hope that the Government won't raise taxes before a 2005 election. But it warned that the surge in the pound would be short-lived as the concerns overhanging the UK - from a budget deficit, huge consumer indebtedness and a tight labour market - would come home to roost. "Bubble trouble currencies such as the pound should continue to do well for now," it said. "But upsides in the currencies in these regions should end next year as tighter conditions threaten to burst credit bubbles and shape market expectations of lower rates." Merrill Lynch expects the dollar to tumble to $1.33 against the euro, a drop of 12 per cent from yesterday's $1.19 value. But it cut its forecast for the euro to surge to 80p against the pound - a level that would smooth sterling's entry into the single currency - to 73p. A surge in the pound against the dollar will be a boon for British tourists but could cause headaches for both businesses and the Bank of England. Khuram Chaudhry, a strategist at Merrill Lynch, said: "UK investors may find company sales exposure to the US unfavourable in this scenario.A stronger domestic currency is likely to mean the Bank is less likely to raise interest rates aggressively." David Bloom, a global economist at HSBC who does not see the pound going much above $1.70, said any spike in the pound would be short-lived. "If you want to sell the dollar because you believe in the structural problems such as the current account deficit then you buy the pound but there's a downside because the UK is also looking a trade deficit, an indebted economy," he said. "If you think those factors will cause the dollar to fall then the pound should fall as well." He said the main beneficiary should be the euro, which has smaller deficits - despite the high-profile row over the stability and growth pact. He said HSBC was sticking with its historic forecast for a dollar-euro rate of $1.35. Mr Bloom warned that if the pound were to fall it could tumble even further than the dollar as there would be little interest from other countries to prop it up. 28 November 2003 05:26 Search this site: Printable Story

To: SeachRE who wrote (499627)	11/28/2003 8:42:58 AM
From: Kenneth E. Phillipps	Respond to of 769667

U.S. Stock-Index Futures Decline as Dollar Drops Against Euro Nov. 28 (Bloomberg) -- U.S. stock-index futures fell before exchanges opened as the dollar dropped to a record low against the euro, sparking concern that foreign investors might sell U.S. assets. ``The dollar reaching 1.20 against the euro will weigh on the markets,'' said Michael Sheldon, chief market strategist at Spencer Clarke LLC, in a television interview with Bloomberg News. ``If the decline in the dollar is rapid, it could destabilize markets overseas and scare investors off.'' quote.bloomberg.com