From Eugene to Eugenics

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  • 11/07/2013

From the pages of the Oregon StatesmanJournal

From Eugene to Eugenics: Oregon's new cost-cutting strategy is to deny care to cancer patients

In an ad for the Affordable Care Act, local folk singer Laura Gibson plucks her guitar and muses about how the “Oregon way” is to “care for each one, every daughter and son.” Though a little corny, the song delivers a worthy message: Oregon is committed to providing everyone access to health care.

The commercial is part of Oregon’s new ad campaign to boost enrollment in the newly created “Cover Oregon” health insurance exchange.

But the reality strums a different, far less organic tune. Even as Oregon drops $3.2 million to spread their “each one” message, the Beaver State is also taking measures to that would deny life-saving treatments to desperately sick citizens.

In August, Oregon’s Health Evidence Review Commission issued an update to its guidelines for providing cancer treatment to low-income individuals covered by the state Medicaid program. These new guidelines require that Medicaid deny coverage for certain cancer treatments for patients that have been deemed “too” sick, haven’t responded well to previous treatments, or can’t care for themselves.

Through these new rules, Oregon state bureaucrats are severely restricting access to care and dooming potentially thousands of local patients to a premature death.

What’s worse it that these new Medicaid guidelines are not grounded in the medical literature or best clinical practices, according to Kenneth Thorpe, chairman of the Partnership to Fight Chronic Disease. Rather, according to Thorpe, they’re based “on the odds of survival observed in a group of patients.”

It’s true that for some late-stage cancer patients, the odds are long than any additional treatment can help. But without access to the latest that medical science has to offer, a patient’s survival rate simply drops to zero.

As B.J. Cavnor of the Northwest Patient Education Network powerful puts it: “Cutting patients off from cures means patients who could have beaten their illness will no longer have that chance.”

It’s a frightening move from Eugene to eugenics. These guidelines dictate that Medicaid only provide “palliative” care – painkillers, acupuncture treatments, wheelchairs, drugs for nausea, and the like.

So while Oregon won’t let Medicaid patients have access to cancer medicines that could prolong or save their lives, it will pay to make their deaths slightly less painful. Is that what Oregon considers compassionate care?

About 19,000 Oregonians are diagnosed with cancer each year. Over 640,000 state residents are covered by Medicaid -- that’s about one in five of the total state population. And the state Medicaid ranks will swell next year, when the Affordable Care Act will raise the program’s income threshold up to 138 percent of the federal poverty line.

Oregon’s new Medicaid guidelines take treatment decisions out of the hands of doctors and patients and put them in the hands of distance state bureaucrat willing to cut costs no matter the human toll. It’s the practice of cost-centric controls over patient-centric care.

Even supporters of the President’s healthcare law have taken to calling these treatment restrictions a death knell for poor cancer patients.

Cavnor, the patient advocate, has described them as “extremely frustrating and morbidly ironic, especially for those of us who have tried to argue that the Affordable Care Act doesn’t allow for ‘death panels.’”

Is this really change we can believe in? Promising to expand access to health care to all while denying it to those who need it most is brazen hypocrisy. Oregon should expect more from itself.

At the end of her song boosting the state’s health exchange, Laura Gibson sings “live long, Oregon.” That’s a good aspiration. Oregon’s state bureaucrats should live up to it.

Peter J. Pitts, a former associate commissioner at the FDA, is president of the Center for Medicine in the Public Interest.


Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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