Letters: The 340B program is failing to help patients in need

From Warren H. Fong, M.D., President of the Medical Oncology Association of Southern California

As the president of the Medical Oncology Association of Southern California and a practicing oncologist for nearly two decades, I have seen firsthand the negative impact the rapidly escalating abuse of the 340B Drug Pricing Program has had on cancer patients, healthcare costs and society. This growth has occurred without a proportional improvement in services to the poor and underserved — the very patients the program was designed to help. Contrary to former Rep. Henry Waxman’s (D-Calif.) analysis (“A program that works exactly as intended,” May 2), 340B is clearly broken.

Since 2010, the 340B program has grown exponentially, without solid evidence that poor, underserved, and uninsured patients are benefiting. Studies examining the amount of charity care provided by 340B hospitals underscore that hospitals appear to be the ones benefiting from the program’s expansion — not the patients, as intended. In fact, 64 percent of 340B hospitals have charity care rates below the 2.2 percent national average for all hospitals, and 24 percent of hospitals account for 80 percent of charity care provided by 340B hospitals.

340B abuse has moved cancer care from community oncologists to hospital-owned and managed centers. Hospitals discovered a great business model: Become 340B eligible despite providing little charity care, access 340B discounted drugs, acquire large populations of well-insured patients by buying community oncology practices, give well-insured patients 340B drugs, charge insurers full price, and make huge profits. The Community Oncology Alliance’s 2016 Practice Impact Report found that about 74 percent of community oncology clinic acquisitions in the past two years were by 340B hospitals. This transformation based on profit, instead of cancer innovation, hurts cancer patients and society.

The bottom line: Abuse of the 340B program is merely turning many Disproportionate Share Hospitals into pure profit centers, and does not “stretch scarce Federal resources as far as possible, reaching more eligible patients and providing more comprehensive services” — the stated mission of the 340B program.

The 340B program is a truly noble program that should continue. However, its altruistic mission is being undermined by unscrupulous hospital administrators who are blatantly violating the 340B program’s intent. No one is benefiting other than hospitals, not the poor or underserved, not cancer patients, and certainly not the American people. We need commonsense reform: Access to 340B discounted drugs should be restricted to entities that primarily serve the poor and underserved.

Upland, Calif.

Recognizing Jerusalem as Israel’s true capital long overdue

From Paul Bloustein

American recognition of Jerusalem as the capital of Israel and the moving of our embassy to that city is decades overdue. The Palestinian threat that such a move will derail peace talks is farce at best and delusion at worst.

Of course, it is solid myth at Foggy Bottom, which has yet to publicly acknowledge that most regional Arab parties to the dispute, recognizing that necessity is the mother of invention, have moved on to more pressing issues.

President Trump should announce that the recognition will occur at a certain date and invite the Palestinians to leave fantasy behind and join with the Israelis to finalize what was agreed to years ago before a delusional Yasser Arafat scuttled it.

Cincinnati, Ohio