Tag: "Medicare"

Headlines I Wish I Hadn’t Seen

nutrition-labelAre serving sizes on food packages intentional attempts to mislead us? No, they are dictated by the government.

Medicare kept paying dozens of doctors after they were suspended or terminated from state Medicaid programs or were indicted or charged with fraud.

Terminal cancer patients in Russia are sent home to die; can’t get pain medication; some are committing suicide. (HT: Jason Shafrin)

Patients at risk: More than 100,000 doctors, nurses, medical technicians, and healthcare aides abuse prescription drugs.

Why We Spend So Much on Drugs

The editors at Bloomberg explain:

prescription-bottleHere’s how the system works: When a doctor administers a drug in his or her office, Medicare pays 106 percent of its average selling price. The doctor keeps the extra as compensation for administering the injection.

What has this got to do with eye doctors? The drug Lucentis, used to treat macular degeneration, cost Medicare almost $2,000 a shot in 2012. Another drug, Avastin, which works just as well, costs about $50. If you were the doctor, faced with a system that pays you 6 percent of the drug’s cost, which would you choose? That Medicare spent a total of about $1 billion on Lucentis in 2012 suggests most ophthalmologists went with the more expensive one.

It gets worse:

This problem goes beyond a single drug. Of the $20 billion Medicare spent on drugs administered by doctors in 2010, 85 percent went to the 55 most expensive ones. In what seems unlikely to be a coincidence, 42 of those drugs also showed an increase in use from 2008 to 2010.

Headlines I Wish I Hadn’t Seen

Canvbnadian study: Almost one-third of patients never fill the prescriptions for the medicines they are told to take.

Jails house 10 times more mentally ill than state hospitals.

Doctor billed Medicare for $21 million in 2012; investigated by the FBI; makes large donations to Democrats.

Washington Post fact checks TV ad Barrack Obama ran against John McCain and finds that all the scary predictions actually came true — it’s called ObamaCare.

Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments.

Doctors Push Back on Release of Data

doctor-xray-2Doctors reacted swiftly and indignantly to Wednesday’s release of government records revealing unprecedented details about Medicare payments to physicians…The top 10 doctors alone received a combined $121.4 million for Medicare Part B payments in 2012…In interviews, many of the doctors said they were just passing through the payment to drug companies. Some said they were unfairly singled out even though they were billing for an entire practice. And still others disputed the accuracy of Medicare data. (Washington Post)

Hits and Misses

Costdog-1 to clone a dog: $100,000.

More lawlessness: Medicare Advantage plans will get a 0.4% increase in premiums instead of the 1.9% cut the ACA seems to require.

Is Starbuck’s recycling your paper cup? Probably not.

Consumer driven health care: There are about 1,600 walk-in medical clinics across the country and the number is projected to double in the next three years.

It’s Zeke vs Me

In the Wall Street Journal. In recognition of ObamaCare’s 4th anniversary. Guess which one of us lacks a sense of humor?

I write:

money-burdenFor the past 40 years real, per capita health-care spending has been growing at twice the rate of growth of real, per capita income. That’s not only true in this country; it is about the average for the whole developed world.

Clearly, this trend cannot go on forever. So what does ObamaCare do about that? It limits the government’s share of the costs while doing nothing to protect individuals or their employers.

The law restricts the growth of total Medicare spending, the growth of Medicaid hospital spending and (after 2018) the growth of federal tax subsidies in the health-insurance exchanges to no more than the rate of growth of real GDP per capita plus about one half of 1%. This means that as health-care costs become more and more of a burden for the average family, people will get less and less help from government — to pay for insurance the government requires them to buy!

Zeke Emanuel with a somewhat different point of view.

Hits and Misses

Milton Friedman’s legacy.

Tom Miller is disappointed in the Coburn/Burr/Hatch health reform bill.

South Korea will not regulate Samsung’s Galaxy S5 (a smartphone with a heart-rate sensor) as a medical device. (See also previous blog entry)

Medicare Advantage cuts: Insurers’ advocacy campaign contradicts Wall Street analysts’ rosy outlook.

The TRICARE Quagmire

TRICARE, the health insurance program for active duty military and their families, has a well-deserved reputation for inadequate quality at an exorbitant public cost:

  • A 2008 survey found that 96 percent of physicians accepted new commercially insured patients, 86 percent accepted new patients on Medicare, and 72 accepted new patients on Medicaid. By contrast, between 2008 and 2011, only 58 percent of civilian providers accepted new TRICARE patients.
  • Premiums for enrollees have not risen in the 17 years since TRICARE’s inception in 1996. As a result, enrollment fees for TRICARE Prime recipients remain at $38 a month, about 12.5 percent of the average cost of comparable private insurance.
  • From 2001 to 2011, general military health care spending  grew twice as fast as the rise in the nation’s overall health care costs.  The TRICARE program has largely contributed to this growth, tripling over the last decade. TRICARE spending now accounts for about 10 percent of the baseline defense budget.

Here are some solutions, proposed by NCPA’s Jacob Casey.

Study: Drug Insurance Reduces the Cost of Other Therapies

Results indicate that obtaining prescription drug insurance through Medicare Part D was associated with an 8% decrease in the number of hospital admissions, a 7% decrease in Medicare expenditures, and a 12% decrease in total resource use. Gaining prescription drug insurance through Medicare Part D was not significantly associated with mortality. (NBER)

Headlines I Wish I Hadn’t Seen

18kqd35hi04oqjpgOne in five doctors may not be able to afford to continue vaccinating children on Medicaid and Children’s Health Insurance Program.

American Hospital Association wants Consumer Financial Protection Bureau to let hospitals use strong-arm debt-collection on patients with debts.

Florida Medicare Advantage Plan to pay for members’ fitness trackers (which means the plan seeks to enroll healthy, not chronically ill, seniors).

Huge privacy invasion: A management consultant uploaded England’s entire National Health Service patient database to Google servers outside the U.K.