Squandering Medicare’s Money

Medicare spends a fortune each year on procedures that have no proven benefit and should not be covered. According to Rita F. Redberg, writing in The New York Times, examples abound:

• Medicare pays for routine screening colonoscopies in patients over 75 even though the United States Preventive Services Task Force … advises against them (and against any colonoscopies for patients over 85). In 2009, Medicare paid doctors more than $100 million for nearly 550,000 screening colonoscopies; around 40 percent were for patients over 75.
• The task force recommends against screening for prostate cancer in men 75 and older, and screening for cervical cancer in women 65 and older who have had a previous normal Pap smear, but Medicare spent more than $50 million in 2008 on such screenings.
• Two recent randomized trials found that patients receiving two popular procedures for vertebral fractures, kyphoplasty and vertebroplasty, experienced no more relief than those receiving a sham procedure … Nevertheless, Medicare pays for 100,000 of these procedures a year, at a cost of around $1 billion.
• Multiple clinical trials have shown that cardiac stents are no more effective than drugs or lifestyle changes in preventing heart attacks or death. Yet one study estimated that Medicare spends $1.6 billion on drug-coated stents … annually.
• A recent study found that one-fifth of all implantable cardiac defibrillators were placed in patients who, according to clinical guidelines, will not benefit from them. But Medicare pays for them anyway, at a cost of $50,000 to $100,000 per device implantation.

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