Tag: "Medicare"

Bossed to Death

This is Jane Orient, MD, of Tucson, Arizona and head of Association of American Physicians and Surgeons, responding to the Cato report described here:

So just who should be my boss? What credentials? What oversight of the boss? Who gets sued if there's a problem?

The "project manager" in cases like Mr. Kling's used to be called "doctor." Seeing to all those details used to be my job when I was the attending internist rounding on my private patients in the hospital, calling the consultants but doing all the medical work outside of the specialty procedures, always looking for trouble.

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Feb 05, 2009 | 5 comments | by

Hits & Misses – 2009/02/03

Tanzania bans witch doctors.

The reason: to stop them from killing albinos for medicine… Many are registered with the government and belong to their own medical association, which opposes the ban, saying its members treat 30 percent of the Tanzanian population…. At least 40 albinos have been murdered in Tanzania since mid-2007, many of them hacked to death in front of their families, and their legs, breasts, genitals and other parts carried off. In one case, an albino child 9 months old was taken from its mother and killed.

GAO: Medicare and Medicaid are at “high risk” for waste, fraud and abuse.

According to the Government Accountability Office (GAO), more than 10 percent of Medicaid payments in 2007 – $32 billion worth – were improper. [Hat tip to Jim Frogue.]

Singapore is considering paying for organs.

Donors will get up to $33,000. [Hat tip to Alex Tabarrok.]

Feb 03, 2009 | 4 comments | by

Congratulations to President Obama

If you are willing to be like Nixon going to China, you can accomplish much in the area of health care:

  • In Medicare, this means acknowledging we cannot continue with pay-as-you-go finance; we must instead move to a system where each generation pays its own way.
  • With health care reform generally, it means acknowledging everyone's incentives are perverse and committing to move rapidly toward a new system in which people reap the benefits of their good decisions and pay the costs of their bad ones.

httpv://www.youtube.com/watch?v=eSegQ9gGFbc

Hail to the Chief(s)

Jan 20, 2009 | 3 comments | by

Update on the Left’s Favorite Health Plan

Reimbursement rates are so low, and billing the program so complicated, that it is hard for internists to get beneficiaries access to specialized care or timely interventions. For  patients, many of whom are uneducated or don't speak English, Medicaid is replete with paperwork, regulations and rejections that make the program hard to navigate, writes Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute and a former senior official at the Centers for Medicare and Medicaid Services.

Accumulating evidence shows that Medicaid recipients' poor health outcomes aren't just a function of their underlying medical problems, but a more direct consequence of the program's shortcomings.  Take the treatment of serious heart conditions:

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Jan 13, 2009 | 3 comments | by

Understatement of the Week

This is a New York Times editorial on Sen. Daschle's testimony yesterday:

He gave no indication of how to pay for all this or how to rein in the escalating costs of entitlement programs, and he was not asked such probing questions by a committee that seems certain to recommend his confirmation.

Jan 09, 2009 | 2 comments | by

Misguided Health Care Reform: Expect Slower Payment, Worse Access

The Health Affairs article [gated, but with abstract] by Peter J. Cunningham and Ann S. O'Malley first discussed here by Devon Herrick, contains two nuggets of information that deserve more discussion. First, most of the proposed health care reform plans under discussion will slow payments to physicians and hospitals. Second, any reform plan that relies on putting more people into Medicaid will make it much more difficult for people to actually get medical care.

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Jan 08, 2009 | 5 comments | by

Uwe Is Not Paying Attention

Speaking of unreasonable addiction to Ponzi schemes, here is Prof. Reinhardt writing at a New York Times blog. He asks, "Can Americans Afford Medicare?" He answers: "What if we couldn't? What would we do – push the elderly into the ocean on an ice floe?" Mercifully, he rejects that option. But then adds, "The best we can do today is to put in place public policies that can help G.D.P. grow now and in the future, to ease the pain of sharing."

Isn't that a little like saying that if you're headed toward a brick wall at 70 mph, the best you can hope for is to slow down to 60 mph? Read what Larry Kollikoff says about the coming generational warfare here.

Fortunately, there are many better things that can be done, as outlined here. My back-of-the-envelope calculation of what we need to do to leave our grandchildren with no higher tax burden (as a percent of national income) than what we are paying today is shown in the table.

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Dec 30, 2008 | 3 comments | by

Medicare: Some are More Equal than Others

This is from a New York Times piece:

CyberKnife treatments take five days instead of the eight weeks for conventional prostate cancer radiation…

As it turns out, Medicare pays for the treatments in 33 states – but not in 17 others…

At an average Medicare cost of $29,000, CyberKnife prostate treatment is not cheap. But it can be less expensive than some other radiation methods, which may cost as much as $50,000.

Dec 19, 2008 | 3 comments | by

Hits & Misses – 2008/12/19

Grassley Goes After Nonprofits. “The legislation would require nonprofit hospitals to spend a minimum amount on free care for the poor…and set curbs on executive compensation and conflicts of interest….”

Whose Life Is It Anyway? “Some companies are tying payments to medical test results. This year, Blue Cross and Blue Shield of Minnesota is offering $200 insurance rebates to its own employees who can maintain ‘healthy levels’ of blood pressure, cholesterol and other risk factors – or show they’re making an effort to improve them.”

Walk-in Clinics Expand Access. For once, a Commonwealth Fund study we like.

Cost Shifting from Medicare, Medicaid Dwarfs Cost Shifting from the Uninsured. “Underpayment by Medicare and Medicaid costs private insurers $89 billion a year, raising the cost of coverage for a family of four by $1,788.” Hat tip to Greg Scandlen.

Dec 19, 2008 | 3 comments | by

CMS Approves Liver Transplants for Four Japanese Mafiosos

Although two of the patients gave the hospital $100,000 a piece and despite a persistent organ shortage for American patients, the Centers for Medicare and Medicaid Services (CMS) said there was “no evidence of misapplied policies, [or] preferential treatment.”

httpv://www.youtube.com/watch?v=PQyClNEfncg

Turning Japanese

Dec 17, 2008 | 2 comments | by
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