July 19, 2011 by Tony Novak
Medicare is the largest and fastest-growing provider of health benefits in the United States and, for the large part, these benefits are provided in whole without large cost sharing concerns from individual patients.
Those who work in the field of health care administration typically share a belief that Medicare spending on doubtful procedures has gone well beyond the “out-of-control” stage. Virtually everyone we talk with who works with Medicare recognizes the problem yet no one has the motivation or political courage to make a change. The systematic belief among patients and providers is that if Medicare covers it, then let’s do it. Yet is seems unlikely that consumers or their medical providers would behave this way if they had any financial stake in the decisions.
This comment used as an example comes from the Pittsburg Post Gazette:
The debate on raising the debt ceiling has been an interesting exercise about
the future role of government. While I have always considered myself left of
center, I feel strongly that we need to address the excesses of Medicare.
Recently, a friend canceled a cochlear implant surgery for her 91- year-old
aunt. Her aunt wanted the surgery because it was “free” and she wanted to hear
better. I just found out that my 75-year-old father had this same surgery! His
doctor recommended it and my father trusted him. The surgery required cutting
into his skull and weeks of recovery — and it didn’t work. He lost all of his
hearing. It was free, though.
Three years ago, Medicare also paid for a very expensive surgery to remove my
80-year-old stepfather’s intestine as he was in the last stage of bladder cancer
with a few weeks to live. He never woke up from surgery.
Is this really how we want our very scarce resources spent? Open up Medicare
for change — or is Big Pharma that influential?
It seems obvious that the way to reduce excessive spending it to re-allocate cost of service to the patient and the provider. This is already happening to some extent. The effects will be sometimes painful but overall decision-making in health care will be improved.