Docs Abuse Tax System
Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers—about 5% of the total—had tax debts totaling more than $1 billion, mainly individual income and payroll taxes. Sen. Norm Coleman (R-Minn.), ranking member of the Permanent Subcommittee on Investigations, is using the report to press the Centers for Medicare and Medicaid Services to adopt the federal levy system, which would allow the Internal Revenue Service and the Treasury Department to tap into Medicare payments to providers in order to cover back taxes. “This is a classic case of the right hand not knowing what the left hand is doing,” Sen. Coleman said in a statement, noting that the federal government could have collected between $50 million and $140 million in 2005 if CMS had participated in the levy program. Medicare officials said at a hearing in March that they are working with the IRS and other agencies to manage payment policies.
Penalized by High-Deductible Plans
High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women aged 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.
Retail Clinics Replacing PCPs
More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The MSI study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions including migraine, dyslipidemia, and hypertension. In addition, 30% of all consumers polled said that the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited scope of clinical services,” and that they should encourage all patients to have a medical home.
Negotiation Could Save $30 Billion
Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, while the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said that pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.
Cuts Would Harm Seniors
Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and the vast majority of doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.