Newspaper article Sarasota Herald Tribune

Medicare Costs and Benefits

Newspaper article Sarasota Herald Tribune

Medicare Costs and Benefits

Article excerpt

Data on payouts provides a new diagnostic tool

Wednesday's Medicare "data dump" -- revealing, after decades of secrecy, how much each doctor is paid by the federal program -- is an overdue step toward smarter medical spending.

Unfortunately, the raw data lacks context and is creating some sticker shock over multimillion-dollar payments to certain specialists. Patience is warranted as analysts sort out the numbers. Remember, the figures issued Wednesday represent costs but not profits for doctors. (For example, most of a $5 million check to a specialist could represent overhead expenses.)

Even so, the information -- involving outpatient doctor care -- opens a window on a complex subject.

It's important to get a handle on all Medicare costs, for the sake of current and future beneficiaries, taxpayers and the U.S. economy. Policy adjustments that protect the coverage and quality of Medicare, while reining in waste, are needed to enhance the program's long-term sustainability.

Overall Medicare costs exceeded $574 billion in 2012. Wednesday's figures looked at one component of that total: $64 billion paid out to doctors in 2012 (and another $13 billion paid to various other practitioners).

Troubling cases

The report and data focus concern on a small fraction of the nation's doctors. As the Wall Street Journal explained, "Medicare paid 344 physicians and other health providers more than $3 million each in 2012."

The Washington Post reported that "the specialties most common at the top ranks of the Medicare payments were ophthalmologists, oncologists and pathologists."

Various factors could account for these high payments. Some of the recipients, for example, may have several support staff billing under the same name. Yet the Post also raised troubling cases -- such as ophthalmologists who routinely use a $2,000-per-dose drug for eye injections rather than an equally effective one that costs $50. …

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