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Thursday, November 6, 2014

How opthamologists topped the list of Medicare recipients

Top earning Medicare recipients
Opthamologists special treatments yield high Medicare returns
The Center on Budget and Policy Priorities states that in 2013, Medicare cost the federal government $498 billion or 14.19 percent of the annual budget for that year.

This is a substantial amount of U.S. spending and therefore warrants attention by administrators and policy makers. Furthermore, if the data release exposes problems within the health care system such as billing inefficiencies, or unnecessary services within medical practices, then its release has the potential to place pressure on the industry to streamline any excessive spending.

Issue

Ophthalmologists received 7 percent or $5.6 billion of total Medicare payments in 2012 according to government data cited by the New York Times. This information is part of a data release by the Centers for Medicare and Medicaid Services authorized by the U.S. Department of Health and Human Services Secretary, Kathleen Sebelius. According to a press release from CMS.gov, the purpose of the data release is part of an ongoing executive effort to increase transparency in medical services costs.

Overall, 880,000 medical professionals received a total of $77 billion in 2012. What the payment distributions demonstrate is that specific types of healthcare services are in higher demand among Medicare recipients than others. Moreover, since Medicare is a medical service provided by the government for older Americans, the information elaborates on where money is being spent and how that spending may be improved or make government subsidized social services more cost effective.

Impacts

Another positive impact of the medical information release is that it helps Americans better evaluate how to allocate their own money to medical service co-payments and deductibles. For example, according to the Washington Post, pharmaceutical use under Medicare is disproportionate across the country. This indicates some regional drug use varies considerably, and is also a possible sign of misuse in some areas and under-utilization of drugs in other areas. The government medical data release also facilitates the use of interactive tools that help consumers to compare how much local doctors receive from Medicare.

Reactions

Doctors have been quick to respond to the information and have claimed the money received was necessary to cover the costs of expensive drugs required in the treatment of specific conditions per the New York Times. While some doctors may like to pass the buck on to the pharmaceutical industry, surgical operations and related non-pharmaceutical medical services are not without costs themselves and in some cases may not be necessary. For example, diagnostic X-rays or other medical tests that do not always provide a great deal of preventative utility tax the medical system and have the potential to do more harm than good.

Medical costs are a systemic reality within U.S. health care. How money is spent within the health care system has economic effects and influences the profitability of pharmaceutical companies and professional practices within the industry. Due to the high level of money involved, heated political and commercial pressures exist that seek to maintain the status quo on spending. That does not necessarily benefit all Americans and the country as a whole. The release of financial data such as detailed medical expenditures is a step toward raising awareness of an issue that will impact Americans' lives for many years to come.

Image: Pixabay/US-PD