05 February 2011

Medicare Services Becoming a Real Problem

Again, Medicare shows that it intends to ration medical care for those over the age of 65. At lease other services are willing to report what is happening within Medicare. This time it is the U.S. Preventive Services Task Force (USPSTF) that is saying Medicare is not aligning with their recommendations.

This article is the most damning of anything I have seen about Medicare and how they are potentially doing actual harm to the elderly. Government led euthanasia? I do have to really wonder if this is not the intent.

Since the USPSTF is mandated by federal law and its recommendations are done with evidence-based rigor, the authors conclude that reasonable policy would be for Medicare to cover USPSTF recommended services. Unfortunately, evidence-based, is pure theory and open to much interpretation. However, this seems to be the medical mantra of today.

This article is still important because it spells out some of the faults of Medicare. Of 15 interventions that are USPSTF recommended interventions for adults 65 years of age or older, Medicare only reimbursed fully for one of these. For 60 percent of preventive services, Medicare reimburses fully for the service or test, but only partially reimburses for the coordination of obtaining that service.

For four services, Medicare reimburses partially for the preventative coordination and the actual service. And for one service, Medicare reimburses fully for the coordination and assessment, but not the test or service itself. In addition, it was found that Medicare reimburses clinicians to provide seven services that are not recommended, thereby potentially increasing harm to patients as well as increased medical costs.

Until the Affordable Care Act was deemed temporarily unconstitutional, it was felt that the ACA was going to pressure Medicare into being more realistic in their reimbursements. Now even that may be put on hold.

Read the article here.

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