It’s been an eventful week for Medicare: Not only did the top Medicare official resign, but he’s now publicly stating that as much as 30% of ALL Medicare spending is wasted. This means that, in his words, as much as $250 billion per year is wasted by Medicare and Medicaid.
Chief Dr. Donald Berwick stepped down because Senate Republicans did not confirm his recess appointment which was about to expire. In an interview with the New York Times Berwick said that between 20 percent and 30 percent of health spending is wasteful. The five reasons for the “extremely high level of waste” include overtreatment, little coordination of care, fraud, a complex health care system and regulations that are pointless and archaic. Berwick defines waste as “activities that don’t have any value” and estimates that Medicare and Medicaid could save between $150 billion to $250 billion a year by eliminating waste.
Hopefully, Marilyn Tavenner, a top official at the agency, who has taken Berwick’s place will continue efforts to reform the system. She’s off to a good start. In a major policy shift the Department of Health and Human Services implemented a provision to make the Medicare claims database available to the public. The massive Medicare database is considered the mother lode of medical information for the U.S. health-care system. The computerized record itemizes medical bills for 48 million beneficiaries.
Nationwide, an assortment of 25 groups will be granted access to the data. These groups are working to improve health care at the local level and will be comprised of doctors, health insurers, businesses, consumers and government agencies. They will analyze, study and publish results on procedures, hospitals and doctors in order to help consumers make better-informed decisions about their care.
However, opening the $500 billion data base to 25 groups is merely the opening act of a more transparent system. The Wisconsin Collaborative for Healthcare Quality, one of the groups selected, discovered daunting challenges due to both mechanical problems as well as the sheer complexity of the information involved in a recent Medicare project.
Marilyn Tavenner says she is striving to “ensure consumers have the access they deserve to information that will help them receive the highest quality care at the best value for their dollar.” To do this she must do more than scratch the surface. She must create more opportunity for access to the data.
Reform of the Medicare system is urgent. Allowing many experts access to the data will lead to valuable insights and the most appropriate treatments. Before cutting services and benefits for older adults shouldn’t waste be eliminated? After all, we wouldn’t tolerate squandering 25% of our own personal resources – how is wasting Medicare tax dollars any different?
Congress is looking for solutions to control escalating Medicare costs. Ask your local advisory group to support the Grassley-Wyden DATA Act. Go to your Senator’s page and let them know you support the Grassley-Wyden DATA legislation.
The author, Candice Rose, specializes in aging and elder care. She is currently serving as the Chairwoman of the Arlington County Commission on Aging in Virginia. You can follow her on Twitter at www.twitter.com/CandiceRose.
“Be the change you want to see in the world.” M. Gandhi