Free Republic

Have you heard about the insurance company that provides free health coverage for the poor? Me neither. What about the hospital that provides free health care services to the poor? Of course, you say. Many of them do! Indeed, some of these hospitals even go bankrupt in the process. It is beyond the scope of this article to discern how economic values are set in a society, but rest assured that supply and demand are but one factor—especially in health care. Notably, health care is the most regulated industry in the country. With compliance comes massive additional costs, not to...

All too often these days, I find myself fidgeting by the doorway to my exam room, trying to conclude an office visit with one of my patients. When I look at my career at midlife, I realize that in many ways I have become the kind of doctor I never thought I'd be: impatient, occasionally indifferent, at times dismissive or paternalistic. Many of my colleagues are similarly struggling with the loss of their professional ideals. It could be just a midlife crisis, but it occurs to me that my profession is in a sort of midlife crisis of its own....

Years after former Alaska Governor Sarah Palin was mocked for being concerned about "death panels," the federal government may reimburse Medicare doctors for end-of-life consultations that critics say would only encourage sick patients to reject costly treatments to prolong life. The New York Times reports that "Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association," which is "the country’s largest association of physicians and medical students" and creates "billing codes for medical services, codes used by doctors, hospitals and insurers." According to the Times, the group "recently created codes for...

Since October, 155,000 New Mexico residents have joined the state’s Medicaid rolls, pushing total enrollment to more than 630,000, or nearly a third of the state’s population. On top of that, 410,000 New Mexicans are enrolled in Medicare, the federal health care program for the elderly. Together, total enrollment in those two federal programs are more than 1 million, or half of the state’s 2.1 million population. ... “It’s shocking, and when you add that to the outmigration of people and the lack of economic growth, it’s almost an incentive to stay poor,” said retired University of New Mexico economics...

Paul Ryan proposed a private health insurance alternative to Medicare for future retirees, liberal critics pounced. It’s another scheme to undermine health care for the elderly by “privatizing” and “voucher-izing” the program, they said.Yet, almost one third of seniors are already in private health insurance plans. They are called Medicare Part C, or Medicare Advantage, plans. And you would be hard pressed to find any Democratic office holder who wants to abolish them. The reason? Seniors choose to be in these plans because they like them better than traditional Medicare.Not only do seniors like them, but they appear to provide...

The White House has rejected a request to publicly disclose documents relating to the kinds of security software and computer systems behind the federal health care exchange website on the grounds that the information could "potentially" be used by hackers. The Centers for Medicare and Medicaid Services denied a Freedom of Information Act request made late last year by the Associated Press amid concerns that Republicans raised about the security of the website, which had technical glitches that prevented millions of people from signing up for insurance under ObamaCare. In denying access to the documents, including what's known as a...

Screening older patients for cancer provided minimal benefit at considerable cost and increased use of invasive procedures, reported investigators in two separate studies. "It is particularly important to question screening strategies for older persons," Gross continued. "Patients with a shorter life expectancy have less time to develop clinically significant cancers after a screening test and are more likely to die from noncancer health problems after a cancer diagnosis."

The government has paid billions to buy power wheelchairs. It has no idea how many of the claims are bogus. LOS ANGELES — In the little office where they ran the scam, a cellphone would ring on Sonia Bonilla’s desk. That was the sound of good news: Somebody had found them a patient.When Bonilla answered the phone, one of the scam’s professional “patient recruiters” would read off the personal data of a senior citizen. Name. DOB. Medicare ID number. Bonilla would hang up and call Medicare, the enormous federal health-insurance program for those over 65.

Next week I'm scheduled for a cervical spinal fusion that costs upward of $100,000, but I won't be paying for it. Like 50 million other Medicare recipients, I will receive the medical care I need more or less free of charge thanks to Medicare. It's something most seniors take for granted -- a benefit we believe we're entitled to because, after all, we paid Medicare taxes all our working lives. But as it happens, those taxes aren't nearly enough to pay for the benefits we receive from the system -- at least for most of us. Despite the fact that...

Immigrants have helped pay the nation’s bills, at least when it comes to health care, according to a new report. Immigrants contributed over $182 billion to Medicare’s Hospital Insurance Trust Fund between 1996 and 2011, according to a study released by the Partnership for a New American Economy, a group which advocates for immigration reform. The study found during that same 15-year period, U.S.-born citizens produced a $68.7 billion deficit for the same fund. The Partnership for a New American Economy, a coalition of mayors and business leaders started by Michael Bloomberg and Rupert Murdoch.

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way. For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare...

Cardiac surgeons and medical societies are asking the CMS to reconsider proposed payment rates for implanting Abbott's MitraClip, a device that treats a debilitating heart condition. Because the device itself costs more than $30,000, the proposed reimbursement rate would make it “prohibitive for hospitals to be able to offer this significant care so badly needed for a large majority of our patients,” Dr. Gregory Helmer, a cardiologist at the University of Minnesota, said in comments submitted to the CMS.

The Obama administration on Friday backed down on restrictions of private insurance coverage for hospice drugs under Medicare, saying the regulations were preventing some terminally ill patients from having access to medicine. Under Medicare's Part A hospital program, hospices receive daily payments for each patient but are responsible for all drugs related to a patient's terminal illness. Medicare Part D covers only prescriptions and medications for curative conditions that are unrelated to a terminal illness.

Under the rules that took effect in May, hospice patients or their families could not fill prescriptions through their Part D drug plans until first confirming that the prescriptions were not covered by hospice providers. Drugs related to palliative and comfort care are supposed to be covered under the fixed rate payments to the hospice. Medicare announced Friday that the rules would be revised so that the additional authorization would be required for only four types of medications: pain relievers, anti-nauseants, laxatives, and anti-anxiety drugs that are “nearly always” considered hospice-related.

Democratic U.S. Senate candidate Alison Lundergan Grimes says Kentucky U.S. Senator Mitch McConnell has taken votes to hurt the state’s seniors but bypassed a question Tuesday about what she would do differently. After addressing the International Brotherhood Of Electrical Workers (IBEW) District 4 Progress Meeting in Louisville Tuesday, Grimes took questions from reporters on her new ad released prior to the event. When asked about the validity of the $6,000 out-of-pocket increase figure used in the ad, Grimes responded by saying McConnell will have to answer to his vote on the Paul Ryan budget. According to a fact check of...

Obamacare advocates in New York have had good reason to celebrate. In contrast to Oregon’s and other state-based exchanges, New York’s exchange rollout was a relatively smooth, successful affair. Now for some cold water: New York still has a long way to go. New York State’s Medicaid program, already among the nation’s largest and most expensive, just grew by 10%. And 87% of the new Medicaid enrollees were eligible under New York’s generous, old rules. This means the state will be picking up 50% of the cost for much of this population—not the 10% headline rate for the newly eligible,...

In terms of direct impact on overreaching government power, perhaps the decision getting the least attention today is the most intriguing. Harris v Quinn addressed a movement in several states — Illinois in this case, but also in Minnesota and others — to force people into public-employee unions even though they are not directly employed by government, but privately employed and paid in part through public aid. The decision in this case narrowly centered on that distinction, but offers a window into a path for broader rollbacks of forced participation in PEU funding: The Supreme Court dealt a blow to...

The owner and operator of a Houston-area ambulance company was sentenced today to serve 97 months in prison for her role in a $2.4 million Medicare fraud scheme. Gwendolyn Climmons-Johnson, 54, was convicted by a federal jury in Houston, Texas, on October 30, 2013, of one count of conspiracy to commit health care fraud and four counts of health care fraud. In addition to the prison sentence, Climmons-Johnson was also sentenced to serve three years of supervised release and ordered to pay $972,132 in restitution. According to evidence presented at trial, Climmons-Johnson was the owner and operator of Urgent Response...

National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials. For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor. The move, effective Sept. 1, follows similar cuts made by the insurer to its Medicare Advantage provider networks in 11 other states... There is also pending legislation in Congress to prevent health plans from cutting...

The federal government wrongfully paid Medicare Advantage programs almost $70 billion, mostly through overbilling between 2008 and 2013, according to a new report. The Center for Public Integrity released the first of its four part investigative series Wednesday on Medicare Advantage payments that examines the use of risk scores used by providers to charge the government more for sicker patients. Medicare Advantage covers nearly 16 million people and is expected to cost more than $150 billion this year. However, reviews by the Centers for Medicare and Medicaid Services have also found billing errors in 30 percent or more of patient...