Posts tagged 'Medicare system'
The New York Times, Washington Post, and Wall Street Journal's world-wide newsbox all had lead articles with regard to a new government report that paints a dire picture of the financial situation of the nation's two largest benefit programs. The recession, of course, has not helped with the already stressed Medicare system, especially the fund for hospital care which will run out of money (purportedly, depending upon who you get your information from) in 2017, two years earlier than the government had predicted a year ago.
The Social Security trust fund is in a bit better shape but will still start spending more money than it receives in 2016 and will be depleted by 2037, four years sooner than projected last year. lawmakers are arguing over whether the country can really afford to expand health insurance coverage, the report sparked calls for the administration to start working on a plan to prevent the two entitlement programs from becoming insolvent.
There is a great deal of work going into the Medicare situation as well as trying to create a similar healthcare system for everyone who does not have health insurance or access to health insurance, to strengthen the Medicare system that definitely needs bolstering and create a health care system that millions of people need.
Lawmakers feel that tax dollars from workers, such as payroll tax, deductions for social security and other funds will be able to help finance all of these ideas. In addition there are some Lawmakers pushing hard to stop subsidizing and just flat-out give banks and othe institutions "bailout money" why not give out less or none at all , for that matter, to fund more of the domestic issues especially. Another idea has been to patner the banks with the insurance companies and help them work together to develop a policy that would be fiscally responsible. If the polcy worked out well, it could very possibly help bolster Medicare and the the vast majority - if not all - of the people in the country that are uninsured.
"The New York Times, Washington Post, and Wall Street Journal's world-wide newsbox all had lead articles with regard to a new government report that paints a dire picture of the financial situation of the nation's two largest benefit programs."" The recession, of course, has not helped with the already stressed Medicare system, especially the fund for hospital care which will run out of money (purportedly, depending upon who you get your information from) in 2017, two years earlier than the government had predicted a year ago.
"The Social Security trust fund is in a little better shape than that, but will still start spending more money than it receives in 2016 and will be depleted by 2037, four years sooner than projected last year.
Lawmakers are arguing over whether the country can really afford to expand health insurance coverage, the report sparked calls for the administration to start working on a plan to prevent the two entitlement programs from becoming insolvent. "
There is a great deal of work going into the Medicare situation as well as trying to create a similar healthcare system for everyone who does not have health insurance or access to health insurance, to strengthen the Medicare system that definitely needs bolstering and create a health care system that millions of people need.
Lawmakers feel that tax dollars from workers, such as payroll tax, deductions for social security and other funds will be able to help finance all of these ideas. In addition there are some Lawmakers pushing hard to stop subsidizing and just flat-out give banks and othe institutions "bailout money" why not give out less or none at all , for that matter, to fund more of the domestic issues especially. Another idea has been to patner the banks with thr insurance companie help them work togethe develop a polcy that would be fiscally responsible. If the polcy worked out well, it could very possibly help bolster Medicare and the the vast majority - if not all - of the people in the country that are uninsured.
There are many other ideas floating around and some are being very seriously lookde at by Lawmakers and the administration, especially when it comes to where revenue from taxes that already exist could be found and used. As the president said in the beginning, this is not going to be easy but we will figure out a way to get through it.
With all the financial issues surrounding Medicare it has become harder to find doctors who readily accept Medicare, or even accept it at all.
Before the increase of fraud, red tape, financial woes, budget constraints and the like, doctors who accepted Medicare were not hard to find. Many doctors used to set aside a percentage of their time to devote to Medicare patients. They certainly weren’t making money on these patients, in fact, many times, they did not even break even by covering expenses, but the income from their overall practice absorbed the losses. Though Medicare was not a perfect system, it worked out for the doctors and their patients.
More recently, with all the Medicare woes, including very slow reimbursement at an extremely reduced rate, the majority of doctors say that it is too expensive to treat Medicare patients. They want to treat these patients and try to treat as many as possible, but are unable to take on new Medicare patients for financial reasons. Their regular practices cannot absorb the losses any longer.
This is not just frustrating to the doctors who would like to help these patients, but it is frightening and frustrating to patients who have spent a lifetime paying into a system that promised healthcare coverage but is now in such shambles that the doctors and specialists these patients need the most will not accept it for payment. This critical situation nationwide is leaving too many of our most vulnerable citizens without adequate care and actually making them more vulnerable because of it.
Lawmakers continue to say they are trying to fix the ailing system but are caught up in partisan arguing rather than bipartisan efforts, while the situation continues to worsen. The question arises as to whether they would rather pay out hundreds for office visits that prevent major health issues or thousands to pay for the health conditions that are not treated because of being penny wise and dollar foolish, as well as short sighted. Surely if there is enough money to fund billions for war, there should be enough to send Medicare recipients to the doctor.
As fewer doctors accept Medicare, there is the real possibility of a far worse health crisis than we see today. If you have Medicare benefits, check with your doctor and call others to make sure they will accept it. You can also call your local health department or hospital for further information about doctors in your area.
There are doctors who continue to accept Medicare, but it is becoming more difficult to find them and Medicare recipients who should be automatically taken care of are having to search for services. The system needs fixing NOW.
Medicare is an essential program that was designed to help the elderly and the vulnerable. Presently, Medicare covers over 44 million people so that they can receive medical care.
Fraud has long been an issue regarding Medicare. There have been too many loopholes, a system that is designed in a manner that makes fraud easy, and too little oversight of the billions of budget dollars intended for legitimate Medicare expenses.
In addition, there have been – and still are – unscrupulous business people out there who have designed ways to defraud the Medicare system. It is one thing to make a mistake, it is quite another to intentionally set up a business network for the express purpose of taking money from the most vulnerable of our citizens, especially when that money is scarce to begin with.
The latest in a series of fraud-based businesses to take advantage of the lax oversight over Medicare dollars is a scheme involving HIV/AIDS clinics in south and mid-Florida. These clinics have made so much money that officials are asking the public for help in stopping the fraud.
Officials have announced a new “Infusion Fraud” hotline, asking the public to call and report phony HIV/AIDS treatment in an effort to stop clinic operators from receiving millions for services and treatments not provided. These unscrupulous clinic operators have been most prevalent in south Florida and purchase Medicare lists or pay patients to come into their offices, and then bill Medicare for millions of dollars in fraudulent claims for treatments never provided. Last week a couple who ran a billing service was sentenced to 14 years in prison for billing nearly $150 million in fraudulent claims for 85 different clinics.
There are several ways that Medicare is trying to combat fraud in that area. They have set up a hotline that people can call to report fraud if they become aware of it. The fraud does not have to be HIV/AIDS related; it can involve any fraudulent issues or scams with Medicare.
Medicare is also sending out Medicare statements to recipients in southern Florida on a monthly basis instead of quarterly in hopes that people will look at their statements and report any treatments or charges listed that were not received or don’t look legitimate. By doing this monthly instead of quarterly, there is less of a time lag, giving Medicare a better chance of catching the perpetrators while they are still up and running and in business.
Records show that last year HIV/AIDS claims for treatment totaled $1.5 billion in south Florida as compared to only $300 million in New York City. This is an obvious imbalance that is receiving attention.
The phone number to report suspected Medicare fraud is 866-417-2078.
As if there wasn’t enough fraud in the world today – especially in Miami – the FBI has uncovered even more. This is not your garden variety every day fraud, this fraud has been big business and cost the government and taxpayers billions – yes BILLIONS – of Medicare dollars.
While many honest citizens are working hard to pay billions of dollars for a war and other conflicts that they may or may not agree with, these individuals have stolen money that could help bolster the Medicare system, which is having some serious financial issues, in case they hadn’t heard.
It brings to mind the old question about whether you would steal from your own parents or grandparents. Apparently, these fraudsters would. In fact, not only have they done that, but by taking BILLIONS away from a system that is so badly needed by our most vulnerable citizens, they are also stealing from their own children and grandchildren. Of course, when you think about it, their parents, grandparents, children and grandchildren may not need the benefits since they will have all the money that was stolen – unless it gets confiscated by the FBI.
The way this particular scam worked, “patients” were recruited to see particular doctors. They were paid each time they went to an office visit. The clinics that these doctors work for then billed Medicare for all sorts of fraudulent services, including AIDS treatment that is not even used any more in the United States.
Medicare does not combat fraud as effectively or aggressively as private insurance companies do, even though they have received funds to do so. One of the primary reasons that Medicare is not effective at preventing fraud is that they do not have a system that prevents fraud before money is dispensed. Without a containment system at the beginning of the claims process, it is impossible to stop fraud because once the money has been paid out, it is much more difficult to get it back – especially because most of the time, the fraudsters have already left the country.
Medicare is a huge agency with an enormous budget and over 44 million people who depend on it. Fraud costs Medicare over $60 million per year. Surely there are ways to eliminate at least some of that fraud. Eliminating even half of it would fix the Medicare budget and the education budget, too.
Mike Leavitt, head of Health and Human Services wrote to lawmakers a few days ago asking for their help in healing Medicare. In the position he is in, he should know what some of the essential issues are that face Medicare and he has some straightforward ideas as to how to address these issues and begin fixing them.
Leavitt started out by stating that Medicare has done a great deal of good over the years, and this is important for all of us to remember. Medicare in and of itself is a good program, but the world, the United States, and the economy today is far different than it was 43 years ago when Medicare first began. In addition, medical costs have skyrocketed for many reasons including new treatments for diseases such as cancer, heart disease, diabetes and others. Many incredible medical discoveries have been made, however, the costs of caring for individuals with ongoing medical issues – especially critical issues – is much more prohibitive than in the past.
Today’s Medicare has more beneficiaries and fewer workers to fund the program. In addition, the costs of the funding will fall to our children and grandchildren, and if lawmakers – on both sides of the aisle – are not moved to fix the problems inherent in the system sooner, rather than later, the burden on the next generations will be overwhelming.
Leavitt states that in 1970 the cost per Medicare beneficiary was about $2,000 and now, in 2008, it is about $10,000. To make matters worse, there are over double the amount of Medicare beneficiaries now as there were before. Add to this the fact that health care costs have doubled but Medicare costs have quadrupled and baby boomers haven’t yet retired, and this is a recipe for disaster.
It is estimated that in the next 20 years the U.S. will be spending more on Medicare each year than on national defense. Families who are now spending about 23% of their wages on medical care will be spending over 40% of their wages on medical care, and Medicare will account for about 23% of that price tag. Add to that the fact that in 1970, about 4 workers paid for each Medicare beneficiary, and currently, less than 4 workers pay for each beneficiary. Then, looking 20 years ahead, only 2 to 2 and 1/2 workers will pay for each beneficiary, which means that workers will carry a heavy burden and the Medicare system may not be able to handle the toll of paying claims for all the beneficiaries enrolled in it.
Mr. Leavitt is urging Congress to consider these critical issues carefully and act on them in a bipartisan effort to fix as much of the problem as possible before it is too late. After all, it is our children and grandchildren, as well as their children and grandchildren who will be forced to deal with the problem if it is not dealt with now.
