Medicare advisers eye imaging, biologics savings

[Old Coot]

Source: Reuters

WASHINGTON (Reuters) - Expensive medical tests, costly biological drugs and overpaid private insurance plans need tighter controls to help rein in costs to the multibillion-dollar U.S. Medicare health insurance program, a panel of advisers said on Monday.

The Medicare Payment Advisory Commission, or MedPAC, in its June report urged Congress to consider how the program for the nation's elderly and disabled pays for such services, in order to temper spiraling expenses that totaled $468 billion 2008.

The commission, an independent body authorized by Congress to advise lawmakers on the Medicare program, said use of imaging scans to diagnose cancer, heart problems and other conditions are growing twice as fast as other care.

"There are reasons to be concerned that some of the increased use in recent years may not be appropriate, which contributes to Medicare's growing financial burden on taxpayers and beneficiaries," it said.

Read more: http://www.reuters.com/article/healthNews/idUSTRE55E54220090615

[enlightenment]

1. I hope they are thoughtful in this approach.

I realise that costs need to be controlled, but denying someone a diagnostic option may not be the way to go.

I also realise I'm having a knee-jerk response, because my elderly father's cancer would not have been caught had it not been for a combination of a CT scan and an 'internal' ultrasound - both pretty high tech tools.

He may be elderly, but other than the cancer he is relatively fit and mentally intact after almost 7 years of treatment. Age should not preclude treatment in the absence of other determining circumstances.

[Cleita]

2. They could start with a big savings by revoking the Medicare Advantage

programs. Seniors too poor to afford Medicare Part B, could be given financial help not only for the monthly premium but the co-pay. Medicare Part D needs to be scrapped and started over. It's one of the biggest reasons Medicare funding is being drained by the pharmas with their expensive drugs. In other words, they need to kick the private insurers and HMOs out of the system altogether and bargain with the pharmas for reasonable prices on drugs.

[dysfunctional press]

3. i had on onset of severe headaches, and an uncle who had a brain anurysm at my age...

but medicare said that the brain mri my dr. wanted for me was 'medically unnecessary'.

fuck them.

[Fire_Medic_Dave]

4. How is your blood pressure?

I had a sudden onset of headaches and checked my blood pressure and it was high. The headaches were severe and almost daily. Finally went on BP meds and my headaches went away. BP headaches are usually felt in the the back of the head and often have a pulsing or pressure type of pain they occur in a small percentage of hypertension patients, which is why hypertension is sometimes referred to as the silent killer.

David

[dysfunctional press]

5. my blood pressure is fine- it tends to be low, if anything.

my dr. and the hospital were able to write the request in a way that the mri was ultimately allowed- and it ended up being mostly normal.

i have a spinal/autoimmune condition called 'ankylosing spondylitis' that plays havoc with MANY different parts of the body in many different ways, at many different times, and is most likely responsible for the headaches in some way...BUT- as my dr. agreed with me- that doesn't mean that everything should automatically be attributed to the condition.

i already take a fair amount of narcotics daily for chronic pain, and i also have a peripheral artery condition- raynaud's syndrome, that means that i can't take imitrex or it's like for migraines. so i get more narcotics. i haven't had any alcohol in over 10 years due to all the narcotics.

[Fire_Medic_Dave]

7. Glad you were able to sort it out.

[SOS]

6. An idea: nationalize the MRI

MRI's cost $40 billion annually in the US.
The Federal government could provide the machines to hospitals at no cost and then limit the fee to $100.
This is how it is done in Japan.