High Level Of Waste In Health Spending, Says Medicare And Medicaid Boss
Editor's ChoiceMain Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance; Public Health
Article Date: 05 Dec 2011 - 0:00 PST
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| Article Opinions: | 26 posts |
Dr. Donald M. Berwick, head of Medicare and Medicaid until last Thursday, stated that up to 30% of spending on health is wasted with absolutely no benefit to beneficiaries (patients). He added that his agency's cumbersome and archaic regulations are partly to blame. He claims too many resources and too much time is dedicated to things that do not help patients one bit; something doctors are fully aware of too.
In an interview last Thursday, Dr. Berwick said:
"Much is done that does not help patients at all,
and many physicians know it."
During the interview, Berwick talked about the previous 17 months, while he was at the helm as Administrator of the Centers for Medicare and Medicaid Services, his failures, successes and frustrations, and dealing with criticisms from Republican lawmakers.
Berwick's appointment, which was to expire at the end of 2011, was done in a way that drew criticisms from both sides of the House. President Barack Obama nominated him in April 2010, then there was an investigation regarding his qualifications, subsequently a temporary recess appointment was given to bypass Congress.
In Thursday's interview, Berwick said:
"I did not even know if I was fit for it. I came with an agenda. I wanted to try to change the agency to be a force for improvement, covering one out of three Americans."
Government is much more complex than he had realized
Berwick went on to explain that the new health legislation is a "..complex and complicated" one. It is a law that takes time to explain properly. "To understand it takes an investment that I'm not sure the man or woman in the street wants to make or ought to make." He admitted that government is much more complex than he had realized.Berwick had been President of the Institute for Healthcare Improvement, an organization that trains health professionals; a much faster-moving environment compared to public office. Being a federal official would sometimes infuriate him, because of the much slower pace.
Even so, because of the new law's ultimate destination, it should be supported, Berwick stressed. He gave the manned moon missions as an example - people did not fully understand the intricacies of rocket science, but supported the ultimate aim of the mission.
Dr. Berwick said:
"We are a nation headed for justice, for fairness and justice in access to care. We are a nation headed for much more healing and much safer care. There is a moon shot here. But somehow we have not put together that story in a way that's compelling."
If up to 30% of Medicare and Medicaid's spending is being needlessly squandered, reigning in that waste could save between $150 billion and $250 billion annually.
Dr. Berwick said:
"I wish they (government) could go faster. I don't think you want government to be impulsive. You want it to be regulated, with just a tad of conservatism."
Berwick listed five reasons for the enormous waste in health spending:
- Patients are overtreated
- There is not enough coordination of care
- US health care is burdened with an excessively complex administrative system
- The enormous burden of rules
- Fraud
Donald M. Berwick (born 1946)
Dr. Donald M. Berwick, Administrator of the Centers for Medicare and Medicaid Services, July 7, 2010 - December 2, 2011
Dr. Berwick was nominated to be Administrator of the Centers for Medicare and Medicaid on April 19th, 2010. Some newspapers at the time commented that he might be able to reduce health care costs. He was criticized by Republicans regarding some comments he had made about health care, saying it involves a redistribution of wealth, rationing care with "our eyes open".
In the United Kingdom there is universal healthcare, everyone is covered, and healthcare spending represents less than 7% of the country's GDP. The USA, on the other hand, spends over 17% of GDP on healthcare and has over 50 million people with no coverage at all, and tens of millions more with inadequate coverage. Berwick advocated adopting some of the NHS (National Health Service) approaches of the UK and its NICE (National Institute for Health and Clinical Excellence). NICE decides which therapies and drugs are covered by the NHS.
Conservatives dubbed him "Obama's rationing man." They said NICE decides what treatments people can and cannot have in the UK. This is untrue - NICE decides which treatments and therapies people will get free (if NICE does not approve it, private health care can still offer it, if it is approved by another national regulatory agency, the MHRA, the UK equivalent of the FDA).
Honors and Awards
Dr. Berwick has received the following honors and awards:- 1999 - Ernest A. Codman Award
- 2001 - Alfred I. DuPont Award for excellence in children's healthcare
- 2002 - American Hospital Association, "Award of Honor"
- 2004 - Fellow of the Royal College of Physicians in London
- 2005 - Honorary Knight Commander of the Most Excellent Order of the British Empire
- 2007 - Purpose Prize
- 2007 - The 13th Annual Heinz Award for Public Policy
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Visitor Opinions In Chronological Order (26)
figures
posted by Rider on 4 Dec 2011 at 10:43 amNow my doctor wants 65$ a month/780$ yr more for "optimal care" program, with a limited number of members, that's in addition to what I already pay for insurance thru my employer.
- I won't be getting optimal care and will be shopping for another doctor--all the new program did was filter out more people--brilliant program-make it so only the ones who can afford it attend.
Waste
posted by rgw46 on 4 Dec 2011 at 10:58 amThere is a lot of waste..and I can prove it>>pass this
around
If medicare doesn't, then private won't
posted by Eric on 4 Dec 2011 at 11:11 amI work in the healthcare field and I can tell you if medicare does not cover something then private insurance wont either they mirror what medicare does!
Need a war on Medicare Accounting/Paying
posted by Norman on 4 Dec 2011 at 11:20 amAs a consumer of Medicare in the past six months, I have discovered a tremendous amount of waste in the Medicare bureaucracy and the incompetence of doctors providing the care.
1. My doctor of 10 years seems to be incompetent to determine the cause of a recent ailment, despite all the recommended tests she could think of. If she were a mechanic, I would have taken her to court.
2. Getting to a live person in the Medicare Bureaucracy is a hard chore.
3. That person knowing the answer or demonstrating he/she cares is even harder chore.
4. Health care system, especially Medicare/Medicaid needs reform badly to weed out the deadwood and outdated cumbersome bureaucratic infrastructures.
Medical Industry Out of Control
posted by David on 4 Dec 2011 at 11:33 amI was healthy 52 years. Went to the doctor 18 months ago for lower back pain. In last 12 months I've had 3 surgeries on spine. Now can barely walk, lost my job and collecting SSDI. Found care to be very uncoordinated. Doctors don't listen and don't answer questions. Quick to order MRIs and then ignore results. All doctors care about is keeping their schedules fully booked. Found office procedures inefficient and archaic. Will never trust another doctor as long as I live.
Does not pass the smell test
posted by Dr. Dennis O'Connor on 4 Dec 2011 at 11:34 amHmmm, Dr. Berwick needs to examine the horror stories from the NHI about needed surgeries put off - including one recently revealed case where the fractured leg was left unoperated for 6 weeks until the misaligned fragments had healed and the NHI now says they will not operate, leaving the patient crippled...
As far as convincing my Medicare patients that they receive 30% too much treatment - good luck with that one, doc - and when you stride to the podium to take questions be alert for over ripe tomatoes...
After 30+ years as the only doc in a farming town, your self serving statements have the odor of male bovine to me...
dr. o
American Healthcare
posted by JonSEAZ on 4 Dec 2011 at 11:51 amOur doctor demands an annual administrative fee from Medicare patients if they are to be his patients. Our previous doctor chose first to stop taking any private insurance, followed later by refusing to take Medicare, and finally simply stopping the practice of medicine. He was in his late fifties and, in my opinion, a very good practitioner of family and geriatric medicine. Many, if not most, medical practices in our area are not accepting new Medicare patients. I have lived and worked overseas twice and our son has lived and worked in Korea for nearly twenty years. We have friends from various countries in both Europe and in Asia and we travel frequently and extensively. I know personally medical doctors in both European and Asian countries. In my opinion, while we in the USA have available to many of us some very high-end medicine, our system is way too complicated and way to inefficient. Moreover, many of the so-called middle class of our nation are economically excluded from the system. Obamacare was not and is not the answer, however.
High Level of Wastes in Health Spending
posted by SD on 4 Dec 2011 at 12:20 pmNot surprised by the figure, although, suprised by the source of of information. I do not know Dr. Berwick, nor he was the Head of Medicare & Medicaid Services, nor affiliation to any political parties. Can politicians including President and Congress deal with this level of wastes? I do not waste 30% of my income, why should I accept 30% waste from Medicare & Medicaid Services which are funded by OUR TAX MONEY? We need to stop this runaway train by placing a limit of %GDP to be commited to Medicare & Medicaid. The system in GB is not perfect, while it does provide a certain level of Health Coverage to ALL PEOPLE, with the option of purchasing more if someone felt like or could afford more, and it only cost 7% of GDP.
More Fraud and Abuse
posted by Ajax on 4 Dec 2011 at 12:25 pmRider,
Your doctor is breaking the law. Health insurance is a regulated industry, which he/she is not part of. If your doctor is already taking money from Medicare or Medicaid for your care, he is part of the Fraud and Abuse we continue to here so much about. Report him immediate and save us all some money. Good luck!
Only Complex Government Can Save Us
posted by John on 4 Dec 2011 at 12:26 pmIt is endemic of the liberal mindset that government can fix everything. If a program doesn't fix the problem it must not be complicated enough. If the guy on the street can't understand it, then he isn't caring enough, doesn't have time enough, or isn't smart enough to understand it. Only complex government run by the smartest and the most caring people on the planet, like Dr. Berwith, can save us.
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