Viewpoints: The toll of Medicare fraud; insurer's Medicare Advantage switch can confuse seniors

Oct 22 2011

Houston Chronicle: Medicare Fraud Must End
In a searing two-part investigative series earlier this week, the Chronicle's Terri Langford wrote about unscrupulous operators, here in Houston, who make millions of Medicare dollars exploiting the most vulnerable of our local residents through private ambulances and for-profit psychiatric clinics. ... Medicare, and American taxpayers, are footing the bill, which is enormous. … While Medicare is in no way responsible for their illegalities, it has known for years that corrupt companies were making hay in Houston and did little to rein them in. It's past time to get serious and put them out of business (10/20).

Los Angeles Times: Anthem Pulls Switch On Medicare Advantage Subscribers
A pair of letters to the health insurer's California customers sparks confusion. Anthem, it turns out, is replacing its California Medicare Advantage plan with 13 regional variations that allow it to set premiums and benefits according to local conditions (David Lazarus, 10/21).

The Washington Post: A Future Of Broken Promises On Health Care
Hard times continue for the Affordable Care Act (a.k.a. Obamacare). The administration has scrapped the law's long-term care insurance program covering nursing homes and home health care. The program was deemed unrealistic. This is a harbinger. As the law is implemented -; assuming the Supreme Court doesn't declare it unconstitutional or Republicans don't repeal it -; disappointments will mount (Samuelson, 10/20).

Politico Pro: Deficit Panel's Credible Accounting
There are many individuals and groups, in the U.S. and around the world, concerned about Washington's serious fiscal challenges and waiting to see what the super committee on deficit reduction will recommend. The first key question they need to address is how they will keep score. Once this is decided, the super committee should focus on three objectives. First, it should make recommendations that can meet or exceed the established deficit-reduction target to avoid across-the-board cuts. Second, it should make recommendations designed to help economic growth and reduce unemployment. Third, its recommendations should facilitate greater deficit-reduction progress from 2012 to 2013 (David Walker, 10/20).

San Francisco Chronicle: S.F. Mayor Should Veto Health Care Measure
San Francisco's Board of Supervisors seems to have lost sight of its mission in trying to close a loophole in the city's health care law. The supervisors' focus should be on ensuring that workers whose employers are setting aside money for their health care are aware of its availability -; and are able to spend it (10/20).

The Seattle Times: Swedish Abortion Decision An Insult
Six little words. But, seven days later, Swedish Medical Center is still getting blowback for its decision to stop performing elective abortions "out of respect for the affiliation" it is completing with Providence Health & Services, a Catholic, not-for-profit organization. … I just wish that those six little words -; "out of respect for the affiliation" -; were about the patients and not the partner (Nicole Brodeur, 10/20).

Minneapolis Star Tribune: Health Beat: What Does Hospital's Star Grade Tell You?
HealthGrades is one of those innovations of modern health care that helps patients choose hospitals with the best safety records. Trouble is, the more you look at the website's hospital rankings, the more questions it raises. … Comparing observed and expected rates of surgical deaths and complications is a great way for the public to evaluate hospitals. Just don't forget the regional context. A hospital rating means little without it (Jeremy Olson, 10/20).

Milwaukee Journal Sentinel: Healthy Youth Act Also Protects State Economy
(The Healthy Youth Act) was passed in response to Wisconsin's public health crisis that included rising teen birthrates in 2006 and 2007 and skyrocketing sexually transmitted disease rates for young people statewide that were costing taxpayers millions. … GOP lawmakers, who recently eliminated funding for birth control programs at nonprofit health care organizations such as Planned Parenthood, have now fast-tracked an initiative to repeal the Healthy Youth Act. ... Continuing teen pregnancy prevention programs is not just common sense; it is an economic and moral imperative that demands lawmakers' attention. It is time to stop playing political games and get back to work building our economic future that includes advancing policies to enhance the health and safety of our communities (Sara Finger, 10/20).

Health Policy Solutions (a Colorado health news service): Medicare Advantage Alive And Well Under Affordable Care Act
[The federal health law] included several provisions to reduce federal spending: Reduce additional payments to (Medicare Advantage) plans over three years beginning in 2011. Require MA plans to meet an 85 percent medical-loss ratio by 2014. ... The American Association of Health Plans (the national political advocacy and trade association for health insurers) predicted these provisions would "result in seniors facing higher premiums; a reduction in additional benefits; fewer health care choices; and higher out-of-pocket costs." So far, pretty much the opposite has happened (Bob Semro, 10/20).

Houston Chronicle: The Surprising Facts About Breast Cancer Risk Factors
Early detection programs and increased public awareness have significantly decreased the number of breast cancer deaths each year. The American Cancer Society reports there are more than 2.5 million breast cancer survivors in the U.S. I believe this reflects new and innovative breast cancer research, improved treatment regimens, advances in breast-imaging capabilities and the benefits of early detection (Angelica Robinson, 10/20).