The GAO abstract can be found here.
This is bad enough, but there's more.
The Times article reports that
the Bush administration is vigorously pursuing money that it says is owed to insurance companies by Medicare beneficiaries. The Medicare agency has sent letters to more than 135,000 people saying they still owe premiums for prescription drug coverage provided in 2006. In most cases, the premiums were supposed to have been withheld from monthly Social Security checks, but the government withheld the wrong amounts or nothing at all. (italics mine.)
So what we have here (and thank you for putting up with the policy-lingo summary) is a case in which the CMS has failed to keep prices down for beneficiaries, failed to achieve savings for the government, failed to make sure that services were what insurance companies said they would be, and failed to make sure that people on fixed incomes were having the correct premiums deducted from their SSA checks. However, they are hellbent on making sure that these same beneficiaries, to whom savings have not been passed on, are going to pay back premiums to the very contractors who are cheating the beneficiaries and the government.
Way to go, guys.
This is something that was predicted by many who work with Medicare, including the Medicare Rights Center in New York. Partial privatization of Medicare has always looked like bad news to the grass-roots, and to those who work with folks whose health has been compromised by the way Medicare HMO's have functioned.
It seems that the fear that Medicare Part D was mostly going to be good for private insurers has been realized.
The really sad thing is that while traditional Medicare's fee-for-service program has been breaking down for years, to the detriment (primarily) of physicians, it was a great baseline service. The problem with traditional Medicare from both the patient and physician perspective was that payments didn't keep up with inflation or with increased cost of service provision. Because the pay for Medicare patients became so low (and I saw this happening when helping an uncle in his podiatry office as a young adult), physicians were reluctant to take on as many Medicare patients as needed care.
But regular increases in pay for medical personnel could take care of that. Heaven knows, the insurers are keeping their own payments as low as they can without losing doctors willing to participate in their programs. And doctors know that all they can do is try to find insurance companies that pay them okay for most of their procedures. (Not visits; check-ups pay virtually nothing.)
On the other hand, traditional Medicare meant that docs didn't have to choose a smaller percentage of elderly patients to see (that is, you either accepted Medicare or you didn't; you didn't have to elect Medicare Advantage plan x, y, or z).
I am once again calling for a single-payer health care system, along the lines of traditional Medicare. Because even at the financial/economic level, Medicare Advantage has been a fiasco for doctors, patients, and the federal government.
